Winding up but not exactly winding down!

So these last few days are rushing by - so many leads to follow  and plans to make and it doesn't seem to be any cooler!
We got back on Monday from Kafue Park where we had spent a wonderful 2 nights - a mixture of excitement and serenity! Just for the avoidance of doubt for all our supporters any recreational time or activities is not seen as part of ZTA time! Though we did take some work with us!
Anyway a wonderful place -Mayukuyuku Camp  -and a very close sighting of lions and a bit too close of an elephant who chose to feed on the trees 3 feet from our tent at 2.0 am! Birds just amazing and a glorious evening boat ride. Really nice people with a wealth of knowledge and great food.
Back here we have caught up with key players in planning the next possible developments and looked through the art work and notes to start the process of evaluation which will go on at home. At UTH we had our final supervision session and were assured that the group will continue to meet as it fulfils a real need as support and learning for all their work.
The certificates were presented by Dr Paul, Head of Psychiatry who has been so supportive of the work and its continuation. At Chainama as well there is a determination to get a module designed to fit in the curriculums at the College, all very encouraging - more work!
We presented at a Seminar yesterday at UNZA School of Health Promotion who are very interested in creative communication approaches. Certainly when discussing the art exercise we gave them there was  a lot of communication going on!
It will be sad to leave Gossner where we have been so much at home and the mangoes here still are not ripe!  Off into the sunset!

Endings and what's next?

Just writing this today as we are off to Kafue tomorrow for a couple of nights hopefully to see some large cats  - but not too close - and for some out of town experience.  So we are just back from various meetings and an exciting visit to the bus station to get our tickets for the journey.
The heat makes everything very tiring to us northerners and just seeing the temperature at home is 9 degrees not the 34 we have here makes me quite jealous!

The week has been gratifying and busy. Lots of contacts about the future to follow up and time reflecting on the evaluations. There has been so much hard work and really interesting response from the trainees in both locations. A great deal about the change in relationship and communication, a real emphasis about how hidden stories emerge and how people find a voice through the  art . Also in writing about their own art making the trainees have shown great insight and honesty about what it has meant for them and consequently how important it is for their patients.

Tuesday was the day at Chainama to present the certificates and celebrate everyone's achievement. Dr Phiri the Senior Medical Superintendent, presented the certificates accompanied by senior staff from all departments. The art work and notes were on display and much interest was shown.
At the end - much to our surprise we were presented with a beautiful framed art work by Margaret who the very talented lady based in the OT department who has been our great support this year and last. Then in addition a wonderful Zambian dress each in the national colours again made by the tailors in OT Esther and Belita. It was very touching and I hope we were able to convey how much we have learned from all of them. There does seem to be a real determination to support and develop Therapeutic Art practice in various ways. We also had chicken and chips provided again for all.
We came home later to a wonderful meal of kapenta - tiny dried fish, nshima and vegetable relishes cooked by a friend who is staying here - Quite a day!
We had also to get ready for UTH and supervision and possibly presentations there and going through the evaluation with Dr Paul. We did not get the presentation done but got some really useful feedback and advice about the way forward from Dr Paul and an agreement to do the presentations next Wednesday as so many folk were not able to be around. The ongoing  Therapeutic Art supervision  group is a really informative process and the intention is to keep it going once we have left.
Thursday was continuing with planning, following up contacts and going though the work and notes. The day goes really quickly. You have to start early to make the most of the cool part of the day and keep yourself going through the heat with the help of fans and mangoes!
Today we had another follow up meeting with Sylvester at the posh shopping centre he uses as an office! Learning more about his plans and projects and seeing where our work overlaps. Very productive. So now we are packing - the forecast is that the rain will start but the bus journey promises to be hot.

