Uganda, this is a see ya later, not a good bye!

 

Hello everyone!

Thank you for following our blogs hope you are enjoying them as much as we enjoyed our time in Uganda. WOW, time flew, these weeks went by really quickly. After our journey in Uganda, Mike and I traveled to some countries in Europe and London, UK. Now we are at the airport heading to ASHP Midyear conference. For those who are not in the pharmacy world this is where we go and talk to multiple residency programs and try to decide where we want to apply to.

I transferred to Wilkes for pharmacy school and I remember being at the interview and when I asked what type of community outreach Wilkes offers among other things they told me about this APPE and about the trip to Guatemala with our former Dean Graham. The fact that I could go to underprivileged countries and serve them, as part of my academic career, was a deciding factor when choosing a pharmacy school to attend. I am so thankful for this opportunity. I am so thankful for having the best preceptors with us there too.

It is really hard to put this entire experience into words. The emotions I felt throughout the entire trip were unreal, it was truly eye opening. I loved every minute of it, even if I cried, because it was sad just to see somethings. But at the end of the day, I felt very accomplished after providing clinical help to the people of Kampala and Masindi. As you probably know, there is a lack of resources in Uganda, however, they make the best out of it. They improvise with what they have and are very innovative. The doctors and pharmacist were very happy to have us there. They were open to listening to our recommendation as well as taking the time to teach us. This made me feel like was of help.

People are incredibly nice and welcoming, despite the hardships they go through. Every person I met said to me “Are you going to come again next year?” I hope I can someday go again, I hope that once I am financially stable I can go and help them even more. I miss Uganda, I miss the people, and especially I miss the children! I miss hearing kids say “Mzungu” (white traveler) and getting supper happy when we wave back. I’ve actually continued to use this word while traveling in Europe, and I told nearly every person I met what it meant. My dad now calls me that all the time, including on facebook comments, and I love it!

I remember walking down the streets of Masindi and seeing a little boy walking down the streets selling fruits as he kicked a water bottle. He seemed happy doing this. So I joined him, I kicked the water bottle with him and he smiled. It just shows you how important little things are. How impactful a smile can be. Pass it on! I don’t know, this may sound silly to you, but it really made my day, and I hope it made his. Honestly, I did that a lot, I simply tried to make children smile and laugh by making funny faces, playing hide and seek after the presentation to the drug shoppe owners, etc.

If you are a younger Wilkes pharmacy student reading this, I highly recommend you take this APPE. It will change your perspective on life, it will help you become a better human being. It sure did that for me!

-Mayi

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A Warm Masindi Welcome!

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!

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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.

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Here are some pictures from the blood pressure screening at the church!

-Mayi

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!

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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!

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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

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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!

A Little Late, But Day 1 (And 2 and 3)

Jambo everyone!

First, I want to apologize for the delay in posting! Between getting settled, jet lag, and a power outage that left us without WiFi, I am FINALLY able to post about our global experience thus far!

On Friday morning, we started our morning with a discussion about Makerere University School of Pharmacy! The faculty member started the discussion with a warm and friendly welcome to their country and the school. We talked about the history of the University and how their education system is structured. Their education system is very different, especially the overall cost and structure of their primary and secondary education. Then, we moved our discussion to the School of Pharmacy and how their curriculum is structured for their students. I think what surprised me the most about the discussion was the mirror-image reflection of their curriculum with the curriculum at Wilkes University. Their semester is 15 weeks long, our semester is 15 weeks long. Their school operates with three semesters (fall, spring, summer), our school operates with three semesters (fall, spring, summer). Their curriculum is organ-system based, our curriculum is organ-system based. As if I was not already impressed by the similarities, the faculty member began reciting basic pharmacy acronyms: I-ESCAPED-CPR and SBAR. For those of you following the blog and not in pharmacy school (HI MOM!), these acronyms are taught to us in Care Lab and they follow us throughout our education. To hear those acronyms be used half-way across the world made me realize that our education system is very different, but our education is very similar. Both student pharmacists, from Uganda and from Wilkes-Barre, were given similar educations, but we tend to use them in very different ways. I can honestly state that I am VERY excited to see what makes us different, but similar!

After our discussion, we went to Mama Box to enjoy some traditional Uganda food! To say I am a picky eater is an understatement, BUT I was willing to give everything a chance at least one. The food was fantastic and the atmosphere was friendly and welcoming! I tried matooke and cassava, both of which are starchy carbohydrates, so I was MORE than content! I shared a picture below of the menu!

