Friday, April 24, 2015

That Escalated Quickly

Originally, when Jessica came to us with the idea to host blood pressure clinics within the community, we were excited to begin this small, yet important project. What we didn't know was that the small clinics we envisioned would turn in to two large clinics and a even larger event. 

This project started as a result of research Jessica and Fay had participated in in Mongu District between 2011 and 2013. Coming here then she had noticed the same trend we noticed this year - that there was an alarmingly high amount of people that had high blood pressure. We knew from school that the prevalence was higher in Africans, but Jessica and her team aimed to gain qualitative and quantitative data in our specific area.

This study, taking place in Sefula, Limulunga, and Mongu (all Mongu District at the time) found that about 33% of people here had high blood pressure. These results are shocking - it means that 3 in 10 people here are at risk of developing complications such as a stroke, a heart attack, kidney disease, or even death.

The study also looked for causes of the high blood pressures. The main things they found were that the diets contained a lot of salt, people were cooking with a lot of cooking oil, and people were not active enough. They also found that medication adherence was a problem either due to lack of education or poor availability of drugs, and that almost half the people here had never had their blood pressure taken before. This made us realize that high BP (or hypertension) was not getting the attention in this community it deserved.

Knowing these study results, we wanted to create a way to not only disseminate the information back to the communities from which it came, but to deliver it back to them in a meaningful way. The way we decided to do this was by hosting these blood pressure clinics. We felt that taking a health promotion approach to this was very important. We also knew that these events would provide us the opportunity to provide individualized patient education as well as gain new data to compare to our past research.

To put on these events, we recruited the help of not only our fellow UBCO Students, but the Zambian Enrolled Nursing (ZEN) Students here as well. This was a total of 64 students! And though the Zambian students had just started their education in the new year, we knew that their cultural insight and ability to translate would be huge in both planning and hosting these events (and, in the end, it turns out that they had pathophisiology knowledge to rival our own!).  

Working with the ZEN students was very rewarding. With the help our our student leader from ZEN school, Nyambe, we were able to watch the students grow and build confidence over these events. Also, knowing that hypertension is under appreciated here, we felt that we were able to hopefully make future change by helping to teach the health care providers of tomorrow of the importance of BP, today.

We formed great relationships with the ZEN students, and by the end of the experience were able to call them our friends. This was not only great for us, but will help when future Canadian nursing students come to their hospital in the next years. Hopefully, the collaboration between these two groups can continue to develop. 

Armed with Canadian and ZEN students at our side, we started planning the events. We knew we wanted to keep Sefula and Limulunga smaller events, but the more people we talked to, the more our Mongu event grew. Specifically, in our meetings with the District Health Office, the Provincial Medical Officer, and with our colleagues at Lewanika General Hospital, the excitement around our event grew so much that we felt that our event planning capabilities were really about to be put to the test.

Suddenly, in a span of three meetings, our Mongu event grew from a table under a Mango tree on the main street of town to an advertised event hosted at Community Hall. We were now planning to have six stations, three Clinical Officer Areas and a mobile pharmacy (for on site treatment), and a guest of honor - no other than Mayor Tombi himself. 

Though we were feeling overwhelmed, and though time was stacked against us (we only had three weeks to plan!) we knew hosting this event was the right thing to do. Over the years, our Zambian colleagues have been so welcoming and so accepting of us coming to practice nursing here. They have given us so much of their time to teach us, inspire us, and show us medicine in Africa. Therefore, we knew it was time to rise to the challenge that they set before us. We knew it was time to give back.

In Sefula and Limulunga, we saw a combined total of 241 people in a span of two hours. And to support our past research, the high BP prevalence rates in these areas was still an astonishing 33.8%! Though these two events were important, we knew they were smaller events that were helping us prepare for Mongu. Through them, we were given a taste of the communities desire to not only learn about high BP, but to become empowered to take their health in to their own hands. This inspired us, and motivated us for our upcoming Mongu event.
Then, after weeks of planning, our main event finally arrived. And we were thrilled with our end result! Throughout our day in Mongu, we saw 242 people in two and half hours. Here, we found a prevalence rate of 37.2%. And with our onsite treatment area, we felt we were able to help people on a whole new level.

As mentioned, one of the main purpose of these events was to disseminate our research back to the communities. So often with research, it is conducted, but the results are never appropriately communicated to the people that matter. In this case, this was the community members. We wanted everyone to know that we knew high BP was prevalent in their town, and that we were just concerned as they were. We wanted them to know that we understood it was hard to access health care and medications, which is why we had on site treatment at our event. And most of all, we wanted the people here to know both through our research and these events that we cared about them, and that we were hoping to make a positive change in their community. That is why through our events, our goal was to disseminate our research through action.

Another goal of ours was to raise awareness. We had the research to prove high BP was a problem, and we wanted it well known so the policy makers could start to make change. That why we were so thrilled that at our event, radio stations, television stations, healthcare professionals, and government officials were present. The Mayor of Mongu called upon the government to take a stand on the issue of high BP, and said that non communicable diseases are not getting the attention they deserve. We even found out later that our event was broadcast on the national news. Hearing this was so rewarding.

We were even more excited when we learned that a radio station we had been working with, called Oblate Radio Liseli, was so excited with our work in Mongu that they wanted to help promote health here. Through this, we were able to start a "Health Corner" segment that will run regularly, and even get the ZEN students on the radio singing a song they wrote about high BP. It is amazing how things snowball!

This was such a great experience. Karen and I had both planned events in Canada in the past for nursing (she planned the Global Gala and I planned a blood drive), and this really made us realize how different it was to plan events in Zambia. So many obstacles arose that we didn't anticipate. Printing took twice as long, communication was hard due to language barries and tricky cellphones, and entertainment became a nightmare when we watched our ZEN friends jam a live wire used as an extension cord in to a power outlet using a pen lid. TIA!

However, this experience made us realize how far we had come and how much we could accomplish. In first year, we started off our nursing education with a blood pressure clinic. Now, four years later, we were helping to create one, while teaching new first year nurses all that we had learned. And for the first time, we felt like we weren't students, but professionals giving back to the community while working in partnership with our Zambian colleagues. And instead of an instructor, Jessica became a mentor to us. As this project and practicum marked the end of our nursing degrees, she became a fellow colleague. 

- Danielle and Karen

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