Don’t try to make it easy, it only makes it harder
Oh, just take it easy baby…
Don’t try, don’t try, don’t try
I’ll come home when the clowns come home. (Widespread Panic)
Well my good friends, its been an eventful week. Yes, sir… event-filled. I somehow managed to find myself on the regional management team’s Supervisory Support Visit schedule. I am not entirely how this happened to me, I know there was a meeting which I was busy taking notes (for you, my loyal readers) and I overheard many people discussing a visit and many many people requesting to be excused. This should have been a sign. But, no I did not focus my attentions on the events of one meeting and thus was subjected to 6 lengthy days of pointless meetings. What goes around, comes around- eh?
So, let me explain what the supervisory support visits are all about. The regional team alerts each of the 4 districts that it would like to provide some “support” to 2 clinics and 1 Health Facility in the region, this alert typically happens about 24 hours before the visit is scheduled to happen. The facility is supposed to be closed and a health profile is to be prepared.The regional team meets at the district hospital, travels to each facility, discusses the health profile, tours the facility and makes recommendations. After all the facilities have been seen we meet back at the district hospital to “debrief” the information back to the district management team.
At least that is how it is supposed to happen.
So the visits went like this: We (the regional team) would arrive at the regional office where we would get in the cars and head out into the bush- Of course the cars were never ready and/or the team wasn’t ready so this involved 1-4 hours of waiting at the regional office for the cars to be ready once we were all piled into the baakies (trucks) we then took off on a 30min-2 hour drive to the site. We were typically welcomed by the staff of the clinic, however the 20+ patients who were lined up outside seemed fairly concerned if not down right annoyed. They must have had some idea what was coming- the clinic would be closed for an indeterminate amount of time and they would have so sit and wait in the sun until it reopened or walk back to their village and try again tomorrow. So we, our group of 17, would be ushered into a relatively small room and we would give introductions and then the clinic would present their health profile. This was interesting on two levels one- the first day I was introduced as “The region’s sweetcake” Yes. The regional director went on to explain that I am shared between Outapi District Hospital and Omusati Region like a sweetcake. She listed all my winning traits they are thankful for- my smile, my funny accent, my blonde hair the list went on until I finally put her out of her misery and introduced myself. You see, she didn’t remember how to pronounce my name, so she just started babbling. Then as a group we practiced saying my name. My favorite was when Ndapandula Shikwanmbae said to me: “Oh! Meme. You have such a hard name to pronounce. Why you named this?” Uhhh I don’t know Ndapandula. So, after the 8th visit I must admit my colleagues had gotten quite good at saying Kreshna Skybul. I’m proud of them, really.
The other entertaining thing about this meeting is that almost none of the clinics had enough chairs for all of us, so there were some rather creative seating options. These included: a brick, a horizontal IV Stand resting on 2 buckets, a ventilator, window sills and my favorite: a table that was shared by 5 people (Your’s truly was seated with one leg over the regional director and one leg over Ms. N and no back rest. For 3 hours). After that experience I hightailed it from the car to the clinic and claimed a chair before the start of each meeting.
Following this presentation, which included a session of grammatical error correction from the regional team, a tour of the clinic was given. Most of the clinics were basically clean and seemed to be decently stocked, and I was looking for crutches and accessibility options- so my tour was pretty quick. No one had crutches and none of the clinics were accessible for people in wheelchairs.
Then the recommendations were given. This took about 3-4 hours. I can’t explain how ridiculous some of the recommendations were in two ways- firstly that this had to be said in the first place OR that the issue they are raising is not important compared to some other HUGE issue. But here were some of the more absurd ones:
(In response to the request that the Health Center be upgraded to hospital status based on the number of patients it sees and the severity of the cases they then have to refer to a larger and far away facility) “I want to thank you for your request. It was considered. However, you failed to introduce yourself and your staff members so I did not who I was talking to and do not know who is asking for this upgrade. Therefore I can only deny your request.”
“The problem with this facility is like the problem with the last facility. We have not opened the meeting with a prayer. How can we expect anything to improve with when have not asked God for guidance and we have no thanked Him for what he has provided. Oh! You all have christian names, but you do not want to thank God…”
“You can not use expired Anti-RetroVirals to treat your HIV patients. They won’t work”
(In response to a Nurse’s request for a car for their facility- which she told a story about how a pregnant mother came in, required emergency care and when the clinic called for a ambulance the transport director denied the request because the driver has already driven that day and it was 9pm at night and he was tired) “You must request transport the day before you want transport at night, that way we can allow our driver to rest during the day”
(Following a complaint from the nurse that transport is not picking up their HIV tests so they can not actually tell people their result and thus are not testing any one) “More importantly, I noticed your flag of Namibia is faded and tattered. Can you explain why you are not respecting your country?”
“I would like to see our clinics taking a part in preventing HIV transmission, our community has started doing it. My church prevents HIV by using 2 buckets when baptizing children. One to scoop water out of and the other to catch the water that might have HIV in it from the child’s head.” (note: this gem of ignorance came from the leader of our special programs division, our number one most important special program? HIV…)
“Dear colleauges. This clinic is having a problem charging their cell phone. How can was assist them to charge this phone?” (Followed by a 45 minute discussion of various different charging methods).
(In response to my suggestion that we start to develop a plan to reach the outreach clinics for NEXT year’s flood, again the floods happen EVERY January-April) “Kreshna. This is a disaster. How can you predict when a disaster is going to happen? If you don’t know when it will happen you can not plan!” (oh, i know… how about a calendar????).
It wasn’t all bad- I got to see some of the clinics that were really trying, in the midst of a flood, expired medications (it seemed that ALL the clinics were using expired medications and they were all be stored on the damp floor and the ones that said “do not expose to sunlight” seemed for some inexplicable reason to be laid out on the shelf of the only window of the clinic), poor training, lack of transport etc. But they were really trying to help and they really cared. And that counts for something, if not everything.