Category: Dr. Julie Thacker - Exeter Wollega Link

Exeter Wollega Link

6.58pm - it's getting dark in Nekemte, by Dr. Julie Thacker

21/4/2015

The last 2 days have been incredibly hot - even the locals think so! When the temperature dropped to 30 degrees, it felt really comfortable!

Another busy day for us all today. Angela and Ian led another morning of Doctors as Teachers, ably assisted by Callie, Nick and Dan. Joe, Timo and Annie led more simulation training for the GP's. This afternoon, Nick and I walked down to the hospital for our pre-arranged teaching with the year 3 students, this time on the cardiovascular system. We began with groups of about 8 each and ended up with about 15 each! We saw some fascinating medicine and really enjoyed learning with the students. The others spent the afternoon teaching the year 2 students on examination of the respiratory system. They then joined us at the hospital and we walked home together through the town. We all stopped for a delicious juice at the tiny juice bar next to the hotel.

Students from both medical schools making friends with one another at the hospital

Nick and Ian loving the juice bar!

Team 2 arriving this afternoon, by Dr. Julie Thacker

19/4/2015

I am writing this sitting in the back garden of the hotel. It is just after 2pm local time (12pm in the UK. The hotel restaurant is full of local people in their best dress, enjoying a weekend dinner together. Behind me is the coffee room where a lady constantly brews hot, strong buna coffee over a little fire. She burns incense on the fire too, so the whole garden is filled with magical perfume.

It is noisy in Nekemte today! There have been several weddings and the wedding parties drive around town in decorated cars and trucks. Everyone that sees them honks their car horn and cheers. It is deafening, but a very happy sound!

Our team member, Tom, left for Addis this morning. We were all very sad to see him go, but unfortunately, he has to go back to work next week. Happily, 3 of the GP's that have befriended us are travelling to Addis today too, so he has good company for the trip.

The big excitement is that our colleagues from home, Team 2, are arriving this afternoon. They are Dr Ian Fussell (Community SubDean), Dr Nick Walker (GP), Angela Lait (Clinical Skills Tutor), Callie Simmonds (year 4) and Dan Nash (year 4). We will not be able to let the grass grow under their feet as our Doctors as Teachers course starts at 9am tomorrow morning in the University. We will have to spend this evening working out how to divide the workload between us. While Angela and Ian deliver the DaT course to the Wollega GP's, the rest of us will be teaching the Wollega students, so that they do not miss out while their teachers are busy with DaT. Dr Eba has asked if we could include the teachers who teach medical sciences and microbiology in our sessions. All welcome - the more the merrier!

Timo, Annie, Callie and Dan are hoping to work on a medical ethics programme with the Wollega students. Hours of work have gone into the preparation of the resources for this - well done guys!

Here is a picture of Team 1 before Tom's departure this morning.

Team 1 (Left to right: Annie, Joe, Timo, Tom and me)

Greetings from Ethiopia, by Dr. Julie Thacker

17/4/2015

We are in Nekemte, Western Ethiopia!

This time I am accompanied by Dr Joe Collinson and Dr Tom Brown (F2's) and Timo Tolppa (year 4 PCMD) and Annie Wood (year 3 PCMD). We are Team 1. Team 2 are arriving in 2 days time. They are Dr Ian Fussell (Community SubDean PCMD), Angela Lait (Clinical Skills Tutor PCMD), Dr Nick Walker (GP), Daniel Nash (year 4 PCMD) and Callie Simmonds (year 4 PCMD).

By staggering our visits, we have managed to cover nearly 3 weeks of the University of Wollega Medical School term time.

So far this week, Tom and Joe have been doing a lot of work, teaching the year 2 and 3 students how to manage an acutely ill patient, using simulation - something that the students have never done before. It has gone down an absolute storm! They have also been teaching this to the junior doctors that teach the students. By the end of this morning, the Ethiopian junior docs were putting Joe through his paces. They have really enjoyed learning this new method of teaching and we hope to support them further next week as they embark on using it with their own students!

Timo and Annie have been very busy meeting with the Wollega students and learning about the way that they learn medicine here in Ethiopia. There has been fast and furious exchanging of email addresses which will enable our students and junior doctors to stay in touch with their Ethiopian counterparts, when the visit comes to an end.

We have made many new friends already on this visit and we are looking forward to carrying this new friendship forward in the future.

Tom and Joe in action teaching the Wollega Students!

The Wollega junior doctors leading the session, with Joe as the student.

I have spent time meeting with the senior medical school and university staff here. They are only too keen to share information and ideas with us. We have spoken at length about setting up research links with the medical school here, which will be of huge benefit to both sides.

We have talked about our next visit which will be dedicated to assessment, scheduled to take place in autumn 2015. We have also started talking about our third visit which will be to run a national educational conference. Dr Eba, Vice President of Wollega University, is especially enthusiastic about this. We are hoping that there will be presentations and posters from both sides - it is a really exciting project!

