19th April 2024
Andrew has been working at the Torit Health Science Institute as a tutor since January 2024. He is teaching Clinical Officers for one semester of their academic year, and will be due to return to the UK in May 2024. He is responsible for 2 modules: Medical Ethics and Emergency Care.
In Medical Ethics the class have been exploring medical ethical principles, such as beneficence, non-maleficence, autonomy, and justice, along with other concepts such as confidentiality, consent, and capacity. Understanding and applying these principles in the realities of a conflict torn and resource poor setting such as South Sudan is very different from an NHS setting. These sessions have produced fruitful discussions as the students have been facilitated to reflect on governing legislation, such as the UN Declaration of Human Rights, and apply the principles into their own working context.
In Emergency Care the students have been covering the necessary knowledge underlying approaches to emergency medicine. Systems of patient assessment, such as a primary and secondary survey have been taught, along with ways to recognise patterns of illness and injury. This class also has a practical component, where the students are expected to demonstrate essential skills in simulation. These skills have so far included CPR, recovery position, choking management, recording vital signs and log roll. The students have taken well to the novel concept of simulation and are now being aided by these sessions to effectively learn and demonstrate their competence.
Outside of class, Andrew has also been meeting with the Principal to help him this about how the institute can develop its existing systems and tutor development.
Term is due to finish at the end of April, which will be followed by student assessments. Andrew is now busy mapping the learning outcomes and activities to the assessments that will be arranged to measure both knowledge and skills in these subjects.
1st February 2024
Andrew has begun his work in South Sudan. The semester has started off slowly and rather informally as most of the students come to the Health Institute from quite a distance, so it takes them a while to acquire the necessary funds and get released from their families. Once the students arrive at the Institute, they should stay in the town for the remainder of the semester, but they get a break after their exams in May.
Andrew is mainly involved in two modules: First Aid and Emergency Care & Professional Ethics.
First Aid and Emergency Care started off as an introduction to first aid, though Andrew is developing it over the course of the module to include scenarios and simulations.
The Ethics module involves various ethical dilemmas and some communication skills. The ethical dilemmas they face in South Sudan are culturally very different from the ones that we face in the West.
Andrew said “I’m trying to get my head around the things that are challenging for them. Resources are truly limited. There are more patients than resources and they must decide who they’re going to treat. I guess we only really get that in a major incident where we have to triage, but that's just the norm here. Every day they're facing a lack of antibiotics, a lack of surgical equipment, and so trying to decide that balance is a huge thing”.
A look at Andrew’s Weekly Schedule:
Mondays: at the Institute delivering First Aid and Emergency Care lectures
Tuesdays: prep day, although Andrew might be getting involved in another module that will take places on Tuesdays.
Wednesdays: travel to the market to stock up on supplies.
Thursdays: at the Institute delivering Ethics lectures
Friday: prep day and meetings. Andrew is in South Sudan with a few others from the same charity organisation so they tend to get together for a team meeting on a Friday to discuss any issues, support each other and have a security update.
Saturday: Andrew and his family take some time for themselves.
Sunday: They get involved in the local churches, and there's always jobs to do around the house.
The area Andrew and his family are living in isn’t safe at night, there's a strict night-time curfew as there's quite a lot of gang type activity in the town. They’ve got a guard dog and a cat. Andrew said “the dog is helpful, he roams around the house and barks loudly if anyone comes nearby, but he's a total softie and just wants to lick your face all the time. Then there's the cat who is meant to eat the rats and keep them out the house, but he tends to just roam around and complain that he hasn't got enough food.”
The house that they’re staying in has water tanks but, there’s no piped water and it's reliant on rainwater in the wet season. Andrew said “In the dry season you get deliveries of barrels of river water. It’s quite hard to make sure that we're filtering everything well to not get bugs. We calculated our water usage in the first week and translated it, we used something like 2000 litres”.
Read more about the project here.