THEN, POSSIBLY, THE BEST PART OF THE TRIP (AT LEAST FOR ME!) (ALSO, this happened on Day 1, so I will just leave it at that.)  Our group visited the Children’s Ward at Mulago Hospital. As you all probably know from my last blog post, I am very interested in pediatrics and I want to specialize in pediatrics after graduation. What you probably don’t know is that I spent two APPE blocks at the Children’s Hospital of Philadelphia learning how to answer pediatric drug information questions and how to manage pediatric patients. To say I feel more than comfortable in a pediatric ward is an understatement, but I do not think I was prepared for the differences I was about to see. However, the differences were not in the education or the rounding technique or the dedication to the patient’s health. The differences were in the resources available to Mulago Hospital’s Children’s Ward. I am going to give a brief example before ending my post. On our first day, we were asked to answer a drug information question about potassium and if a potassium dose was appropriate for a hypokalemic patient. At Wilkes University, our goal time for answering a question is about 90 seconds (HI DR. FERENCE!). Our team took about 15 minutes to answer a single question. So, let’s reflect and ask ourselves some questions.

What went well? We worked together, we used skills specific to team members, we asked more questions to get the whole background, we answered the question, we formulated a recommendation, and the provider accepted our recommendation.

What didn’t go well? We didn’t have immediate access to our databases, we were unfamiliar with units, we were unfamiliar with drug packaging, we were unable to see more than one lab value, and we were a little too flustered over the status of the patient’s potassium.

What could be done better next time? I believe going into our next clinical experience, we need to remember that our resources our limited, but our education is not. At Wilkes University, we were given all the tools to be student pharmacists in the United States, but we are in Uganda. It is time to adapt and learn that we cannot let lack of resources impact our quality of care.

And with that being said, it is my time to stop blogging and start sharing some of our FANTASTIC pictures from Day 1, Day 2, and Day 3! On Day 2, we spent our morning at the Gaddafi National Mosque and our afternoon at the local craft market! On Day 3, we spent our day traveling to the Equator and taking WAY too many pictures!

Kwaheri Kwa Sasa (Goodbye for now!)

Katy

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A peek inside Makerere University School of Pharmacy!

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Our menu options at Mama Box! “Food” basically is a choice between sweet potatoes, cassava, yam, pumpkin, posho, kale, Irish potatoes, chapati, brown rice, white rice, and matooke.

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A picture of the outside of the Children’s Ward! (We will try and provide more pictures, but we still try and respect HIPA in Uganda!)

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Rubi Mink, Mayi Batista, and Brittany Gurreri at the top of the minaret at Gadafi National Mosque!

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Dr. Manning, Autumn Peck, Bethany Chmil, and Katy Campf representing their Kappa Psi Pharmaceutical Fraternity pride at the Equator!

IMG-4871.JPGMayi Batista, Bethany Chmil, Katy Campf, and Michael Hummel enjoying the sun and watching the soccer game at the Equator!

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Brittany Gurreri, Rubi Mink, and Autumn Peck played in an INTENSE (and adorable) soccer game with the kids at the Equator!

Katy Campf, Student Pharmacist Introduction

Jambo and hello everyone! My name is Katy Campf and I am one of the seven FANTASTIC students headed to Uganda! I am in my last year of pharmacy school at Wilkes University and over the last seven years, I dreamed about going on an international pharmacy practice experience! Well, in about twenty-four hours, my dream becomes a reality as we board our flight(s) for four weeks of public health and adventure!

After graduation, I plan on pursing a PGY1 at a children’s hospital and a PGY2 specializing in pediatrics. I have been surrounded by pediatric medicine my entire life and I wanted to use my APPE electives to help solidify my decision to pursue pediatrics. I can honestly state, that I knew I wanted to be in pediatrics the first day of my second block. I truly found my place in pharmacy and my place allows me to take care of our little friends!

Now, I bet you are all wondering what Uganda has to do with my love for pediatrics. Well, as much as it does have to do with pediatrics, it really doesn’t have to do with pediatrics at all. During my first semester of college, I was required to take a First –Year Foundation course. My course was titled ‘Be The Change’ and the course was based off of Gandhi’s quote “You must be the change you wish to see in the world.” Over the last few years, I often found myself thinking about the quote and the change I want to make as a student pharmacist. As a student pharmacist, I believe everyone should have the opportunity to experience other cultures and the way they practice medicine.  In pharmacy school, we learn “the best way” to treat a patient, but in all reality, “the best way” may not be available. “The best way” may not be practical. Ultimately, “the best way” may not be the best way. I think trips, such as this, can show just how much a student pharmacist can make an impact and be the change. From teaching pharmacists to measure blood pressures to vaccinating little friends to promoting poison prevention, I want to use my education to help be the change in Uganda.

Overall, this trip is a once in a lifetime experience and I cannot wait to share it with you! And don’t worry, I’ll share PLENTY of pictures along the way! 📸

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PS- I am HUGE Disney fan, so here’s a picture of me sporting THE cutest Minnie Mouse ears from my trip in August! My favorite Disney quote is “Adventure is out there!” and I cannot wait for our adventure in Uganda!