Archives for March 2019

3 pieces of advice as you set your goals for 2019 and beyond

March 25, 2019 Jennifer LeBlanc Leave a Comment

By: Rachel Ollivier, PhD student, Dalhousie University

The following was prepared by Rachel as part of her invited panellist presentation at the 2018 Global Health Students & Young Professionals Summit (GHSYPS) in Toronto in late November. The panel was aimed at providing students and young professionals with an opportunity to discuss and share insights related to career preparation, education, interdisciplinary approaches in global health, and opportunity-seeking. With Dr. Donald Sutherland acting as moderator, Rachel participated as a panel speaker alongside Katrina Plamondon, Dr. Genevieve Bois, and Abena Thomas.

Good afternoon everyone,

In the next 5 minutes, I want to share with you 3 key learnings. I’ve nursed in 3 provinces, 3 countries, and am currently a PhD student at Dalhousie…so I hope I have something useful to share with you today!

Learning is both a practice and an attitude

An attitude of learning will never go to waste and is lifelong- there is no endpoint.
Oftentimes as students or young professionals, I think we’re taught that expertise is the goal.
Be humble in the little you know and you will never go blind to what surrounds you.
Example: I used to use the world “help” a lot when I was talking about my global health work. This implied that the entities I was working with needed my help.
The point is: don’t aim to be the expert, but rather find ways to challenge what is said or done.

Be coachable

Any positive feedback I have received as a student or a nurse has not come from getting it right the first time or knowing the answer. In fact, I learn much less when I get it right the first time than when I have to adapt, problem-solve, and diversify my perspective in order to achieve a set goal or outcome.
Being able to always try again, improve on my abilities each time, and reflect on mistakes or shortcomings is what has been most important in achieving my goals.
Worry about what you can control, not what you can’t. In academia and in clinical practice, there’s constant pressure to know everything, to be personable, well-rounded, knowledgeable, energetic, and enthusiastic at all times. As advocates, practitioners, educators, or researchers in global health, we are human just as any other and must know our boundaries while recognizing that failure is essential to growth. Know that low points also mean something and show you what’s missing.

Maintain relationships

Global health is a small world and you never know who or what might come in handy
The benefit is there and has immensely expanded my opportunities in Canada and abroad
In fact, I’m up here presenting because of it!

Research project. Africa. One week. Insane? I thought so, but man was I wrong

March 15, 2019 Jennifer LeBlanc Leave a Comment

By: Lauren Adolph, Dalhousie Medical Resident, PGY-3 OBGYN

The team from Kybele and children of Archbishop Amissah Memorial Catholic School.

Last year I had my first opportunity to travel to Cape Coast, Ghana after discovering the relationship between Dr. Heather Scott, the NGO Kybele, and Cape Coast Teaching Hospital (CCTH). These parties share a joint commitment to improve maternal and newborn health and respect for the expertise each party contributes to this goal. One unaddressed priority identified by CCTH caught my interest: obstetric triage. I had an interest in triage from prior research, and thus was born (no pun intended) my joint resident research project to evaluate the implementation of systematic obstetric triage at CCTH.

A proposal was completed, submitted and accepted to ethics. The only thing left to do was fly to Ghana, identify resident and staff OBGYN partners, and get to work collecting data. A big task for 5 days? Yes. But amazingly, we got it done.

The customs officer looked at my immigration card and asked, “Are you a doctor?” After my confirmation, he quietly added, “Your patients are very lucky to have you. Thank you for coming.” After an overnight in Accra, we boarded a bus for the 2-hour drive to Cape Coast. Jet lag cannot be a factor when you have limited time to reach such big goals. So, it was straight to the hospital for morning rounds, meetings, small group breakout sessions, furious manuscript writing, data gathering, re-writing quality improvement indicators and testing these in real time—while ensuring our local champions worked right alongside us and fully held the reins by the end of our week. These were our days at CCTH: long, full of new learning, productive and immensely fulfilling.

