Thankful…

After a long, long journey home (46 hours of total travel time), and a day or so of trying to readjust my time zone, I find myself reflecting on the past month with a great deal of emotion.  This trip brought many challenges – emotional, physical, and intellectual.  I think today is a perfect day to write about these thoughts.

If I’m being completely honest – I went to Africa this time with an agenda.  The last time I went I realized that I had fallen in love – with the country, the people, and the experience.  I loved the intensity of the connections I made while I was there.  I wasn’t sure I would ever feel that connection again – I had spent the past year trying to figure out what made it all so impactful to me.  As I prepared for this trip, I tried telling myself that it would be still be good, just different.  But in reality, I was scared that this trip wouldn’t allow me to access those emotions, and would feel routine and tedious.  My agenda on this trip was to “get over it” – to work hard and to do the absolute best for my students, but to move on from the feeling of being in love that I had struggled with.

But now on the other side, I can say that I completely failed to “get over it”.  This trip was everything I could have hoped for and so so much more.  The heart and soul of this experience was the students.  I cannot be more proud of the work they did – in the clinic as well as the interpersonal work that an experience like this demands.  They all challenged themselves to grow and change and to be flexible professionally and personally.  They are now able to do things that most other pharmacy students in their class cannot do – think laterally and creatively about clinical issues and take in to account other cultures, complications, and in some cases the almost complete lack of resources.   I know know for sure that it is the maturity that develops on a trip like this that is perhaps the most important outcome.

I also simply cannot express my gratitude to the many people in Uganda that helped us to set up experiences and also spent hours shepherding us through the professional and cultural challenges of these experiences.  Winnie, David, Janine, Arthur, Walter, and so many others cared so much for us and gave so much of themselves without expecting anything in return.  It is just how the Ugandan people relate to the world.  I sincerely hope I can become a bit more like them every day – and say to everyone I meet “You are welcome”.

And once again I was reminded that Uganda is a country that is so incredibly rich in one of the most important resources in the world – community.  As I write this I am watching a local news report about a person who is trying to “score three TV’s – a 42″, 55″, and 65” at a Black Friday sale.  I can’t help but see so clearly that for how much stuff people have in the US, we lack so much in community these days.  The smiles, the welcome, the sharing that all of us experienced on this trip will last with all of us forever.  I hope that all of my students on this trip and in to the future can see that this is the true value of the experience.

In the coming days I am asking each of my students to write a little bit about what they are feeling now that they are home.  These feeling are acute now, but they do fade, and it is important to capture them so that we may be reminded and not lose the clarity we have right now.  For me – I didn’t get over it.  I didn’t turn it in to just part of my job, in to a vacation from my everyday.  It was so much more intense than any other part of what I do, and it asked so much of me. I am still in love – with the country, the people, the sights, the tastes, and the intense personal challenge that I find so much growth from.  And you know what?  I’m now more in love than ever before – because now I have 8 other people that I found so much appreciation and insight in to.  So they will join the reasons I love Uganda and Africa, and they are now also part of the bittersweet longing I’ll feel every time a song or a taste or a smell takes me right back.  I hope they all know how much they mean to me, and that my appreciation for them will follow all of them in to the future no matter where they go.  I told them all I sometimes have difficulty moving on from things.  But now I know I shouldn’t “move on” – it is precisely these connections that sustain all of us and create community even when people are far away.

Oh – we also ended our trip by going on a safari trip!  It was spectacular – I hope that the student share their beautiful pictures and their wonder at experiencing yet another display of Uganda’s richness.  And I hope we are all inspired to protect and to visit these natural spaces – to lose them would be a tragedy to the community we are all a part of.

I can’t wait for my next trip.  It is an honor to work with these extraordinary students and to help give them these experiences.  Until then – stay tuned to this blog for updates and developments from Wilkes and our efforts to develop teaching and learning opportunities in public and global health!

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Community……….and changing my mind.

