Thursday, November 28, 2013

Harvest Plus Cooking Demonstration in Ryamiyonga

Health Education 
For three days in a row we have been out in the field doing cooking demonstrations as part of the Harvest Plus program establishing orange sweet potatoes and high iron beans in SW Uganda using Volunteer Health Teams.  The VHTs at the three sites we visited are among the best of the many Healthy Child Uganda (HCU) sites. 

VHTs and Their Community Members Gather
There are a couple of other NGOs working in the area on different issues with the rural health units.  One such group I just learned about is the USAID-funded SecuringUganda’s Resources for Essential Medicines (SURE).  The health units at Ryamiyonga HC II staffed by Nursing  Aid  Agnes and Kibaare HC II staffed by Nursing  Aid  Keneth are both sporting their prizes when I arrive. 
Agnes has a lovely bright green and blue T-shirt while Keneth has a similarly coloured cap because they won first prize among all the other rural HCs.  They proudly tell me that they are always winning the prizes because their health units are well run and managed.  I can believe it, as they both run a tight ship and I would also like to credit their training as Trainers for the VHTs at which they both excell. I tentatively suggest this and sure enough they agree with me. 
A Balanced Meal

Wednesday we are in Ryamiyonga.  Each VHT who attends has brought with them two community members, most of them mother with children under five.  The cooking demo has been slated for the same day as Immunization, so the mothers can also get their under fives’ immunized.  In addition to the invited guests the porch of the Health Center is packed with women and children, as many as 30 sit on benches. 
Shucking High Iron Beans
We have received a call from Keneth, the health worker, to pick up his vaccines at local HC IV depot.  This takes a while as they do not have a proper vaccine carrier and a box has to be outfitted with dry ice for the half hour.  Fire wood has been collected, peeling is started and the foods people have brought to produce a balanced diet are prepare.  This group has lots of OSP and organize to steam hem with their skins on.  I am not sure who we are demonstrating to because most of those attending are familiar with both beans and sweet potatoes.
Using the Harvest+ Poster
The coordinator, Angella, does a health education presentation on the Balanced Diet using the brightly coloured Harvest Plus poster she has brought.  She then asks one the VHTs to do a session on Vitamin A.  They seem reluctant, but one finally agrees.  Angella then demonstrates the flannel board story, Stone Soup, which highlights the food groups and properties of micronutrients, Vitamin A, iron and iodine.  She asks for someone to do a return demonstration and a young girl from the community steps forward, assisted by the group.  After we are finished, Agnes asks if she can get these felt pieces.  She tells me she has felt remaining  so I tell her I will make and send the patterns to her.  It is hard for VHTs to keep teaching the same health messages and new materials and new approaches are always in demand. 
Kigezi Basket with Banana Leaf Repair
This group has supplied beans and OSP from their own harvest, so time is spend shucking the beans.   They request but do not receive even token payment although beans have been provided by the project to the other groups.  It seems like penalizing those  who are most independent.  As well they have brought pumpkin, onions, potatoes, greens, Irish potatoes, small eggplant and sweet potatoes for a balanced meal.  I notice the banana bark “patch” in the bottom of the potato basket, a lovely example of thrift and the extensive use given even simple household items here.  
VHTs Sign Their HEd Songs
The VHTs sing a couple of their health education on Maternal and Child Health and their anthem about their own volunteering for the visitors, a way to remember all the details and information. So far they do not have songs about nutrition but we expect them shortly.  A group of local "raggamuffin" kids join us, listening carefully.  We hope they will at least be still around when the meal is cooked but by then they have all disappeared.  We need to find a way to get OSP to them too.
Plenty of OSP for the Community
Certainly as the OSP are washed and prepared it is obvious that there will be plenty for everyone to sample, even to consume in plenty.  While Ryamiyonga is high up on the hill and often cooler than other parts of this subdistrict, it has always been a fertile place full of hardworking farmers.
What a joyous evenT to celebrate. When we finally sit down to eat, Agnes, the health worker who supervises the VHTs in this area has finally finished her clinic and is able to join us.


