Day 10: Pediatric Centre of Excellence (PCOE)

Not a lot of photos today, but we had a great learning day at PCOE. To our delight when we arrived we saw a flyer advertising our training presentation for the afternoon!!

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We had about 25 people attend the presentation including several parents who learned strategies to facilitate language development in their young children.After the talk Sr. Ornella, one of the pediatric neurologists asked if we could possibly present it again to the medical students again tomorrow! If that is able to happen, what a great educational experience we hope it will be for the soon-to-be physicians, who are often the first point of care. We hope they may use the information to help counsel the families of the children they see.

From Erin:

Our day at the Pediatric Center of Excellence was very eye opening for me. This center offers aid, counseling, and medication for children with HIV and AIDS. Being from the United States, I don’t know anyone personally that has HIV or AIDS so this center really was overwhelming in the fact that most of the young children we saw today had this disease. I was able to sit in on multiple 6 month check-ups, observe the nutrition counseling that they provide for the families, and see adherence appointments where the nurses counseled patients on their medications and gave advice to the patient and caregiver. Most of the young children that I saw contracted the disease from their mothers during childbirth. Because they have had HIV their entire lives, it hasn’t yet been explained to them why exactly they are taking medications and going to the doctor so often. I was not aware of how bad the stigma was regarding HIV and AIDS in Africa, but have learned that many parents put off telling their children about their status because they don’t want to have to tell them that they gave it to them. 10 years old is the suggested age at which parents should disclose this information to the children. Even when the child learns about their HIV status, they are counseled to not tell anyone else because it is likely they will get bullied at school. However, today I saw 2 children who didn’t even know why they were taking medicine. One of the young girls had been told that it was because she had a heart defect, which really struck me because she thought she was dying because of her heart. She also mentioned that no one monitored her taking medicine and finally it came out that the young girl hasn’t taken medicine for HIV since April. The nurse even seemed devastated because this young girl doesn’t know how dangerous it is for her to not take her medicine. I witnessed the nurses practically begging the parents to tell their children about their health condition because the nurses do not believe it is their duty to do so. The parents are responsible for this but some fail to take action. During the appointments, I observed again how independent the children are in Zambian culture. The nurse or doctor spoke to the patient, even if they were 10 years old. The child was asked how much of each medication they took and at what times exactly during the day. In the United States it is very common for the parents to just answer for the child and I was amazed at the responsibility put on the child with something as important as this. Although I was reminded that because this disease is so reliant on medication it is important that the child takes responsibility early in case anything would happen to the parents. A nurse even asked a caregiver if anyone else knew about the status of her child just in case something would happen. I was also surprised at how the appointments were conducted at PCOE. In America, we have the full attention from the doctor and have complete privacy. Especially in patients with HIV and AIDS, I assume the appointments in the United States are conducted with a sense of confidentiality, yet here we were sitting in on these appointments hearing everything about the patient. This made me feel out of place and guilty for sitting in on such a private matter for this family, but have learned that this is normal in Africa and the appointments often are not conducted with full attention or privacy for the patients.

Whitney with Jerry at the Registration desk…

After our rotations at PCOE were completed, Ms. Masters and Dr. Krishnan gave a presentation on speech and language development to parents, staff, and members of the community. During the presentation it dawned on me yet again just how second nature stimulating language for children is to many people in the United States, yet these people could have been hearing this information for the first time. The parents who asked questions at the end of the presentation had a sense of desperation in their voice for answers regarding their delayed children and I could just see the heartache that they go through on a daily basis. Everyone seemed very appreciative of the presentation and we are hoping that this information can be spread to many doctors in Zambia so they can counsel parents on methods and activities that can be performed at home to stimulate language development. We go back to PCOE tomorrow and I can’t wait to learn even more from the amazing staff and from the eye opening experiences I know I will have.

Tonight we also packed our final lunches for the program! Our daily routine after the day’s work is to eat dinner, and then meet for a discussion of the day and prep for tomorrow – after we pack our daily lunches of PBJ sandwiches, chips, fruit and cookies.

Can’t believe that we only have two more work days left for the SLHS in Zambia 2016 program!!

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