2019_gho_blog_resident_lauren_colleagues_sitting

Dr. Richard Pinkrah, Dr. David Walawah and Dr. Lauren Adolph collecting data for their research.

Our goal was to support change at the heart of the hospital, and that meant implementing policy and practice improvements while developing a system of collecting and analyzing institutional data on quality of care indicators that would inform the next round of self-sustaining change and improved care at CCTH.

And the overwhelming poverty and suffering? It would be hypocritical to say I was fully prepared to face the stark contrast between the healthcare at CCTH and what we take for granted in North America. What stood out as extraordinary then, was the dedicated and talented staff at CCTH who function in a system overrun and severely under resourced. Despite these constraints, these superheroes resolve to deliver the highest clinical standards. Their training is steadfast and resolute. These courageous leaders work daily to achieve the true vision of Global Health—equity in delivery of health care across the globe.

To learn more about global health experiences for Medical Residents please visit the resident section of our website.

PLANS Professional Profile: Crystal Watson

March 11, 2019 Jennifer LeBlanc Leave a Comment

Written by: Nnamdi Chiekwe, Therapeutic Recreation Student

Interview with: Crystal Watson, Certified Therapeutic Recreation Specialist

Promoting Leadership in health for African Nova Scotians (PLANS) is writing a monthly blog post highlighting “Faces of Black Health”. This post highlights Crystal Watson and the profession of Certified Therapeutic Recreation Specialist.

Crystal Watson, Certified Therapeutic Recreation Specialist

What do you do?

I am currently the Executive Director for Recreation Nova Scotia, a non-profit organization striving to improve connection within the recreation sector so that we can promote and advocate the benefits of recreation as part of the lives of Nova Scotians!

What’s your role in your health Profession?

Certified Therapeutic Recreation Specialist (CTRS)

I am a Recreation Therapist by training, credentialed through National Council for Therapeutic Recreation Certification (NCTRC) as a Certified Therapeutic Recreation Specialist (CTRS). My primary role as a Recreation Therapist is to use recreation and leisure opportunities as a therapeutic tool. We consider the recreation interests and experiences of the individual we are working with, and we also take into consideration what their needs are or any kind of barriers that they experience that may be a consequence of their current health state. It really is about recreation and leisure and how we can make improvements to one’s overall health!

If you feel comfortable sharing, can you explain your experiences as a Black Health professional in your field?

I wish I could say it was easy. I was the first person of African descent to be a Recreation Therapist in Nova Scotia and I think with that alone comes a lot of expectations. We don’t necessarily have to explain the particular preconceived notions that some people may have of you when you go into these particular environments that you may not necessarily feel safe in. Healthcare is not something that folks of African descent are necessarily accessing or feel safe in those spaces, and for me that was a challenge that I had to overcome. At times, being the only one in the role that I was in, meaning that I was responsible for making decisions I was accountable for, sometimes you would have your judgements questioned, which made you think that you weren’t doing things right. So, for a period of time I second guessed my abilities to do the job and do the job effectively, but I quickly grew out of that and realized that I had the expertise and that there were opportunities for me to contribute in positive ways. I was reassured, as a result of my contributions by the reactions of the clients, which is, I think, what helped me to realize that I was doing ok and didn’t need to be validated by my co-workers because the work that I was doing with the clients spoke for itself.

Can you explain your experiences and ability to access health services?

I think as I matured, and because of my education, that made accessing health a lot easier, because I knew what kind of information I was looking for based on my own training. Of course, that puts you in a place of privilege because you kind of know, but at the same time your knowledge can be questioned by the health care professional, they may have some preconceived notions about you.

What tends to go well with me when it comes to healthcare is the fact that I try to equip myself a little bit when it comes to wanting to have the information that I need or that I feel that I need.