So this is Dana writing this post…..just so that you can tell 🙂

As I reflect on the past three days, I find myself coming back again and again to the concept of community.  I think if there is anything I find on these trips I have taken to Uganda, it is that community is the central and strongest tenant of what we seek out as human beings.  It is what underlies why we do things – as medical professionals, as students, and as teachers.  Let me explain.

Friday of this past week we had the opportunity to tour the Infectious Diseases Institute (IDI) – they are an organization that is supported by Makerere University as well as the CDC and other NGOs in many countries and Uganda.  The work they do there is simply inspiring.  They have a large facility on the Mulago Hospital campus that houses what I can best describe as a fully integrated medical home for HIV care.  They serve over 8,000 patients that travel from all over the country to get there, and they provide free medication, physician visits, prenatal care, pediatric care, psychological and social counseling, lab services, urgent care, and clinics for the various associated conditions such as Cryptococcus and Kaposi Sarcoma.  Additionally the Institute coordinates multiple clinical trials of medications – everything from pharmacokinetic and dynamic studies of how antiretroviral medications interact with other meds to studies of how to best reach certain populations within the community.  It was quite simply mind blowing – I’ve never seen a fully integrated clinic like that in the United States.  It was clear also how grateful Uganda and many African countries are to the PEPFAR program originally instituted by GW Bush for AIDS relief in 2003.  The impact of this program are so so impressive to me – it is really eye opening to understand how much the US has impacted the rest of the world.  And it is changing my opinion of GW Bush as well for instituting it. I’ve had really interesting “ah ha” moments about many things while I’ve been here this trip – many of them things that my liberal political mind finds difficult to square right away.  I don’t want to get controversial, but I’m finally able to see the other side of the concept of socialized medicine, as well as religious involvement and support of medical facilities.  I am always open to new viewpoints but I may be processing these change concepts for a while.  That said – I can also see the power of global community – and making sure medical care is not for profit – things that do fit well with my existing ideology.

We also got to spend part of the day at the part of IDI that deals with initiatives such as Antimicrobial stewardship.  These are huge efforts that are really focused on the world as a global community – preserving antibiotic usefulness for all people by preventing unnecessary use.  The staff talked about the projects for this having to come from the community – not be imposed upon it.  This is the only way it would be accepted.  The amount of effort that these things take is simply mind blowing, and pharmacists in the community in this country are poised to be an integral part of it.

I could speak at length about all the things we’ve done, but Friday night we had to say goodbye to Winnie and David, and it was one of the hardest things I’ve had to do in this trip so far.  They both have accepted all of us and Wilkes University as a whole as part of their community – going out of their way to make sure we were cared for and included. We are all incredibly grateful for Winnie’s mentorship as she has arranged and helped us process all of our pharmacy experiences here.  They have both given of themselves simply because it is the right thing to do, and they hope that it will be passed on.  Often this giving probably came at an inconvenience to them, but it is simply what they do.  I am having a hard time accepting that all of this help can be given so freely, as it is often not at home sometimes.

And finally we have now moved on to Masindi – a place where I instantly felt as if I was back at home (it helps that Janine was literally there greet us as we got out of the car!).  I am excited for this group to experience a place closer to “small town” Uganda, and the community ties that run deep.  It was great to see familiar faces and step back in to familiar spaces.  I hope that we can bring some of our love to this community – we have a week planned that is filled with outreach and support for the pharmacists and medical community here.

Off and running…..

Hello Everyone!

The past two days have been just a whirlwind.  Thanks you all for waiting as we got ourselves together to get posting started!  We arrived safe and sound In Uganda and met up together at the Customs line in the Entebbe airport on Wednesday night October 24th (the students and I and Dr. Prelewicz had taken different flights but they arrived within 10 minutes of each other at Entebbe).  After arriving at the Makerere University Guest House in Kampala at about 1am, we were all exhausted and went directly to bed.