Wednesday, November 27, 2013

HMEF Student Project Prize Winners, 2013

1st Prize, Rukunya
Saturday morning, November 23 at 8:00 am, student groups are already busily moving about the classroom mounting their posters on the walls.  Some have as many as 20 full manila sheets Often it is hard to find the name of their site on the posters.  Their places have been assigned randomly in advance by Moses Ntaro, the assistant coordinator of the Community Based Education Program at MUST 
It seems the examiners are going to be the ones who have to move.   This will not be easy as the classroom chairs are welded together in sets of four.  Nonetheless there is a sense of excitement in the room, among examiners and students.  I make a mental note that we are going to have to limit the number of posters in future.  It is going to be hard to hear seven groups go thru the Challenge model, one after the other. 
2nd Prize, Kisoro Hospital
The six student groups selected by faculty examiners as the best in their group  are from: Kisoro Hosp, Rukunyu, Ruhoko, Kabuyanda, Bugoye B, and Rubanda PHC.  Our job is to select the top three to receive the Hillman Medical Education Fund prizes.  The prizes will allow them to present their project at scientific gatherings outside of th university.  This is the second year the prizes have been offered.  The first year, not all groups were aware of the prizes, but this year, the visibility of  last year’s winners have helped to spread the word and the competition has intensified. 
I missed the assessments done earlier this year but it is clear that there is more polish to the presentations this year.
3rd Prize, Kabuyanda
The community projects we will be evaluating have been done by groups of multidisciplinary students drawn from medicine, lab, pharmacy and nursing.  The students spent 5 weeks in rural field placements throughout the South West of Uganda.  They were attached to Health Center III or IVs. 
We are interested in learning if and how they connected with the community-based health workers at the site, whether they engaged the community in the project, how they dealt with any setbacks and their sense of commitment to the community.  Many of the projects have to do with sanitation and construction of Tippy Taps and latrine covers this year.
Best Diagrams
All group members are involved in their presentations.  Transitions move smoothly between them, each having an active role.  They are dressed up and professional in their presentations.  I am most engaged by their answers during the short question period.  One group is superb, as they tackle each question adroitly, we examiners find a more difficult one for them. Our questions just seem to bring out their best.  What magnificent skill!   The ability to anticipate and handle questions is an important part of research and we are going to have to give it more weight in future.  Also a couple of the diagrams and maps are excellent, vivid representations that deserve recognition
Quality Map
 A week or two prior to this event, two student groups, the Kabuyanda Group and the group from Bukoko, wrote up and presented their projects as scientific papers at the Mbarara University of Science and Technology (MUST)Research Symposium.  They were the only undergraduates who presented and both did a spectacular job.  To do this takes a fair amount of time and commitment by their supervisor and one of the dynamic supervisors, Dr. Wilfred  Arubaker, assisted both groups. 

Latrine covers
At the same Symposium, I heard a well-presented paper on interocular pressure presented by former MUST student, now an Ophthalmologist, Dr. Simon Arunga.  Simon along with Dennis Mala facilitated a Cholera Workshop developed from their rural student placement a couple of years ago at the Towards Unity for Global Health (TUFH) International Conference when it was held in Kampala.  More than 30 people attended their workshop and they received rave reviews.  It’s a great reminder to me about how important student presentations are in developing skills that support us in our future careers.
Challenge Model
It is hard in such a group to pick winners, however when the scores of the examiners are tallied  1st prize goes to the Rukunya group; 2nd prize goes to Kisoro Hospital group and 3rd prize to Kabuyanda group.
The Kisoro group also a winner was last year.  Their faculty supervisor, Simon Rugera from Laboratory Medicine is justly proud of his groups.  It's a great day for celebrating the students, their supervisors and MUST University.


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