End of session feedback - junior doctors from both countries working together.

Like on our last visit, we have been overwhelmed with kindness and hospitality - so much so, we are starting to avoid meals if we are to avoid bursting!

Tomorrow we are hoping to run a mini specialty half day on diabetes; with a talk on long term management, lead by Timo and Annie, some simulation scenarios, lead by Tom and Joe and I will be doing some bedside teaching in the hospital next door.

I'll keep you posted!

Breakfast in Ethiopia before another busy day - left to right, my lovely Team 1, Tom, Joe, Annie and Timo.

I've added some pictures to give you a flavour of our visit.

Yours
Julie
Hospital SubDean Truro

Ethiopia Videos from Dr. Julie Thacker

3/5/2014

Dr. Julie Thacker has shared some videos for everyone to see of her recent trip at Ethiopia last month. Please watch the videos and read the corresponding segments (written by Dr. Julie Thacker).

Driving between Addis Ababa and Nekemte, Ethiopia. April 2014

The journey from Addis to Nekemte takes about 7 hours by 4x4. The road is tarmaced all of the way now - when Rob and the students went it was a much harder trip.
Addis is on high ground, high enough to get altitude sickness, with a lower plain between the two. The mountains are very beautiful - lush and green. You pass through many villages and little towns on the way - you see some in the videos. Cattle, goats, dogs, people, hyenas and I even saw a monkey, wander across the road, taking their lives in their hands...

Palm Sunday Procession. Nekemte, Ethiopia. April 2014.

I heard the Palm Sunday Procession from my room at the hotel and ran down to watch. So many people were singing and dancing - it was a joyous occasion. If you look closely, you can see many people wearing head bands made of palm leaves.

Wedding in Nekemte, Ethiopia with bajaj taxi guard of honour! April 2014.

I also heard the sound of the wedding procession from my room, while I was preparing a lecture. One of the bajaj (little taxi) drivers was getting married. His friends provided the guard of honour for him. It was funny, sweet and uplifting to watch, all at the same time.

Early morning view from the lecture room. Nekemte Hospital Ethiopia. April 2014.

The view from the lecture room is my favourite clip, taken at 8.20 in the morning. It was so beautiful and peaceful and also not too hot, as the sun was still quite low in the sky. I taught here a few times; once with Rob in a joint session on renal disease.

It's Hot, Hot, Hot in Nekemte Today....., by Dr Julie Thacker

12/4/2014

There was a huge thunderstorm overnight - crashing, banging and lashing with rain. Still managed to sleep well - the heat seems to leave me shattered at the end ofthe day. Anyway, woke to beautiful blue skies and a very busy Nekemte. The call to prayer started early - most Ethiopians are orthodox Christians and many attend church on both Saturday and Sunday. I tucked away a delicious fetira (pancake with honey) and chai and set off for the hospital lecture room, ready to start at 8.30. When I got to the hospital, there was a large crowd of people surrounding the hospital gates. The gates had been barred and no one was allowed in - when the hospital is full, it is full and that is that..

I sat in the doorway of the lecture room for a few minutes while the students were getting their books out, looking out over the view of Nekemte. The birds were singing and we were surrounded by lush greenery, coloured with bougainvillea and hibiscus. Not a bad place to spend some time learning with a great bunch of young people!

The students had asked to do a session on diabetes, following on from a young patient we saw together on the ward yesterday. 28 years old, diabetes for 10 years, under treated for most of that time due to all the difficulties of managing this condition here, now presenting blind in one eye, with what looks like end stage renal failure and congestive cardiac failure. This appears to be all too common here and getting worse as the Ethiopians westernise their culture.

We had a great session - lots of hard work, but lots of laughing too. After we were done, we all walked back to the town centre where I am staying. They think my big floppy hat is hilarious - they may have a point! By the time we had started to walk back, the sun was high in the sky. - it was baking.

I spent the rest of the afternoon hiding in the shade of the Internet cafe, working on our report of the visit.

Looks like another thunderstorm may be on the cards for tonight...

Yours

Julie

Busy Day! by Dr. Julie Thacker

11/4/2014

Another busy day. Went to teach on ward to find I had been allocated 16 students for bedside teaching in one group. It takes a long time and a very patient patient to endure that many goes at listening to the heart, including me!
Great bunch though - lots of laughs.
This lady enjoyed being part of the teaching!
Rob off early tomorrow - he has donated his left over bananas as a parting gift.
See you all soon,
Love,
Julie

Note: Some faces in this photo have been blurred for privacy reasons.

Ethiopia… & Photos of Wollega University, by Dr. Julie Thacker

9/4/2014

Actually, as Ethiopia works on a different calendar to us (including 13 months per year), today's date is 30th July 2006 or 2007 (not sure of the year...). Also, their clock day starts at 06.00am, so what looks like 7am to us is 1am to the Ethiopians. Added to that, Ethiopia is 2 hours ahead of GMT. This makes arranging a time to meet up, for teaching or something, a serious challenge.

