Hello (again) everyone!
Just for a little bit of clarity, there are two posts in this blog. A blog post by Mayi and a blog post by Katy! And, as always, a few pictures!
Well, I LOVE MASINDI! The people, the children, the animals, the flowers, ahhh everything! On Saturday Rubi, Mike, Dr. Manning, Janine and I (Mayi) went downtown. We did somewhat of an experiment. We created patient cases and went to “drug shops” and pharmacies to see what the workers would recommend us based in the patient case. For example, one case was back pain and the worker recommended aceclofenac, a derivative of diclofenac. She made sure we knew to take it after meals, twice a day, and she also asked if the patient had ulcers. She was not a pharmacist, but she was still trained to ask key questions when recommending an NSAID. I was really impressed to see other nonpharmacological recommendations, such as when we asked to buy Doxycycline they asked “what for” and responded for malaria prophylaxis, she then proceeded to give the correct dose AND to tell us to still sleep under a mosquito net!
After this experiment, we were able to get a deeper understating of medication availability, like birth control. We did not find birth control on the first try so we had to go to a different drug shop. It was a great learning experience. I feel it will be beneficial when we start clinic and rounding tomorrow!
We went to the market after this to buy some “give aways.” Among other things, we got a rooster! YES, a rooster!! We decided to name the cock “Katy.” (Katy Campf, another student on this trip, is “anti-chicken giving” because she is scared of chickens, roosters, and hens). Katy, the chicken, was not very handsome, but he was a good boy! Mike carried him 1.5 miles to Jeannine farm, where she will be kept safe until Wednesday when we give him away. I am sure he will make a family HAPPY and FULL! Anyways, the market was really cool, lots of beans, fruits, and vegetables. Every little kid calls us “Muzugo” (white traveler)! They get sooooooo happy to see us and to get a wave back from us. It is adorable!
Above is a picture of Dr. Manning, Mike, Rubi, and I (Mayi), at the market!
Here is a picture of the roosters!
Above is a picture of Dr. Manning, Mike, Rubi, and I (Mayi), at the market!
Here is Rubi, Katy (the rooster), and I.
Sunday, we were up bright and early for a blood pressure screening at a church. We got to the church around 7:30 AM! We screened 150 patients, and explained the importance of checking blood pressure, since there are normally no signs of high blood pressure, but it still can be very dangerous. All the people were so eager to learn about their blood pressure even though the line was long and the day was hot. I especially enjoyed playing and educating the children as well as holding them! Additionally, praising to Jesus in the church was amazing. There was so much joy, so much dancing, everyone was smiling. It was a phenomenal experience! Words nor pictures cannot describe our time here.
Here are some pictures from the blood pressure screening at the church!
WE MADE IT TO MASINDI, but not before we stopped at the Ziwa Rhino Sanctuary! The sanctuary is home to twenty-six wild white rhinos and their main goal is preservation and conversation of the beautiful species. On our trek, we were able to see four rhinos and two of the rhinos were the smallest rhinos in the sanctuary! Although the rhinos were all wonderful, the babies of the sanctuary were my favorite. The youngest baby of the sanctuary was born on August 10th, 2018. She was THE cutest three month old and the overall experience of the sanctuary and the trek was a once in a lifetime experience!
Katy, Mayi, Beth, Brittany, and Michael take photos of two rhinos inside the Ziwa Rhino Sanctuary!
