Edendale

On Monday we arrived in Edendale early and were greeted by Joy Van der Plank who works with a program called iTeach. iTeach is a nonprofit organization that trains nonmedical personnel to screen potential TB and HIV+ patients on the wards. If a patient tests positve the iTeach "warriors," as they are called, guide the patients through their clinical workup. In the morning we attended the iTeach weekly morning meeting, where each warrior shared statistics of the previous week's patients. After that we had a tour of two medical units that treat TB patients, including the isolation rooms. On these wards the sickest patients were closest to the nurses station. We had the opportunity to meet with nurse managers and discuss various medical topics from HIV to diabetes to TB. We compared and contrasted practices in South Africa and the United States.

After the morning, we headed back to the iTeach office where Joy invited nurses from around the hospital, including student nurses to attend an hour long diabetes lecture given by our own Jillian Baker. It was interesting to hear about the obstacles diabetic patients face in managing their disease. Many are unable to do daily finger sticks because the equipment is too expensive. We tried to share practical tips for managing diabetes in such situations. We ended the day by attending a session on the updated South African guidelines for ARV treatment at the TB clinic. The most significant aspect was that D4T will no longer be used as a primary ARV medication, unless the patient was previously taking it without complication. We then boarded back into our van for the hour long trip back to Durban, making sure to take in the beautiful countryside.

Tuesday we traveled back to Edendale to visit the Edendale College of Nursing. We were warmly welcomed by the principal of the college, Clementine, as well as the faculty. After meeting the faculty and learning about their respective curriculum, we headed over to the auditorium packed with faculty and students to engage in a panel discussion about nursing training programs in South Africa and the US. We were taken aback by the greeting they provided us with. About 20 first year students stood up on stage and sang a traditional Zulu gospel song. It was incredibly beautiful. We have attached it so that hopefully you can enjoy it as much as we did, but no video could do their performance justice. The president of their student organization prepared a detailed description of the nursing program from a student perspective for us. Afterwards Jill, Meredith and Candice described our curriculum at the MGH IHP and talked a little about nursing programs in general in the US. We also fielded any questions they had. It provided for a very interesting discussion regarding the difficulties nursing students in South Africa face. Examples include, the patient load they take on because of short staffing, lack of equipment and resources and the acuity of patients they see as novice nursing students. We ended the day with a tour of the campus. The campus is beautiful and we left feeling fortunate for how much access to technology and resources we have in the US.