It's a wrap_ by sdsdfqw21


									 It’s a
The fifth PATA forum has come to an
end. Twenty-five weary but happy
treatment teams are heading home,
heads packed with new ideas and hearts
hopefully lighter, thanks to the
opportunity of sharing their cares and
concerns with colleagues
     Random conversations with
delegates, invited speakers and our local
partners from Wits ECHO are agreed
that they have enjoyed quality time at
this PATA Gauteng forum.
     Presentations have been of the
highest quality, discussion has been           LOOKING FORWARD: Grace Phiri, Rose Mathaha, Limakatso Maphotsa and
informed and passionate. Teams are             Manyatso Penane from the Queen Elizabeth II Hospital in Lesotho discuss which tasks
coming away with a sense of                    they want to set themselves in the year ahead.
accomplishment. Each team has set
itself a set of quality improvement tasks      collect, this will save many organi-              We thank our facilitators, the
and we look forward to reports on the          zations the trouble of reinventing these      translators, our session conveners and
progress they are making.                      to meet their own needs.                      chairs and all the experts who gave us
     This forum has produced a rich                The PATA steering committee is            such excellent plenary presentations.
harvest of training and educational tools      indebted to Melanie Evans (conductor of       We thank our participants for their
from MSF, PHRU and TARSC. PATA                 note), Jenny Watermeyer (presenter,           enthusiasm, which fueled the process.
will be creating a web page listing all        data projector rescuer and master class       We wish everyone safe journeys home
available tools. This will be the start of a   leader), Vuyiswa Mboyi, Lil Hobbs,            and success with the tasks they have
new resources project we hope to               Natalie Renaud, Ashley Petersen and           chosen.
develop with the help of David                 Lucia Fundisa Matshoba for their hard             Hamba kahle, Fambai zvanaka,
Goetghebuer of MSF.                            work, their efficiency and dedication.        Hamba kuhle, Poitu vanga, Ibowan,
     If the PATA website                       Without this team no-one would have           Murabeho, Adeus, Au revoir, Seyeso,
( can serve as a              enjoyed this seamless conference.             Totsiens, Goodbye. – Paul Roux
storage venue for every resource we

 The invaluable input of Expert Patients
PATA initiated its Expert Patient              delegates were able to find out more from     them.” Expert Patients have the
Programme in 2007 which now includes           clinics who benefit from the support of       opportunity to learn new skills and
47 clinics and 200 Expert Patients in 14       Expert Patients. More PATA affiliated         become role models in the community.
countries.                                     clinics present at the 5th PATA Forum such        All clinics taking part in the program-
     They are trained to support the           as PIH (Rwanda) and Baylor (Swaziland)        me receive funds to pay, train and manage
medical staff with clinical and admini-        told L’Equipe PATA how they now rely on       Expert Patients. Clinics are asked to
strative tasks, such as weighing and           their Expert Patient team.                    submit quarterly update reports to PATA
measuring patients, pill counting, and to          Terri Litty from Baylor Swaziland         for monitoring and evaluation purposes.
run support groups.                            stressed that “Expert Patients are invalu-    The programme is funded and co-mana-
     At the speaker’s corner, PATA             able. The clinic could not function without   ged by One to One Children’s Fund, UK.
The patients are
the experts
                                                                                  Jenny Watermeyer