I’m not always sure that health care professionals sometimes think about the broader context of cultural competency. It’s really challenging because I think a lot of the times we are inundated with this information about cultural competency, and we think that “oh I took into consideration that this person is of African descent” and created this sort of checkbox system, but we don’t think about anything else that is going on in that person’s life. This is something that we could do better as health care professionals on a broader scale. If I’m a person experiencing a specific health issue, that may be one of many things that may be happening with me that has an impact on my health. So, if I’m caring for a parent, or I have young children, or I live in a really bad neighbourhood, or I don’t have a job, all of those determinants of health are what I think we need to be more conscientious of when we’re working with individual’s who specifically come from communities where there is a level of vulnerability or marginalization, or whatever terminology we choose, but they are just grossly impacted by a system that just wasn’t created for them.

How have you found/finding community in your profession?

It’s actually interesting because I graduated from my undergrad degree in 2000, and there were a few of us that went into Therapeutic Recreation and I’d say that we’re still very close today! We still connect, and so for me community in the profession begins there and having those key folks in my circle. The Therapeutic Recreation community is closely knit anyways, though at times I feel that I am a little removed from it now because of my current role, I know when I was in it there were fantastic mentors and professionals in the field that I felt comfortable connecting to and brainstorming and working with through professional organizations, which I think is really important. I think all students should become involved in their professional organization and maintain those connections as a professional. It’s very valuable for us to maintain that network so that we establish appropriate communities of practice but also having that continuous learning that comes from understanding what your colleagues are doing and how they are contributing to the field.

To read other professional profiles and and more about PLANS please visit the PLANS webpage.

Returning to the Birthplace of MicroResearch: Two Weeks in Mbarara, Uganda

March 5, 2019 Jennifer LeBlanc Leave a Comment

By: Shawna O’Hearn, Director, Dalhousie Global Health Office

While there is a high demand for training and learning about community-based research, there are few formal, structured training opportunities. Established in 2008, MicroResearch aims to add capacity to global community-based research by empowering communities to address their own unique health issues.

MicroResearch ensures small research projects will have a real impact on health. The training develops a local culture of inquiry while identifying and solving health problems. Collaborations are with institutions in Uganda, Kenya and Tanzania as well as new partnerships in Nova Scotia.

Group discussions, MicroResearch Uganda 2019

MicroResearch offers a two-week workshop with interdisciplinary trainees and local teachers who collaborate as instructors, coaches and mentors.

During the 2-week workshop, 20 to 30 participants are taught practical research skills in daily seminars. Small groups transform an idea into a research project with a knowledge translation plan
After the workshop, teams continue to refine their research proposal with their local and international coaches.
Proposals are submitted for review and upon approval, the teams begin their research.

While I have been involved with MicroResearch in various capacities and locations over the last eight years, this was my first trip to the birthplace of this program. In January 2019, I ventured to Mbarara, Uganda with Dr. Noni MacDonald to deliver the two-week training program to 30 eager emerging researchers.

Participants in the training program at Mbarara, Uganda

We worked with an incredible group of faculty connected to the Maternal Child Health Institute, including;

Jerome Kabakyenga is the former Dean Faculty of Medicine of Mbarara University of Science and Technology, Uganda and is presently Director of the Maternal Child Health Institute (MNCHI). He is also one of the founders of MicroResearch with Drs Noni MacDonald and Bob Bortolussi
Teddy Kyomuhangi is the Program Manager with the MNCHI and was introduced to MicroResearch as a participant in the 2010 workshop. She is now a teacher, coach, reviewer and onsite coordinator
Scholastic Ashaba is a psychiatrist who was also a participant in the 2010 workshop and now she is a teacher, coach and site coordinator
Francis Oriokot is a pediatrician who is a lead faculty member

Scholastic Ashaba and Francis Oriokot, Uganda 2019

During my time in Mbarara, I was honoured to work with experienced researchers and dedicated learners. I spent time with two individuals and documented some of our discussions capturing their passion for locally driven research and the importance of training and capacity building.

Odendi Gideon Robert

Manager of Mental Health Programs, Luzira Prison, Kampala, Uganda

Odendi Gideon Robert

Robert is trained as a registered psychiatric nurse and clinical officer. Through his work, he recognized the importance of mental health and completed additional degrees in counselling and clinical psychology. His educational knowledge is evident as we talked about his current role within the Ugandan Prison System. He is in charge of mental health programming for the only maximum prison (Luzira) in Uganda.