After a good nights sleep and some settling in, we met with Janine on Saturday and started to create our plan for the day. For those of you who don’t know Janine, she is a missionary in Uganda and she acts as our coordinator while we are in Masindi. She has lived in Uganda for about 10 years and spends her time helping others through her work with her church. Janine came to our morning meeting with a plan: the group was to break up into two teams and go to separate areas of town. Here, we were to approach local pharmacies with a scenario and see what prescription medication they would recommend and ultimately, sell to us. Over the last few weeks, we’ve learned a lot here in Uganda, especially how community pharmacy operates. Their pharmacists and prescription drugs sales do not rely on written prescriptions or instructions from a doctor. The entire prescription process from physician to pharmacist sometimes relies solely on the pharmacist. After clarifying the situation and setting a budget, we started our walk to the outdoor market with Jimmy, the town celebrity. To be fair, Jimmy is another volunteer with the church and helps Jeanine with just about everything, but walking in town with him felt like we were walking around with a celebrity. Everyone we met was welcoming and thanked us for our service and visiting the beautiful country of Uganda. I’ve never felt more comfortable 7,000 miles away from than when I was walking around a busy Ugandan market with Jimmy. BACK TO OUR PROJECT, we visited three pharmacies with the same story and a few random prescription medications to request if we could access them.
SCENARIO: A 56-year old female presents with lower-back pain. The patient has a few drugs allergies, but the most pertinent one is penicillin. What would you recommend?
RANDOM PRESCRIPTION MEDICATIONS: Birth control, doxycycline, meter-dose inhaler
Pharmacy 1: The pharmacist asked the age of the patient and recommended a topical pain reliever (a herbal-combination diclofenac product). The pharmacist demonstrated how to apply the medication, but neglected to ask if there were any drug allergies.
Pharmacy 2: The pharmacist asked the age of the patient and recommended piroxicam and a beta-lactam antibiotic. The pharmacist wrote how many times to take the medication, but when asked why an antibiotic was needed, she stated that it had to be taken with the piroxicam. The pharmacist neglected to ask if there were any drug allergies and did not counsel the patient on what to expect when taking the medication.
Pharmacy 3: At this pharmacy, we particularly asked for birth control and doxycycline for malaria prophylaxis. Both medications were sold to us, but the pharmacist recognized Jimmy and asked if we were the pharmacy team presenting to Masindi district on Wednesday. With that being said, the pharmacist potentially knew our background in medicine and deferred her counseling session to our baseline knowledge.
After our adventures in town, we traveled back to meet with the other team and discuss our experience. My biggest take away from the day was that critical questions were not asked. In the scenario, our patient had a penicillin allergy and was sold a beta-lactam antibiotic. In the drug requests, our patient was sold birth control without asking if she needed counseling. In the drug requests, a patient was given doxycycline without asking if the patient took the medication before and knew about the increased risk of photosensitivity. In community pharmacy, asking questions is essential when trying to provide the best patient care. My experience with the community pharmacies of Masindi has left me feeling a little uneasy, but that’s why we are here on this trip! We are here to help, it’s plain and simple.
On Sunday, our group had an early morning for a blood pressure screening at Jimmy’s church. Jeanine helped coordinate the event and all we needed to do was bring our blood pressure cuffs and our stethoscopes. Jimmy met our group in town and brought us to his church and WOW, were we welcomed with open arms! The people of his church were so accepting of our group and continued to thank us for our service in Uganda. We observed a few minutes of the ceremony before shuffling outside to set up our blood pressure clinic. Before we knew it, we checked over one-hundred and fifty pediatric and adult blood pressures over the course of five hours. The clinic was hectic and required A LOT of coordination and translation, BUT the entire event was a huge success!
Autumn, Jimmy, and Stacy work together to check the blood pressure of a church parishioner!
The church parishioners could not thank us enough and everyone who required counseling asked appropriate questions! However, my favorite part of the day wasn’t related to the blood pressure screening at all. It was fully related to the people of the church. These people were so grateful to have us present at the church and they were so willing to welcome us and help in anyway that they could. Parishioners volunteered to sit with our groups and translate for those would could not speak English. They volunteered to help others fill out paperwork and explain what the paperwork was for. They even offered to drive our group home from the church to our hotel on their boda-boda (Ugandan motorcycle). The entire morning was humbling and I cannot try and put into words what I felt at the church. Our group has one week left in Uganda and while I’m preparing for the goodbye, I know a piece of my heart will be left in here in Uganda.
Katy and Stacy work together to check the blood pressure of a church parishioner!
Thank you for taking the time to read our blog and we hope you continue to follow us through our last few days in Masindi!