Jenny Watermeyer is a speech therapist, communicator and            struggle to understand and remember all the information
researcher from Wits University and spoke yesterday                 they are given, e.g. the name of drugs, dosage instructions
morning to PATA delegates about the importance of                   etc. Misunderstandings can have terrible impacts on patients
communication.                                                      and on their treatment.
     Communication is sometimes forgotten when health                    With this in mind, Jenny continued by explaining to
professionals face so many other challenges. Jenny found            PATA delegates what concordance is. Concordance is about
that patients misunderstand health professionals and                how health professionals interact with patients. It is about
recognised that communication is hard, but offered PATA             “connecting” with patients. Patients are expert in their own
delegates some ideas to improve communication at the                life and health professionals must learn to negotiate by
clinic level. The context in Africa is very different to the        using the patient’s personal context and by referring to the
rest of the world. For instance, in the USA or the UK,              needs of patients.
patients are now encouraged to be assertive, to question                 Communication is not a set of rules for all clinics and
what medical professionals tell them. But this is not always        all patients. Health professionals must identify specifics
appropriate in Africa. “Context is key,” stressed Jenny.            within the environment of their clinic and use simple
     Multiple languages (there are 11 official languages in         strategies (pictures, props, body language). It is also crucial
South Africa and many more are spoken), cultural                    that health professionals check that patients understand by
differences, lack of professional interpreters, migration,          asking them to demonstrate or explain as well.
poverty and discrimination are just some of the many                     “Show your patient that you are human, that life is also
obstacles faced by health professionals in communicating            difficult for you,” she said. “We need to work with what we
with patients. Health professionals need to be aware of             have. Focus on communication, on connecting moments
differences and to adapt to their patients. They need to            with patients, maximise every opportunity and consider
familiarise themselves with the situation their patients are in     where patients are coming from.”
as much as possible.                                                     If we see patients as experts, this will facilitate
     “This is obviously a real challenge when medical               communication. Jenny had two key take home messages: 1)
professionals have 5 minutes with each patients, and 50             All health professionals should be concerned about
more waiting to be seen outside,” said Jenny.                       communication and not only counsellors; and 2) Don’t
     However, it is crucial to acknowledge that patients            make any assumptions.

                                                  PATA facilitators play a very           was a first timer as a PATA
   PATA                                           important role in the workshop          facilitator and was deeply
                                                  sessions, making sure the               impressed by “the seriousness and
   facilitators                                   discussion are focused and that all
                                                  participants are able to express
                                                                                          commitment shown by people to
                                                                                          the task at hand”.
   impressed with                                 their concerns and share their
                                                                                               She realised that no one was at
                                                                                          the forum for an easy ride and
   forum                                               We asked this year’s PATA
                                                  facilitators what was, in their
                                                                                          appreciated that people come from
                                                                                          “different perspectives,
                                                  opinion, the highlight of the           backgrounds and have access to
                                                  workshops. They all seemed very         different levels of resources, but
                                                  impressed by the level of               there are a lot of common threads”
                                                  participation and how hard-             that connect the teams.
                                                  working the participants were.               Sara Stulac (PiH, Rwanda) is
                                                       Gertrude Guveya (nursing           also a member of the PATA
                                                  sister from Zimbabwe, in the            Steering Committee and attended
                                                  photo left) is a member of the          all 5 forums. Again, Sara found that
                                                  PATA Steering Committee and             the workshop sessions were the
                                                  has participated in all 5 PATA          highlight of the forum, making
                                                  forums. Gertrude realised from          PATA so unique. She was pleased
                                                  the workshop discussions that           to observe passionate discussions
                                                  nurses do so much of the work in        among doctors and to see everyone
                                                  healthcare delivery. She                so eager to participate.
                                                  commends the spirit of teamwork
                                                  in all teams and noticed a real         PATA would like to use this
                                                  improvement in the multi-               opportunity to thank all
                                                  disciplinary workshops compare          facilitators who have given their
                                                  to past forums.                         time and support to make the 5th
                                                       Melanie Pleaner (AFCI, SA)         PATA Forum a successful event.
    Our continent in colour!

                                                                     CLINIC THOUGHTS:
                                                                     Job Shimankana Tabane Hospital,
                                                                     Rustenburg, South Africa
                                                                     “A sense of teamwork was instilled at the forum. I really
                                                                     appreciated the discussion about disclosure. Before I didn’t
                                                                     know whether I was doing the right thing or not.”
                                                                     – Queen Lebelo (at left in the photo above)

                                                                     “We’ve been neglecting the psychosocial needs of our
                                                                     teenage patients. We need a special clinic maybe for those
                                                                     aged between 14 and 18 years. We’ve learnt a lot and it’s
                                                                     time to return and implement it at our clinic – the Auntie
                                                                     Stella and Say & Play kits will definitely be used.”
                                                                     – Tebogo Tshengiwe (centre)

                                                                     “The adolescent focus helped us a lot. We’ve got a problem
                                                                     with teenagers, but we didn’t know how to deal with it. We
                                                                     feel very privileged as a big hospital with the resources we
The beautiful embroidered wall-hanging made by the women             have, especially compared to what many of the other clinics,
from the Keiskamma Clinic in Hamburg, South Africa.                  from neighbouring countries, have to make do with.
                                                                     – Madria Geissler (right)

