Well it’s official! Day one of the
training has come and gone and I am happy to say that despite a late start,
everything went off perfectly. Dr. Goedken arrived early yesterday morning so
we met all afternoon to arrange last minute details with Dr. Dawit and Dr.
Hezkiel. Dr. Dawit, the principal investigator on this project, has been
traveling all over for the past few months and MIA in terms of the project (why I have been working exclusively with Dr. Hezkiel). Dr. Dawit was initially in London on vacation, followed by Canada conducting a training session,
and then in Colorado as his expectant wife was awaiting delivery of their first
child, so we had a lot to catch up on. Of course, despite the fact that I had
sent out schedules and lectures almost three weeks ago, begging for approval and
feedback, this was the meeting in which they wanted me to rearrange everything.
So I busied myself with a to do list, being the good administrative assistant
that I am, and tried to calculate in my head just how little sleep I would get
in order to finish all of this work. After a quick coffee, we headed to Black
Lion to set up the simulation lab with all of our materials. The lab where we
are holding the training is a surgical skills lab donated by Johnson &
Johnson and is absolutely gorgeous. It bears no resemblance to the dilapidated
facilities it’s contained within and is constructed entirely of marble. Even
the tables are marble topped! It contains projectors and screens, flat screen
TVs, and laparoscopic equipment. It’s hard to believe this exists in Ethiopia, but thankfully for us, it does. At a small fee of course.
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| The simulation lab where we are holding the training |
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| Our training materials. |
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| Our visual aides for learning VIA. Every participant got one of these to put in their respective clinics. |
Once
we had set up our pelvic models, notebooks and charts, we headed to the grocery
store to buy some extra supplies to outfit our clinics. Since we are trying to
treat this VIA screening as a portion of an overall reproductive health checkup, we wanted to
supply the women with condoms and sanitary napkins. Luckily, our budget is
pretty extensive so we felt comfortable outfitting the hospitals with a
substantial number to utilize after we leave. Not so comfortably, at least on
my part anyway, we bought 600 condoms and almost 500 sanitary napkins. So here
I am, being my awkward white girl self in Ethiopia, strolling the supermarket
with a shopping cart filled with multiple economy sized boxes of Sensation
condoms, ribbed for extra pleasure of course. I got a few stares as did Dr.
Dawit and Dr. Goedken who were with me. As Dr. Goedken said, they probably
wanted to know how this Ethiopian man scored two Farenji women. That of course,
made it even more awkward.
I spent the evening at Lime Tree, with Dr. Goedken and Alisa, the PGY-4 OB/GYN
resident, catching up, and I, stuffing my face with pizza and chocolate cake to
soothe my nerves and frustrated anxieties. All the while, I am praying that
Friendship supermarket doesn’t close so I can run to and buy multiple packages
of hot dogs that we will use tomorrow to train the residents in cryotherapy.
Apparently the end of a hot dog looks like a cervix and mimics the consistency
of human tissue, who knew? Luckily, my amazing roommates were able to grab some
for me and I could breathe easy knowing one of my tasks was done.
I
finally got home at around 9:30pm and quickly got to work creating two new
lectures, amended two old ones, re-writing the schedules, going over my
presentations, and resending all of this material to those involved in the
training. Of course during all of this, my internet wireless stick ran out of
money and stopped working and I almost fell asleep multiple times, but finally
around 1:30am, I finished my list. I wish I could say I crashed into bed, but my
nervous energy kept me bouncing around until my alarm blared at 5:30am. Off to the
Desalegn Hotel I went to meet Dr. Goedken for breakfast and to discuss other
concerns we had. On the way, I received a phone call from Dr. Goedken telling me about even more
changes that I needed to make, so I busied myself on my computer in the cab
ride over. My driver told me I work too hard and wanted to know when I was
going to focus on having babies instead. Oh dear.
I’ve
had a lot of time to reflect on Discovery over the past couple of months and
have realized that my project really has nothing to do with medical research despite what our curriculum says.
In reality, I have spent this summer experimenting as a glorified
administrative assistant. I have made schedules upon schedules, set up meetings
and canceled meetings, facilitated purchases and deliveries, printed literally
thousands of sheets of paper just so that when my attendings meet, I can
literally redo it all again to their liking. I have dealt with people being
unreachable, with people talking down to me because I am a medical student, and
simply put a smile on my face to get the job done, but even now that it is almost over, I can’t
say that I’m relieved. It could be the lack of sleep talking, but I am pretty frustrated that I almost feel as if my role in this project has been
viewed as inconsequential. Regardless, the project is not about me and is
really about the women here, but still, it’s hard not to feel a little let down
after all this struggle and so little recognition.
Dr.
Goedken and I quickly ate our breakfast and met with Dr. Dawit in the lobby. Of
course, even though it was 7:30am and we needed to be at the hospital at
8:00am, he insisted we could have coffee and still be on time. Sure. At 8:20am
we arrive at the hospital and I run up the stairs as our training is scheduled to
begin in 10minutes during which I need to set up the projector, print the
schedules, set up the room, and overall prepare everyone for the day ahead. Of
course this entire time, I am being admonished for my lack of flexibility and
inability to conform to “habesha time,” but I find the whole idea so
ridiculous, I can’t budge unless in a completely disgenuine way with a strained
smile on my face. I understand the need to assimilate to another’s culture when
trying to enact change, but the idea that you have to budget an extra hour into
a training, a training that you have spent literally thousands of dollars on to give free
medical training to residents, because they will all be late (for no good reason
either, mind you) is absurd to me. Also, when planning yesterday, we were told
we needed to buy notebooks, pens, and bottles of water for every participant as
this was expected from presenters. I think they forgot to note that this is
what is expected from white presenters. Anyway, I digress.
At
9:30am, the residents begin rolling in and much to my amazement, all nine
senior OB/GYN residents, 3 nurses, and two attendings were present, meaning we that we are training a total of fifteen people. We began our day with introductions and
lectures, discussing the pathophysiology of cervical cancer, counseling women,
and even doing role-play (with me as the Ethiopian woman of course) so that the
residents could practice answering common questions. We even had two tea breaks with
coffee and cookies and a wonderful lunch catered to us! I couldn’t believe that
so many different components came together so nicely. Despite our late start,
we finished a whole hour early, much to the joy of the residents.
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| Dr. Goedken giving the first lecture |
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| Dr. Hezkiel lecturing about HPV and cervical cancer |
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| Dr. Dawit lecturing about the pathophysiology of cervical cancer |
The afternoon was spent freezing hot dogs as practice and more grocery shopping. Tomorrow we are starting the clinical practice portion of the training, which is the last big hurdle of this week. Hopefully all will go smoothly and we will have patients actually show up to clinic! Keep your fingers crossed.
As
my eyes are sagging and my stomach is in knots, I am having trouble balancing
my thoughts of pride in the success of the first day and the frustration I feel
as I am used as a menial laborer. I know it’s the role of the medical student,
but it’s hard to swallow at the end of today. Despite my best efforts, this project
has become really ingrained in me and to feel as if I no longer have control is
difficult. I guess it’s a good lesson to learn as I continue on in my training,
but today I am feeling a little worn out.
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