dpmitchel – GW Blogs from Abroad

Hospital Happenings

AdminJanuary 31, 2014December 14, 2018

I completed my weeks of observation at St. Mary’s Hospital and I definitely learned so much! As my aim was to gain a holistic understanding of the implementation of prevention of mother-to-child transmission (PMTCT) of HIV policy into practice, I spent time in many wards and departments of the hospital. I shadowed doctors, nurses, and counselors in the antenatal clinic, a visiting OB/GYN from one of St. Mary’s referral hospitals, doctors and nurse midwives in the maternity ward, nurse midwives in the Midwifery and Obstetric Unit (MOU), a doctor from the pediatrics and nursery wards, and an HIV counselor in the MOU. I really got a unique chance to learn about the health system in South Africa, health professionals’ views on their system and PMTCT, and a plethora of information about obstetrics.

There certainly were challenges throughout my time at the hospital; for one, most of the communication between healthcare professional and patient was in Zulu. I was glad for my 7-week intensive Zulu class from SIT, as even a preliminary understanding was helpful to build connections with professionals and patients alike. I was grateful for the people I shadowed who clued me in on patient issues and provided me with in-depth explanations of medical conditions for my learning purposes.

As far as PMTCT goes, it was very interesting to see the most recent South African PMTCT guidelines (from the beginning of 2013) actually implemented in practice. I won’t bore with a long explanation of the program, but it involves testing all mothers for HIV status, providing them with counseling and antiretroviral therapy (ART), supplying HIV-exposed newborns with ART prophylaxis, and following up on those newborns to ensure that the virus is not transmitted to them. Getting a chance to observe all of those policies firsthand was invaluable.

The last step in the ISP process is now to compose a paper about my Learnership at St. Mary’s that will be somewhere between 30-70 pages. By the end of my write-up I can definitely say that I have a good grasp on PMTCT policy in South Africa. Hopefully I can take the information I’ve learned here and take it back to the DC to do some sort of comparative research to our PMTCT programs in the States; that way I’ll be able to give back some of the knowledge that I’ve gained by shadowing at St. Mary’s.

Sala Kahle, South Africa!

AdminJanuary 31, 2014December 14, 2018

By dpmitchel

Sanibona from Sarasota, Florida! I’ve been home from South Africa for almost a week now, and I can definitely say that I miss that country and my program. As we finished up our Independent Study Projects (ISPs), all of the students on my trip were proud of our productions and we presented our papers to one another as a final part of the program. My paper ended up being around 40 pages, yet all of us felt we could have written much more on our topics!

Reflecting on my time in South Africa as a whole is difficult as there were so many eye-opening experiences throughout the semester. The completion of the ISP was definitely an accomplishment that everyone on my program was proud of; we’d spent the entire semester building up skills to accomplish a small bit of research, and then had the ability to execute our plans. As my project was centered on PMTCT of HIV, I feel like I’ve only scratched the surface of all there is to know about the topic, and hope to craft a senior thesis (when the time comes!) about HIV.

There was a question that came up when we conducted our projects: “will we actually be making an impact on these communities we are studying?” The short answer, to the shock of my fellow students and I, was no. The three-week research period left much to be desired in the reality of helping the communities we studied as a whole. However, through our projects, we were able to affirm the individuals we worked with and were able to tell their stories in our papers. We can use our ISP experiences as a kick-start to investigating topics in the future that can really make an impact on communities. For me, my ISP really opened up the world of research on HIV and PMTCT, and has given me a paradigm through which to view HIV problems not only in the South Africa, but worldwide.

Thanks to everyone who took the time to read about my studies in South Africa. Sala kahle (stay well)!

Twitter: A #GWU student wraps-up her studies in South Africa #GWAbroad

Hospital Visits Make the Heart Grow Fonder

AdminNovember 11, 2013December 14, 2018

By dpmitchel

Sanibona from South Africa!

As our program is nearing the beginning of our ISP period, we are ending the classroom academics and preparing to go out into our various research endeavors. We finished our Zulu course, have heard many lectures on community health and policy, and have completed 3 homestays. We spent a week travelling to two rural homestays, Impendle and UMthwalume, which were wonderful experiences to help us gain perspective on health issues from a more rural point of view. We finished our main 5-week homestay in Cato Manor, and it was sad to say goodbye to our families!