PATA’s Melanie Evans and Barbra Kaim            Maseabata Ramoeletsi (left) and Katlego Mahamo (right) from
(TARSC) unwrap the stunning painting            the Baylor Centre of Excellence in Lesotho share a laugh while
presented to PATA by Avisa from Mozambique.     working on their goals for next year.
                                                                              CLINIC FOCUS:
                                                                              Groote Schuur, Cape Town
                                                                              “No matter where people come from,
                                                                              whether they were from urban or rural areas
                                                                              – they all had similar issues to deal with in
                                                                              their clinics. But they also had very good
                                                                              ideas and solutions to these problems. We
                                                                              can implement some of these in our clinic.
                                                                              The forum was great for team building too.”
                                                                              – Thania Hisham (in the back, second from
                                                                              right in the photo)

                                                                              “Training, training, training – it is clear that
                                                                              we need more adolescent-specific training.”
                                                                              – Phumla Tyulu (in the back, at left)

                                                                              “Some of us work with kids and others work
                                                                              with adults, but we need to begin
                                                                              specialising in adolescents too.”
                                                                              – Fatima Noor (front row, second from left)

                                                                              Also in the photo: Vuyiswa Mboji,
                                                                              Michelle Brown, Lucia Matshoba and
                                                                              Vaughan Stannard.

                    Delegates were very accommodating and open. It                            I’d like to encourage
                    was enlightening to hear the kind of things people
                    are up to and how similar our approaches to
                                                                                              everyone not to
                    working with children with HIV and AIDS are.                              falter in our efforts.
Victor de Andrade
                    I’m still humbled and in awe of kids living with                          Keep working hard.
                    HIV and AIDS and their families. I have a
- Facilitator                                                                                 The sky is the limit.
                    continued respect for their determination, their
                    strength and their resilience and I’m humbled by
                    the work that delegates here at the forum are
                    doing in teams and in their clinics.
                                                                                          Dr Batanayi Muzah
                                                                                          – Nyangana RC Hospital, Namibia

                                           Dreams may be slow in coming, but
                                           they will come. It took us four years                          Grace Phiri, QE II
                                           to get a TV in our clinic!                                     Hospital, Lesotho

                                                                                          Let’s press on, let’s
                                                                                          be part of the
                           I liked meeting people
                           from different countries                                       solution, always.
                           and it was great to work
                           together. But it was
                           difficult to control the
                                                                                        Dr Prithiviraj
                           number of handouts                                           – QE II Hospital, Lesotho
                           teams were able to take.
                           It was also hard to read             Apologies & Correction
                           people’s handwriting on              Apologies to the Mpilo Clinic team (Zimbabwe) who in
                           the registration form to             yesterday’s paper were misquoted. The clinic is starting
                           update the clinics’                  paediatric patients in line with the World Health Organisations
                                                                (WHO) recommendations at 6 weeks of age. We regret the error
                           contact details!                     and are extremely grateful for the work that the Mpilo team
                                                                continues to do.
                                                                Contributors to this newsletter during the past week:
                              Vuyiswa Mboji                     Lil Hobbs, Nathalie Renaud, Ashley Petersen, Victor de
                              - Team PATA, Kidzpositive         Andrade, Melanie Evans, Paul Roux, Elizabeth Obimbo, Francis
                                                                Ateba, Dean Solomon and Toast Coetzer. Thanks, everyone!
Time to
pull up the
Eight clinic teams were asked to
present at the Speakers’ Corner
yesterday morning.

After providing a brief overview to
contextualise their clinics, the speakers
then moved onto ‘Be Proud, Be Brave’
where they shared the successes of
their clinic.
     They told delegates what they are
proud of and what motivates them in
their work. They also shared current
disappointments in their workplace.
     The fantastic work being carried
out by individual clinics scattered all
over Southern Africa is a true
testament to the commitment of team
members in providing quality, ongoing
care to their patients. This is despite
the often difficult working
     Speakers noted the importance of
forming partnerships between clinics,
experts and teams.
     Goals must be achieved through a
committed approach. We must accept
that progress takes time. We also have
to learn at the hand of our failures.
     As Dr Prithi succinctly
summarized: “An elephant can’t be
eaten in one big bite, it takes one bite       CLOCKWISE FROM TOP: Dr Batanayi
at a time…”                                    Muzah (Nyangana RC Hospital,
     In the same way we must work on           Namibia), Rosemary Nyirenda (Tisungane
developing the ‘little things’ which           Clinic, Malawi) and Nyathi Kaluma
will grow into larger outcomes in time.        (Mpilo IO Clinic, Zimbabwe).