We all woke up Thursday morning a little bit groggy but went on to have a pretty busy day getting a few things set up for our stay here.  We got our money exchanged and some cellular lines set up so that we can be in communication with everyone in Uganda and at home. It doesn’t sound like much, but with Kampala traffic, it took the whole afternoon.  We were also help up a little bit by the very rainy weather.  It is the start of the rainy season here but I certainly don’t remember this much rain when I was here last year at this time.  The locals say the rains have been a lot less predictable since people have cut down much of the forested land in Uganda.  Winnie, our tireless host in Kampala, even volunteered her husband David to be our driver while we are in Kampala.  I have been quickly learning that you have to double and triple check bookings and plans, so it is wonderful to have Winnie looking out for us as we navigate the town.  Winnie is also out main organizer and advocate for the work we do to collaborate with Makerere University School of Pharmacy as she is a faculty member there and a pharmacist.  She has worked with Wilkes for a very long time and we appreciate her deeply.  We hope to be able to provide the same welcome when she visits the US someday!

Today (Friday) we got a chance to go and introduce ourselves at the University and to meet with Kalidi Rajab – the head of the clinical pharmacy unit at MU.  He gave us an excellent introduction to the practice of pharmacy in Uganda, and let us as lots of the questions that a person has when encountering a very different health care system.  After a morning at the school, we went on to Mulago hospital to catch the end of rounds in the Pediatric wards and to introduce ourselves to the pharmacy interns and physicians and nurses there.  Even though we only saw a few patients this first day, I am confident the experience has already made a lasting impact on the students.  They will be posting about this first clinical experience as soon as they digest and debrief a little bit this evening.

We also hope to cap off this evening with a night out on the town.  Mayi is an excellent dancer and she is eager to get all of us moving and enjoying ourselves.  As for me – I only dance when I’m really feeling a bit crazy, but I think with some encouragement and perhaps some instruction from Mayi, I’ll be dancing quite a bit this evening!

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Arriving at Entebbe
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Maribou Stork!
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Ducked in from the rain for lunch
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Kampala traffic with a visitor
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Mulago lunch
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Makerere University SOP building
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Traditional Ugandan food for lunch
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A sweet little girl we met at Mulago
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She loved our watches and selfies 🙂

 

Preparing for the fall 2018 trip to Uganda!

Hi Everyone,

In preparation for our upcoming trip to Uganda (we leave on October 23rd), I would like to introduce myself and our wonderful students and preceptors.  I am confident that we are going to have an excellent trip and I am super excited to share our work and adventures with  you.

My name is Dana Manning, I am an Associate Professor of Pharmacy Practice at Wilkes University.  I have worked for Wilkes for more than 10 years now, and this will be my third trip to Uganda with pharmacy students.  The partnerships between Wilkes and Uganda were developed in approximately 2011 by a dear friend and former faculty member at Wilkes.  In the years since, many pharmacy students have participated in trips to Uganda and experienced the important learning that comes with studying abroad.  I am excited to have the opportunity to take students this fall and to help develop our global experiences in the years ahead.

During the remainder of the academic year, I am busy teaching Oncology and Nutrition topics in the pharmacy curriculum as well as precepting students practicing in a transitions of care clinical pharmacy service at the Regional Hospital of Scranton.  Personally, I have three children (15, 10, and 7) and a very busy dairy farmer husband.  I love growing my own food and cooking – one of the things I like the best about these experiences is the opportunity to immerse myself in the foods of another country.  I am passionate about providing opportunities for people to broaden their minds and to take them out of their “comfort zones” and in to places where there are new perspectives to be found.

In the upcoming days the preceptors and students of our fall 2018 cohort will introduce themselves, and you will get to learn all about the things they are excited for and the ways they hope to grow from this trip.  I hope that you follow us throughout our trip – there will be many stories and lessons and pictures to come!

Welcome to the new blog!

This post will mark the beginning of the Wilkes University School of Pharmacy Public and Global Health blog.  While the Wilkes SOP has been engaging in a variety of public and global health activities for a few years now, we are expanding and deepening our engagement with the world with pharmacy student experiences in the UK, Africa, and Alaska.  With this blog we hope to capture the excellent work that our pharmacy students are doing all over the world and to chronicle the experiences that contribute to an excellent pharmacy education.  By engaging with public and global health we develop as pharmacists and as people – and it is a privilege that we are grateful to have.  Happy reading!