Rob and I taught this morning on renal failure. I did the clinical bits and Marshall raised the academic bar by talking about the histology of glomerulonephritis. Once again, the students threw themselves into it completely and worked very hard. We could all learn a lot from their work ethic.

I've spent this pm trying to clear up the mass of emails that have just about crashed my home email account and beginning to write a report that Rob can combine with his to send to all the important bods to keep raising the profile of the link.

Hopefully, tonight will be quiet - we have had a lot of evening meetings to make the most of our time here......cos I'm whacked today!

Yours

Julie

Photos of Wollega University

Click on the photos below to view actual size.

It's 15.08 Ethiopia time, by Dr Julie Thacker

8/4/2014

Rob and are are just cooling down after a morning touring the University Campus in 80 degrees! We had a great meeting with Dr Eba, the Academic Vice President of the University. He is as keen on getting our link established as we are, which is great news. The University Campus is home to 11,000 students, across all the faculties. I was interested to see the ambulance they keep on site in case of emergencies, but I suppose the campus is like a small town, so needs it's own ambulance - although it feels strange. The campus also has it's own medical centre, complete with space for students to be admitted if required and on call medical staff overnight. I saw a great pile of iv ceftriaxone on the pharmacy. I asked Dr Bilisuma if they gave first dose iv's here before students were admitted - he said that they could put a cannula in, give the iv's, then send the student back to their studies with instructions to return for their next dose!

I think we may have to work on toughening up our UK students...

Rob and I are teaching together tomorrow, which will be fun, then I am doing bedside teaching all afternoon on CCF. Should be good....

Yours

Julie

........Go!! by Dr Julie Thacker

7/4/2014

I have had an amazing day today!

Had another lovely breakfast of fetira. Tried another cup of coffee, but have had a tachycardia ever since...

Managed my first ever solo trip in a bajaj without sustaining any injuries.

Taught for 3 hours on the ward this morning and for another 2 hours this afternoon, about 18 students in all. The students are a fantastic group of people - very hard working, keen as mustard and just so grateful for any help at all that we can give them - I have found it a very humbling experience.

It was a bit different for them, they are used to being taught in a completely didactic fashion, so being taught in a question and answer type way threw them at first - but by half way through they were asking me loads of questions about everything which was great. A couple of the nurses came and joined in too, which was also really good - they wanted to see and hear the physical signs and also spent time asking (very good) questions.

Rob has photocopied loads of copies of the clinical examination booklets that our students made for them today, so we should be able to hand them out tomorrow. I have been asked to give a lecture on renal failure on Wednesday. I tried to explain that I'm not a lecture type of gal and would prefer to sit down with the students and learn together, but I'm not sure that was understood, so we'll have to see how it goes. Hopefully, it'll be a Marshall - Thacker double act!

Yours

Julie

Ready, Steady…, by Dr. Julie Thacker

6/4/2014

Slept like a log once I'd got my mosquito net to fit the bed - I have discovered that a copy of the Oxford Handbook of Clinical Surgery makes a brilliant wedge. Slept through the 4.30am call to prayer from the local orthodox christian church - Rob could not believe it.

Had a fantastic breakfast of fetira (looks like fried flatbread with honey drizzled over it and coffee - 2nd cup in 12 years - I'm gradually getting my taste for it back. So bombed by the coffee, we quick marched to the hospital to look round. We had a tour from Dr Asfar, the internist who is in charge of the students. At one point, he showed me a side room with blacked out windows. He asked me what I thought was treated in there. I guessed meningitis, but the answer was tetanus. They have cases so regularly, they have a designated room. He coudn't believe it when I said I had only ever seen one case in my life!

There is a medical ward (many more men than women - apparently men tend not to want to make a fuss if the women of the house get ill), surgical ward (lots of sigmoid volvulus due to high fibre diet), paediatrics, obs and gynae (very few hospital births but lots of ca cervix secondary to HIV), neonatal unit with a resuscitaire and a couple of warming cots,ED with approx 40 attendances per 24 hours (mainly acute shortness of breath secondary to pneumonia, heart failure secondary to rheumatic heart disease, and trauma from RTA's and fights. There is an OPD, with an appointments system for some patients. Psychiatry patients are treated on the medical ward - mainly depression and anxiety and quite a few young cases of DSH.

Drug prescriptions are free for HIV patients and TB patients. Prescriptions are also free for pregnant women. HIV patients are supported in the community by carers that seem to be organised by NGO's in the area.

After the tour, Dr Asfar arranged for me to teach for 2 hours tomorrow morning and again in the afternoon, 16 students in total. He has asked me to teach on stroke, so fairly safe ground!

We spent the afternoon going for a long walk around the town, trying to get into the more rural areas so Rob could spot for wild birds, with some success.

We celebrated with a delicious mango, avocado and papaya juice (in layers - very cool) at the juice bar next to the hotel.

Now for dinner and early night - tomorrow it's time for me to deliver....

Yours

Julie