Each time I describe all of the activities and undertakings that I do in PNG, there are times when I can’t myself help but feel that I am part of the little circle of friends that include Frodo and the Hobbits, Gandalf Greyhame, Aragorn the Dunedain, Gimli son of Gloin, Boromir son of Denethor, and Legolas of the Woodland Realm. For those of you who do not know, these characters are from the movie The Lord of the Rings, and are the members of the Fellowship of the Ring, set on a quest and mission on track to Mordor to destroy the Dark Lord Sauron’s “one ring that rules them all”. I suppose it is because of my repeated use of the term ‘Fellowship” that I have always associated it with my favorite movie series of all time. One will probably think of me as a nerd or a geek, but there is parallelism that I can totally relate. No, my quest is not to reach the summit of Mt. Hagen or Mt. Williams in the highland province of Goroka, nor am I set to destroy any piece of jewelry, apparel, or trinket. My mission is simple yet complex, easy but hard, fun and anxiety provoking all at the same time, but nevertheless an unprecedented adventure that is slated to become an experience I will never forget. The juxtaposition is so surreal and visceral especially since I am still here and living the experience day in and day out. The third month is halfway through now and it will soon come to an end again to signal the 6-month Fellowship being halfway done. It will also herald the start of the 4th month and the start of the second half of the experience. I equate it to the trials and tribulations that the young Hobbit from Hobbiton experienced as he and Samwise Gamgee, together with their pots and pans and rock salt from the Shire, journeyed until the end to find themselves triumphant. I admit that I still have some time to go and deliverables to do so it is still premature to call this journey of mine a winner. After all, I am still plagued with the stings of isolation and loneliness at times, but thanks to my family, friends, colleagues, and professors from back home for reaching out and checking in on me every so once in a while to say hello. E-mails like these lifts my spirits up, inspires, and gets me going again. I suppose it is fair to say that I am now in the process of slow adaptation here and getting used to my daily PNG life. So, why don’t I give you guys a snapshot of the things at work that are keeping me busy these days…
Workdays are from 8 to 5, M to F. I go to bed between 830 – 930 PM and I get up at 6 AM to start the day. Two weeks ago, I started to roll out one of my major deliverables for the Fellowship (there it is again) and that is to train a group of unlicensed assistive personnel at the clinics on how to obtain vital signs correctly and properly. See, one of my objectives is to improve the client flow in the two busy clinics I am working with. It sounds so simple, doesn’t it? Initially, I thought it was going to be a rather easy undertaking but now that I am implementing and taking action on it, I find it not so simple as I thought, matter of fact, it is rather complex, at least in the logistical sense. The idea is to train this group of individuals so as to actively take part in patient care. In so doing, all patients will have their vital signs taken and the flow of patients will be a bit faster since the licensed clinicians will go directly into assessment, treatment, and prescriptions. You are wise if you had figured out that not all clients in the clinics have their vital signs obtained. As a matter of fact, majority of them don’t. This is the primary reason why I made it one of my major objectives to deliver. In my mental image, the unlicensed assistive personnel will be obtaining the vital signs before they get seen and it will be most prudent for the clinicians to glance at the vital signs results first when they get the medical chart and identify any questionable results before they proceed with their job. Now, as I mentioned, it is a bit complex because trying to coordinate a schedule that everyone can agree on is a bit taxing. Some of the staff in the training comes from the other clinic which is about 15 to 20 minutes away depending on traffic. In addition, it takes a bit of ingenuity to gauge learning and understanding. I learned not to rely on PNG folks answering “Yes” all the time even though there are many who still have multitudes of questions, misunderstanding, and totally missing the concept. In essence, some of the “students” in the class are nodding their heads and answering “yes” even if they don’t get some of the stuff that I am trying to teach. I am not sure if there is such a term for this complex of “trying to please the master/instructor/teacher”, and this is exactly what has been transpiring. Picture this, I am in the middle of class explaining the differences between oral, axillary, tympanic, and rectal temperatures; radial, brachial, carotid, and pedal pulses; and all of the background information concerning the topic and I have been getting robust “yes” from everyone. During our next class, I asked a few questions for review and the whole class reverted to the classic “avoid the gaze”, “look down”, or “pretend I’m writing” mode. I should know since I was once a student not so long ago and I admit that I also used the maneuver one too many times. Last week, I devised a plan to work with them individually within the group setting. Review classes are becoming more common. I am now thinking that this is going to be a real challenge and I am just hoping that this plan will work so as to attain a win-win situation (for them and for me that is). I am determined to make this class succeed. For those of you who know me very well, I consider training someone and imparting the things that I know a personal project and objective. If the person satisfactorily performs the job well, then I have done my job. On the other hand, if the person performs less than satisfactory, then I have failed. This last notion might be arguable to some since everyone’s learning curve is a bit different. I can’t help myself but to think that the student’s performance reflects on the teacher’s deliverance.
