Outreach Education!

During my first week at my placement in Kasoa, I was working at the hospital for maybe 4 hours/day, helping with preventative care, which is only given to infants and small children and consists of registration, weighing, immunizations and vitamin A supplements, and on a volunteer basis, family planning (or different forms of birth control) and voluntary counseling and testing for HIV (VCT). The same department at the hospital also handles outreach, which includes education in the community and trips to the field to do the same preventative work for children that we do at the hospital, and during my second week I got involved with some of that.

On Monday and Tuesday I went out into local communities to talk with them about malaria and cholera, which mostly ended up with me listening and failing to understand while the others from the hospital talked about the diseases in Twi, the local language. I’m starting to learn a few key phrases, but I think it will still be a while before I can talk about malaria or cholera. I did speak in English a few times on Monday, and one time what I said was translated into Twi, and the second time I was speaking to a group of schoolchildren who could understand my English fairly well. However, I apparently left a lot out… I need some more practice talking about these issues in a way that is relevant to the local population.

Talking to Walantu village women who are smoking fish

Wednesday I was back at the hospital and tallying for each child that came in for weighing – whether they were new or had previously attended, and below one year, between 1 and 2, or over 2 years. There were none over two years, and few above age one. It was a hectic day, but still, most of the visitors had cleared out by noon. The hours officially continue until I think 3pm, but I have never stayed that late because there is nothing for me to really do at that point.

It was fortunate that they were all gone by then, despite the craziness earlier in the day, because that afternoon I went to Maranatha Preparatory School to give a talk to 7^th and 8^th grade students about malaria. I’d made a powerpoint for my own reference, then written out my notes, gone over them a bit with Eric… but never practiced the actual talk. So I arrived somewhat apprehensive about speaking to an unfamiliar type of audience, particularly since I knew very little about the background they would have on the topic, but feeling confident at least that I knew what I would talk about.

Writing some key concepts on the board

Answering a student question

The talk went reasonably well, especially since it was my first one, but there’s definitely room for improvement. I think the students learned a little bit from me, although I don’t know how much of what they repeated at the end was from what I told them or their own prior knowledge – they definitely threw in things I hadn’t talked about. Eric recorded the whole talk and I will be reviewing it before my next one, so I can figure out where I can make changes and get through to the students more effectively.

I also talked with Raul and Eric about additional work that I can do – the hospital is always finished by noon or 1, and even when I am there I don’t feel like I’m contributing very much, so I’m going to begin designing a full health education curriculum that I can use in different schools in the area and that can also be used by future volunteers. I’ve downloaded articles and reports from the ministry of health about previous health campaigns and the most significant diseases in the country and the general plan for reducing morbidity. I also downloaded articles about health education ideology and methods and I will try to set up my new curriculum based on these. To start, I’m focusing on malaria, TB, HIV, and cholera, but it may be later expanded.

There’s also a huge opportunity now with the school education work to do some data collection – try to assess what they know prior to the talk, what they have learned after the talk, and what they retain 1, 3, 6 months later (timeframe TBD). I’ll set this up in conjunction with Eric and Raul and have to get it approved by Yale before I can begin, but I think this can actually produce some interesting results, and give an assessment of how much people know in general.

Thursday I went to Adom, another small village near the hospital, to do outreach weighings and immunizations. We had about 10 children in the 2.5 hours we were there, much less than the same amount of time at the hospital. One of the children had some sort of skin infection/rash that looked like it could have potentially been measles, but the child was to young to receive the immunization, and received no additional care or referral about the rash. I also thought it was interesting that although one mother came with both a young child (less than one year) and one who was maybe about 2 years (still within the age that they should have gotten monthly weighings), only the younger child was weighed, and the nurse that I was with made no comment about the other child not being weighed.

Friday, today, is African Union day, and so Amanda and I have decided to take advantage of the holiday and take the day off from work. But I’m still trying to get a bit of work done; I’ll be looking over some of the documents I mentioned earlier and trying to develop new talks.

This weekend we are off to Kumasi for a day, then to Cape Coast and Elmina castles and Kakum National Park to see some wildlife and walk across the canopy bridge!