While this prison has a capacity for 1700 inmates, there are currently 4000 men and women housed here. There are visiting psychiatrists who are contracted to guide mental health treatment but much of this work is left to Robert and his team to assess, implement and evaluate.

With such a large clinical case load, his passion for research and evidence-based practice guided his commitment to be part of the MicroResearch training in Mbarara in January and February 2019.

Robert describes the MicroResearch training as detoxifing. He explained that

“during my education, teachers did their best but we did not develop well. We were in the hands of teachers who equally needed education. I grew up in a war area so didn’t receive the best education.”

He continues to explain that research was not part of education and grew to have doubts about his role in research.

As he looked around at the academic posters on the wall, he reflected that

“I didn’t even know what I didn’t know. When I look at these posters, I can see the research process and steps that we must follow. This training has removed doubt, allowed me to think more maturely and develop confidence in my ability to be a researcher. It has cleansed me to be an advocate for research and built my confidence that I can integrate evidence into my work.”

Robert has always believed that the community is the starting point for any part of change. Shaping the research questions with the community from the beginning will result in relevant research on local health problems. The second part of community engagement is returning to the community with results as part of the feedback loop. These steps are essential to successful research and addressing health disparities. He credits MicroResearch for giving him the tools to integrate knowledge translation into his work.

Robert continues to be driven by the question:

“what can I do to contribute to influence change and to improve the quality of life for those living with mental illness?”

Through this training, he expresses a sense of hope, direction and a future that includes an active role in research to guide his work supporting inmates with mental illness within Uganda’s criminal justice system.

Beatrice Katusiime, RN

Intensive Care Unit, Mbarara Regional Referral Hospital

Beatrice Katusiime

Beatrice is enthusiastic, committed, and driven to understand research as it applies to communities and health. Her eagerness to learn is contagious making her a perfect fit as a new faculty member within the MicroResearch program in Mbarara.

In 2018, she participated in the MicroResearch training and was part of a team that explored prevalence of self-prescribed medication in postnatal mothers. She was the leader of her team and speaks passionately about the development of the proposal. At the time, she was completing her Bachelor in Public Health and she credits MicroResearch as strengthening her research skills for her university training which resulted in her receiving the highest scores.

A year later, Beatrice is teaching in the program and a coach for one of the teams. She is driven to improve her teaching and research skills as she seeks feedback from her peers and students. She acknowledges her strengths and identifies areas for further work as she continues in this journey. Self-reflection and continuous quality improvement are key to a successful health and research career.

Beatrice references MicroResearch as a “knowledge reduction process.” She explains that individuals join the program with their unique lens, focus and specific knowledge. As they begin to work in teams, they start to learn from other professions and recognize that their approach to the problem is only one part of understanding the complexity of the issues. They must begin to reduce their commitment to their unique discipline and begin collaborating across professions. They begin to conceptualize the problem with the team.

“People arrive with many textbooks in their head but as they work together they synthesize and begin to develop one comprehensive resource to understand the problem and work with the community.”

We also discuss the results of research and we recognize that it is not uncommon to see results shared in international journals with high impact factors and community members do not benefit. MicroReseach is a tool to guide community needs with findings that can be translated into policy. It looks for solutions to local problems.

Beatrice is passionate about the voice of community in the research process.

“You have to go to the community, understand the problem and draft the proposal with their input. You cannot assume you know the problem.”

Beatrice is a registered nurse who works in intensive care at the regional referral hospital. She plans to start a Masters in Public Health. The MicroResearch community is fortunate to have a new faculty member with a foundation in community driven research who is committed to working in collaborative teams to address health inequities in Uganda.

To learn more about MicroResearch please visit the National MicroResearch website or the MicroResearch Nova Scotia website.

Thank you to the support from Academics Without Borders