How we care for each other at Baylor Clinic, Botswana
                                        To start proceedings off, Eunice Mangwane              That is: taking care of their emotions.
                                        broke into song: “Be bright in the corner, where           “We have morning sessions; I liked Eunice
                                        you are! Be bright in the corner, where you are!”      yesterday when she started off with a song. At
                                             Then Bakani July Johnson asked participants       Baylor clinic, every single day come rain or shine,
                                        to raise their hands and say something to one of       we have a song in the morning. We all sing in the
                                        their team members. Only one hand was raised:          morning. We have a special song, singing for the
                                        Rita from Newlands clinic (Zimbabwe). She              patients. Of singing together, smiling together, we
                                        turned to a colleague and said: “Cordelia, you         are binging each other closer.
                                        are wonderful . You are a joy to work with.”               “We also have what we call birthday celebra-
                                             “Aren’t you concerned?” Bakani challenged         tions. We have one Friday when we all eat toge-
                                        participants. “Aren’t you concerned that only          ther and celebrate all the birthdays for that month.
                                        one person raised their hand? At Baylor, we            Sometimes we do group socializing. Maybe we go
                                        have what is called challenge clinic, intensive        to Linga Longer (a pub). Everyone pays for
                                        follow-up clinic. I can’t handle it on my own. I       themselves, but we still go.
                                        can also get stuck as a social worker.                     “If you don’t do this in the clinic, then you
                                             “A lot of us are going through grief and          will take these issues home. By meeting with each
                                        bereavement counselling with our team. Some of         other more often, it gives us a chance to discuss
                                        us are HIV positive, and others are grieving for       things with colleagues.
                                        issues in their families or with their friends.            “Management will never take care of you
                                             “One thing that we believe in as a team at        socially, but you can come up with your own
                                        Baylor clinic, is that for me to take care of you, I   ideas. Let’s find comfort in our own teams. We
                                        have to do my job. And if you are not doing            have our own personal lives.
Bakani July Johnson spoke                                                                          “If you keep a happy face, then our patients
about caring for the carers at          what you are supposed to be doing in your clinic,
                                        you are not doing the right thing for your team.       are going to appreciate us.”
Baylor Botswana.
On Day 2 of the PATA forum, Melanie Pleaner (AFCI) read out a story in the plenary session
about geese flying in a “V” formation. Making the connection between clinic teams and the
geese is evident. Like geese, the more we come together, unite and focus the more effective we
can be in our work. Supporting our team members during good times and bad and working
together towards a common goal are essential. We look forward to hearing about the ongoing
progress of your clinic. Here is the text from her presentation:

                   Why do geese fly in a “V” formation?

        As the geese take flight from their point of departure,
  they lift off from the water, haphazardly, crying and squawking.
 Yet, in a matter of seconds, a line begins to emerge from the mass
 of brown feathers. This line straightens, arches slightly, and then,
         as on cue, bends sharply to form a perfect V shape.

   The flock of geese fly in “V” formation for a very pragmatic
 reason: a flock of geese flying in formation can move faster and
      maintain flight longer than any one goose flying alone.
Whenever a goose falls out of formation, it suddenly feels the drag
 and resistance of trying to go it alone and quickly gets back into
    formation to take advantage of the lifting power of the bird
                        immediately in front.
  When the lead goose gets tired, he rotates back in the wing and
                     another goose flies point.

  These geese cry and squawk from behind to encourage those up
                      front to keep up their speed.
  Finally, when a goose gets sick, or is wounded by gunshot, and
 falls out, two geese fall out of formation and follow him down to
 help and protect him. They stay with him until he is either able to
  fly or until he is dead, and then they launch out on their own or
   with another formation until they catch up with their group. .

FACT: flying in “V” formation, the whole flock adds at least 71%
    greater flying range than if each bird flew on its own.

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