Sunday 25 October 2015

week 4

Another action packed week. I had meant to write something earlier but technology has been playing up and also life has been very full.
Yesterday was Independence Day and for the last few days more and more Zambian flags and banners have been appearing everywhere- we actually spent the day a bit out of town through the drying landscape at a beautiful area called Monkey Pools. Here a small river has been dammed and pools made for swimming under the trees. The water was wonderfully cool though Zambian friends thought it far too chilly. There were huge dragonflies and bright scarlet smaller ones, butterflies of all colours, purple water lilies and fleetingly a flash of a brilliant kingfisher. We ended the day in a busy Ethiopian restaurant full of Independence Day revellers where the food was delicious- so it is not all work!
The groups at Chainama went very well this week - with us realising from the recorded observations that we needed to be a bit more pro-active in explaining the importance of fuller descriptions of the art work itself. There were some really interesting and positive reactions from the patients. One gentleman being "overwhelmed" by what he found in the room. Trainees are showing real insight as to how they can see the approach being useful in different situations. Another session with the Trainee Clinical officers on Tuesday afternoon - a smaller group as some on practical placements and some interesting feedback though it is of its nature a much less in depth training. The walk across the hospital to the College was not so overwhelmingly hot this week!
In Chainama  this year we are quite rightly being expected by management  to justify the value of our training.
The group at UTH brought some very interesting case work to the supervision group and the discussion was very general with group members showing real insights into the process. As well we did some interesting work on enabling stories to emerge in the experiential work. We had two half days this week with the 1sr year neuro-psychology Masters students. A lot of them come from a special education back ground which added a new dimension to the work and lead to some interesting discussion. This again is a very short introduction and I think some of them were disappointed they were not  at this stage receiving the full practice based module.
We are learning a lot from the trainees about the systems here and how issues of child abuse and "defilement" are approached and managed. We are always trying to keep our approach as open and responsive as possible which necessitates endless rewriting material and thinking on the hoof!
Lesley has been following up research support and on Friday after treating ourselves to a leisurely lunch we set off to a meeting with the director of MHUNZA ( Mental Health Users Network Zambia). Sylvester Katontoka. We have met before and he is a mercurial character with a burning passion for the cause. He has been and is involved in Government and International level negotiations, representing the  service users. We ended up, after an interesting taxi ride, meeting him near where he is staying as currently he is only getting round with the aid of crutches. It was a useful if far- ranging discussion and we have his support and co-operation for any feasibility work we can get funded.

So Friday found us pretty exhausted but pleased! During the week friends staying here had come to supper and a couple of evening saw 
us sharing a beer of two.  The purple of the jacarandas has been gradually replaced by the staggering brilliance of Flame Trees and though the ground is getting drier and drier the range of blossoms is still amazing and the scent of the Frangipani is wonderful. The tree next to where I am sitting is hung with still small hard mangoes. I don't think they will ripen before we leave sadly but I am really hoping to be  here long enough after the rains start to see the changes that will bring


Sunday 18 October 2015

week 3

So another week and so much has happened. The work started at Chainama Hospital in the big OT room and despite the usual nailbiting wait to see if anyone would show a very good selection of about 20 staff turned up. A really good mix of professions and experience, We had arrived far too early as Mr Manda who has been driving us wasn't sure of the traffic which can be horrendous. The drive passes through Ntendere which is crowded settlement area and at that time in the morning it is packed with children going to school, stalls opening, delivery trucks, mini buses and everything under the sun all crowding on to the bumpy dusty road. Some very impressive smart lady police trying to keep things moving, Zambian drivers in town seem mostly very accommodating and responsive allowing the traffic to move as best it can and negotiating roundabouts and junctions. Hooting is only used as a thank you, a gentle warning or a "Do you want a mini bus?"
Anyway back to Chainama - there was a long delay before the promised projector and screen arrived - thanks to the Physio department and we got  it fixed up. We had to do some rapid adjustment to our running order but the general tolerance and the interest got us through. The practical exercise as always really grabs people. We hopefully ended the morning with some arrangements for the practical work and some enthusiasm to get going. We were very hot and  I think the waiting and the uncertainty had taken its toll - we were exhausted and by the time we had had some printing of handouts done - everything take so long as there is often limited paper and ink and by the time we had fetched ours we were drooping badly! We did summon the energy to get Mr Manda to stop at Pick and Pay for some much needed beer!
The next day was to be a full day with the first practical group in the morning and the first of 3 sessions for trainee clinical officers in the afternoon. The practical session was as usual busy and fascinating - 2 new trainees turned up so that was a bit of a distraction but good stuff and patients clearly getting a  lot out of the experience. The midday heat walking across the dusty short cut to the college was quite a trial but taken slowly we arrived and found a lively chatty student group, very responsive and engaged. Wednesday is the full day at UTH with case feedback and art work and some theory which will be the pattern for the next 2 weeks. Interesting and thought provoking,
We have signed up to do a very brief introduction to the 1st year Neuropsychology intake on Thursday and Friday morning next week. The rest of the week was spent going through the work - refining material and starting to kook at grant applications for the next stage!
The nearest shopping centre is a 40 min walk and if you leave early enough it is manageable but a pick up to get home is essential - just too hot. Gossner where we are has successfully installed solar power so we are now not so off on and can keep the beer cool! We took an evening stroll round the vast and fortress like edifice which is the US Embassy just up the road and were horrified to see the fumes coming out from their vast diesel powered generators. Why don't they have a solar powered system? I am contemplating writing to Al Gore! Out for supper last night with some of amazing msumbos (Europeans) who have made their lives and work here - oh and on Friday we went to a fantastic food festival - delicious! So it is not all hard work and there continue to be wonderful birds in the garden.