Another one of my key deliverables is co-facilitating an Infection Control Refresher program. I developed and delivered a two-day training program on Standard Precautions, Transmission Based Precautions, Personal Protective Equipment, Handwashing, Bloodborne and Airborne Pathogenic Microorganisms, and Occupational Health and General Work Safety Overview. My other comrade who co-facilitated with me developed a training program on Environmental Health and Hygiene and Medical Waste Management. Some practices and activities that are considered routine in US, like handwashing, are sometimes viewed as something optional in patient care and not necessarily mandatory. Needless to say, I spent a good time deliberating on handwashing alone, from the science behind it, to techniques in properly and accurately doing it. The best part of the handwashing session is the surprised faces I saw from everyone when I told them that Pseudomonas aeurigonosa like to thrive underneath the fingernails and nail polish acts as a catalytic converter that arms and protects them. The entire two days’ worth of training proved to be a busy but yet productive work because we had a good and robust interactive turn-up of attendees. My slight worry concerning this training surfaced this weekend when I was correcting the post-test exams. Descriptive statistics indicate the mean, median, and mode of the test scores is around 73. Highest grade was 97 and the lowest was 44. But despite this, I am glad that we had a good attendance rate for the training and that participation was at an all-time high. We employed PPT presentations, group discussions, group work, role playing, and demonstrations. And, I have pictures!!!
There seems to be an ideological constant in this country and that is the notion of “PNG time”. Whenever an activity (meeting, presentation, appointment, etc.) is planned at a certain time, chances are that activity is not going to take place at the exact appointed time. For instance, the 2 days training in Infection Control was slotted to begin at 830 AM. The first day, we did not started the training until about 945 am because half the class was late. There was a slight improvement on the second day because we started at 9 AM, which was still a little late, but nevertheless earlier than the day before. It’s the same with meetings and appointments. Somehow, it is somewhat expected and customary to be around 30 minutes late. The normalcy of this ideology in PNG is quite an eye opener and, quite frankly, very hard to get used to. My driver—Gary—and I sometimes get into a respectful discussion about the issue because even he sometimes picks me up a bit late in the morning. The worst part of it is his lack of judgment to notify me. We had an agreement that he should notify me immediately should he become unavailable for a ride so that I can arrange for an alternative means of transportation in time. I think as time goes on, Gary is starting to get to know me and all my “American” ways. He means well and I recognize it. There are times when I just reflect back and tell myself that I really should be the one adapting and getting used to the ways around here. I really am in no position to impose my ways and mentalities that I am accustomed to. After all, I am the expatriate, the visitor, and the foreigner in this land. Sure, I can respectfully ask, but by no means should expect. I am only human, and like I mentioned before, it is quite hard to get used to this mentality. It is a lost cause to try and change this ideology because it is so pervasive and deeply ingrained. For someone to set an example by being on time or even a bit early on meeting appointments, conferences, or presentations will probably impress a few on that one day only, but it is highly unlikely that the impression will last so as to induce change. It is what it is. During these times, I find solace and answer on the famous prayer line: “God, grant me the serenity to accept the things that I cannot change”.
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