So again this week has rushed by - I had determined to write up on Friday which was supposed to be home based day reflecting on all the amazing evaluation and assessment data we had gathered from both training sites earlier in the week -BUT an early morning and somewhat cryptic series of communications from Sylvester - from MHUNZA - we found ourselves rushing to a symposium to mark Dignity in Mental Health Day held at Chainama. I've never seen Lesley move so fast as she switched from domestic to public dress! It turned out to be a really useful and informative day and included a chicken and chips lunch! We were welcomed with true Zambian generosity as we were not on the official guest list.. There were presentations from the Ministry, Care providers and Users and from the Hospital itself. We got a picture of the planned developments in the service and the Hospital but also a perspective from the staff side, the area health providers and from Human Rights, service users and Legal Aid perspective. All in all we gained a much more rounded picture of the present position of the service and its aims and aspirations. So much hope is pinned on the passing into law of the Mental Health Act which is due for its first reading this year and which will provide the framework to support the planned growth of the service. The day also gave us the opportunity to meet with some of the key people we had on our list to contact -including two senior staff we had worked with last year- and so were able to confirm a planning meeting to discuss the future of the work in Chainama. So we got home late afternoon too overwhelmed to do much but reflect, cook and sleep!
Then yesterday the solar power system had a relapse and we were without power for most of the day. We spent our time struggling with our plans for the future - trying to define our aims and make best use of all the support we are receiving here. We rewarded ourselves with a walk to the road end, short minibus ride and a meal at the wonderful Lebanese restaurant with a friend who is staying here briefly and some newly arrived VSO workers.
To go back to earlier in the week - Monday was the last patient group in Chainama. A good and productive session again with a range of patients and ways that the time is used. Tuesday was full on! all the Chainama trainees turned up and we spent about 2 hours on the reflective evaluation which ends with trying to arrive at what they consider the most important changes for them and the patients. So much material. The Hospital sent someone to video the process but in our group we were so absorbed we barely noticed him. We will see the result next week! Most trainees chose to take the short written assessment and we spent the afternoon marking them which turned out to be not so daunting as the system we had worked out did seem to be effective..
Wednesday at UTH as well as a supervision session we went through the same process of evaluation and assessment . Ending the afternoon with a somewhat exuberant art group! The scribble warm up technique has really grabbed the imagination! More marking!

It is worth saying here that the temperature has dropped significantly by a good 15 degrees in 24 hours so we have had to resort to socks and digging out the fleeces. By the end of the week it had climbed back up to a pleasant mid to high 20s - but no real rain just one heavy shower.
Thursday was again full on and we were only able to survive it because of the lower temperatures. We had a productive follow up meeting at the Ministry of Health - more planning to do! We found a small print shop in a market area where they do colour and can print on card - so we sat in a café and finalised the wording for the various certificates then this poor guy spent over 3 hours getting the printing sorted.

We sat there for a while tantalised by the smell of all the food being prepared on the stalls around us but we had to leave him to finish as we had to go to the University Medical School to meet with a Lecturer in Public Health who Lesley knew of through her research. He was very enthusiastic and helpful with information and contacts and signed us up to do a presentation at one of there weekly seminars. So you can see why Friday was  so needed as a consolidation day! What will next week hold.

Making good progress

  Well, already we  are over half way through the training and it it so good to see how the trainees are really grasping how useful art is for  helping communication and understanding.  Hospitalized patients frequently express their appreciation in having the opportunity to  join in the art group  ---  away from the ward for an hour  or so, and with some 1.1 time with a staff member. I particularly feel for the younger ones  who may come --  teenagers who are missing home and school. At least in the group they have the chance to do something familiar  - drawing and writing.


 Groupwork  has been part of some of the trainees experience - they were amazed they could create a whole town plan in 20 mins --  and recognised how ideas can be generated better in a group and  that different  individual priorities could be a focus for reflection.  

 We are now turning our focus to the end  of the training  - which  will be on us before we know it! -- so have been fine tuning the evaluation  process and the  assessments . Gathering data for the research arm of this work  is also to the fore.  We want to measure the efficacy of this training  so that it can be put to best use, here in Zambia. Many health and development programmes fail  simply because they  do not listen  enough to what is needed and adapt their inputs accordingly.  Our approach is to continually reflect on  our work and adapt  the training accordingly. While their are obviously some cultural and language  difficulties in communication, we do our best to minimise these effects.

 Home life is therefore a tapestry of  discussions and writing, as well as eating and sleeping -- with an occasional walk round the garden once the temperatures drop a bit later in the day. Our office space is the dining table ---, but we do long for a printer.. as getting any printing done is dependent on their being  power on at the local post.net at Kabalonga or hospital resources  - which often have shortages of ink.

  Yesterday we had a morning out  -  at the Dutch Reformed Church monthly market. Due to our lack of exercise through the week we started early and walked  the 20 mins to the nearest minibus pickup. Thankfully our journey - squeezed in with everyone else in increasing temperatures was short. The market is a rich array of  crafts, furniture, beautiful bedding and clothing made from bright chitenge material, vegetables and fruits and  a wide range of  food and drink ---  and a shady place to sit under the trees. Christmas presents were on our minds, and with a fair bit of bartering -- we managed to pick up  some nice things.

 Overall  a good week of training  - with some useful leads as to how we  may be able to make this training even more widely available.....