Our new office - the hub of learning...

The St Mary's Juba Link office.

This is where all the small group teaching goes on

When it comes to teaching, there is nothing more satisfying than seeing ‘the moment of revelation’- the part where a student suddenly understands something that had hitherto eluded them. Their eyes light up, they smile and they nod knowingly as the epiphany is realised. This happened numerous times today.

The St Mary’s Juba Link is in full swing and I feel really encouraged and hopeful of the future. The recent audit has alarmed the doctors and plans are underway for a full restructuring of the way the departments run and the introduction of triage. The audit also highlighted a huge deficit in training and a postgraduate training programme has been created, the first of its kind in Southern Sudan. Nurses have sessions in the mornings, and we teach the junior doctors in the afternoons after our ward work is over. Every Saturday from 12.30 pm there is a grand round for all departments, although this is often frustrated by weather conditions...

Monday teaching with the ward sisters.

They are learning about observation charts

We are starting with the foundations of learning- the recognition and management of the sick patient using the method of airway, breathing, circulation, disability, and exposure (ABCDE). To many people in Juba, this is a completely new concept and the teaching is often slow to start with, as one would expect. However, today it was lovely to recap on Mondays teaching and people were shouting back the answers that they had learned the day before.

Teaching today. Some of the ward sisters are already taking the initiative and teaching others how to do observation charts

We are currently training the ward sisters in ABCDE and by the end of the week, they will know some common causes of problems with each, how to assess each component and the basics of management. They will also be able to write in an observation chart and urine chart. Yesterday they couldn’t write obs. Today, they were proficient. Next week (and for the next month) they will be the teachers and together we will teach the junior nurses ABCDE.

Todays teaching with the photo taken next to the whiteboard

The junior doctors are being taught in the afternoon. They learn the same things as the nurses but in a bit more detail.

Today we taught the doctors about airway and breathing. James shows the doctors a chest x-ray showing fluid in the lungs (a pleural effusion)

The aim here is to make ABCDE the common language of healthcare in the Southern Sudan and also to make people appreciate that this is the first building block of training- all internationally recognised healthcare courses such as Advanced Trauma Life Support, Advanced Life Support, Paediatric Life Support etc use ABCDE at their heart.

I am secretly hoping that in one month, there will be observation charts on the wards and everyone will be talking ABCDE and recognising sick patients and managing them early. However, in the Southern Sudan things take a lot longer to happen than in the UK. I remain hopeful but am mindful of this fact. Patience is the key.

That’s all for now. I shall tell you how we got on at the end of the week.

Bye for now,

David xx