Currently, all of us are currently busy trying to make last-minute changes to our research projects. Although I was investigating the topic of emergency care in South Africa, I started toying with the idea of doing a hospital shadowing for my ISP. We went on an excursion to Chatsworth, a predominantly Indian township near Durban, and visited a hospital there, which piqued my interest. What cemented my decision was a recent visit to St. Mary’s hospital, a Catholic non-profit District Hospital that is both privately and publicly funded.

When we visited, we had the chance to see their maternity ward, antenatal clinic, and labor and delivery ward, and that reminded me just how much I loved my original topic of research! I originally wanted to compare the rates of mother-to-child transmission of HIV in public versus private clinics. After spending time in South Africa, I know that would be near impossible to investigate in the small 3-week research window we are given, but I think I have found a way to adapt my original topic.

We (as undergraduates) are not allowed to conduct research in a hospital setting in South Africa. So instead of doing research, I will be completing a Learnership, which will is purely observational and non-publishable. For my Learnership, I’ll be observing prevention of mother-to-child transmission (PMTCT) protocols at various stages in pregnancy at St. Mary’s Hospital. Hopefully I’ll get to shadow in the antenatal clinic, the maternity in-patient ward, the nursery in-patient ward, and the midwifery and obstetrics unit. This way, I can get a complete understanding of the PMTCT process from counseling newly pregnant women to testing newborns for HIV. What makes this topic so relevant to the community is that HIV is a potent reality for a sizeable portion of KwaZulu-Natal, the province we are studying in.

I’m all set up to start November 1^st, and I can’t wait to start shadowing!

Research Beginnings

AdminSeptember 24, 2013December 14, 2018

By dpmitchel

On my SIT abroad program, our schedule and classes are focused around building up our final independent study project (ISP). We can choose from any topic that we like, and it’s been hard to narrow it down! Everyday we have speakers from the local university, the University of KwaZulu-Natal, or from health leaders around South Africa. Coming into the program, my original idea was to compare the rates of HIV transmission from mother to child in private versus public clinics. However, after discussing the idea with my Academic Director, completing primary research about that topic in such a short amount of time is not realistic. Also, from discussing health issues with local South Africans and observing health in my homestay, there are so many other cool topics to choose from!

In one of our classes, our lecturer was discussing emergency medicine in South Africa. As a certified EMT-B, I listened intently. He said “everyone is really critical of ambulances,” and as to their reliability, it boils down to questions of will the ambulance come? Will it not come? When will it come? What happens if the available ambulances don’t work? What if road conditions in rural areas become unfit for driving? All of those seemed very relevant questions to consider. These ultimately become questions of access, which I think would be really great to study for my independent study project. Plus, I’m curious to talk to some South African EMT’s! I’ve talked to my Academic Director and it’s a large possibility that I can do ride-alongs in the local Durban ambulances. That way I can get perspectives on care from the EMT’s firsthand.

As part of our SIT curriculum, we created and conducted Family Health Surveys for our homestays. We are currently staying in Cato Manor, a lower income (relative to America) area in the outskirts of Durban. Interviewing them to get their perspectives on ambulatory care was very interesting. From their accounts, emergency care in South Africa is very hit-or-miss. One of my family members said that for children, the ambulances arrive very quickly, but for older people, they come very slowly. I’d be interested to investigate the triage system in the public emergency services systems, especially because public EMS here is often under-resourced and understaffed.

The main challenge I will have in gathering data for my ISP will be the language barrier. We are taking Introductory Zulu, the primary language of KwaZulu-Natal, and although we can speak a little bit, it’s hard to conduct interviews with potential miscommunications. SIT is preparing us for this challenge, however, with our immersions in Zulu-speaking homestays. Overall, I’m excited to keep researching and investigating my research project while enjoying my time in South Africa.

Sawubona from South Africa!

AdminSeptember 4, 2013December 14, 2018

By dpmitchel

Sawubona (Hello)! I'm currently abroad on the School of International Training (SIT)'s Community Health and Social Policy Program in South Africa. I chose this program because instead of traditional study abroad where you take classes at a foreign university, SIT is a program based on experiential learning. This morning, our Academic Director discussed with us exactly what "experiential learning" is. Instead of straight lectures, it's a combination of concrete experiences, reflective observation, abstract conceptualization, and active experimentation. Basically, this means that we will be integrating trips to museums, NGO's, hospitals, and having discussions on-site at various places around South Africa. To culminate our trip we are each required to do an Independent Study Project (ISP), which completes the experimentation portion of SIT. ...continue reading "Sawubona from South Africa!"