Thursday 15 October 2015

week 2

So a week on and it seems like an age. A lot has happened both in the work and in just being here. Sitting here in the cool of the morning outside our bungalow it would be easy to just think we were on holiday! The garden is lovely despite the grass being burnt pretty dry. There are numerous birds that I have been somewhat fruitlessly trying to identify - long beaked sunbirds - little bright blue insect eaters and so many more. I just saw what was either a stork or a crane fly over and on our way to UTH ( university Teaching Hospital) on Wednesday the sky was quite full of large kites presumably finishing the nightly clearup. To add to the unfamiliar bird song we have neighbouring geese and peacocks over the wall!
We have spent a lot of time working on teaching materials, adapting our content to the new groups of trainees. We did our first day for the group at UTH on Wednesday. 20 mixed highly qualified professionals who are practising as psychologists, teachers and nurses and half are in the second year of their neuro-psychology Masters.. The course is a big commitment for them in their already busy schedule but there was a general enthusiasm to start using the practice gradually with their patients/clients. This week they will start bringing this work back for discussion and supervision in the group which is big part of how the skills are transferred.
We start our programme in Chainama tomorrow. Chainama is the main Psychiatric Hospital for the country and we worked there last year. This year we have very different trainees. 10 professionals working on the wards, nurses, social workers and Clinical officers and 10 nursing assistants and OT staff. In addition we are doing a shorter programme for trainee Clinical officers. The practical work in Chainama is in groups held in the big Occupational Therapy building where we worked last year.


So this week will see us trying out a full programme and adapting as usual as we go along! Power is a real issue, the regular power cuts seem to becoming increasingly random. Getting material printed and photocopied takes time - the local Post Net's printer and copier has not been working for over a week so this means another taxi ride to another shopping centre. Also we try to avoid using these for printing as Lesley already has had one stick corrupted and last year the same happened twice to me.
Beside all the working we have taken advantage of a Zambian / German/French musical week. Some of the visiting musicians have been staying here. Last Sunday was an amazing concert in the university chapel of sacred music from European and African traditions. Wonderful even though we got stranded after in the dark waiting for a driver as we rang the wrong number and ended up dragging someone away from his Church work party ! He forgave us! On Friday was a performance of the Magic Flute as you have never seen it. The snake was wonderful red and dragon like! Some glorious singing, quite an evening.

Sunday 4 October 2015

Blog 1    We flew into in Lusaka on 29th September – in the very early hours and following a long journey from Edinburgh to Amsterdam and finally Nairobi to Lusaka. Our purpose? - To take forward the Therapeutic Art training programme (a staff training programme we have developed over the last few years) - at UTH and Chainama Hospitals. This is the first time we have been in Zambia at this time of year – the hottest time! A lot of the areas of green in Lusaka have already turned brown and dusty – but the jacaranda is a sight to behold with its flowers burgeoning in a kind of misty purple haze.


Gossner Mission where we are staying is a haven and just now is feeling freshened after a dramatic thunder and heavy rain fall- releasing amazing scents from the earth and the many blossoms still around. This week we have been doing plenty of meeting and planning with the hospitals, and it really seems that we are personally welcomed and appreciated here with plenty of participants keen to join our training workshops and gain skills in Therapeutic Art. We are used to adapting our timetables to fit with Zambian staff and trainee schedules – And with some changes we have been able to finalise 2 training courses in 2 main Lusaka hospitals, which will train trainee psychiatrists, trainee neuropsychologists, nurses, clinical officers, social workers, ward assistants, physiotherapists and occupational therapy assistants over the next 6 weeks. We have a research arm of our training this year - well supported by the head professionals here -which is exploring how best our programme can be validated and then rolled out and sustained. We therefore have our work cut out and as is needed in training, therapeutic and research work, we need to have our eyes and ears open wide, to listen well and to be open to the challenges and joys of the unexpected….. This is what makes this work our passion – and it so refreshing again to meet the openness and enthusiasm for new approaches. We will try and keep track of this journey through this blog.
The view from our verandah