Makaela Newsome
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Student: Makaela Newsome
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Responsibilities

During my 10-week internship with Kigezi Healthcare Foundation (KIHEFO) I worked with both their Rabbit Breeding Program, which is actually a joint effort between them and another agricultural nonprofit called Go Organic Africa, and their newly opened maternal care hospital, Kirigime Health Centre.

My weekly duties varied because a lot of the internship was independent work.  I followed a timeline for when I needed to turn in particular deliverables. On average, my day started around 8:30-9:00am when usually I would begin doing independent research for my projects, which could be the entire day depending on how the electricity and Internet were working. Other days I participated in field site visits to KIHEFO run facilities, such as the main and mini rabbit breeding centers, the nutrition clinic, and the maternal clinic.  I also participated in community outreaches such as the monthly HIV and cervical cancer screening outreaches.  I attended deliveries at the maternal clinic, which could be at any time of day or night.  There were also weekend activities that I was required to attend such as the last Saturday of the month when the nutrition clinic does their check in with mothers and children that they have rehabilitated.

Within the Rabbit Breeding Program, I was able to design and implement a monitoring log for families to use to track their rabbit breeding program experience and for KIHEFO to use for better surveillance data. The logging system consists of a monthly calendar with color-coded stickers to indicate one of the following events: a rabbit died, a rabbit was born, a rabbit was bred, a rabbit gave birth, a rabbit was eaten, a rabbit was sold. The appropriate colored sticker is then placed on the date the event occurred, if a large number of rabbits are let’s say born, bred or sold then for literate families they can write the number in the middle of the sticker, if the family is not literate they may place as many stickers as needed to represent the event. The back of the calendar has information for staff members to fill out after they have collected the calendar which includes totaling all of the stickers for each event, counting the number of current living rabbits, asking the family about total income received from rabbits sold that month, and taking the height and weight of children in the household and make note of whether or not those children are attending school. This calendar will be collected and replaced at the end of every month.  I also designed hutch cards that were also designed and implemented for pilot use in the main rabbit breeding centers with hopes of implementation into the mini breeding centers as well. Hutch Cards are small cards that are created for breeding pairs of rabbits; there is one card for the female (a doe card) and one card for the male (the buck card). The cards track when the rabbits are bred, by which rabbit were they bred with, the results of the breeding (whether or not the rabbit became pregnant), how many of the offspring lived or died, and how many were successfully weaned. These cards help to track how successful individual rabbits are at breeding in order to decide which rabbits will continue to be bred and from which rabbits the new breeders will be selected.

At Kirigime Health Centre, I developed a Midwife Receptiveness Questionnaire, observed seven births under usual practice conditions, and began implementing the World Health Organization’s (WHO) Safe Childbirth Checklist. The Midwife Receptiveness Questionnaire was developed to gauge the receptiveness of Kirigime Health Centre Midwives’ to using the WHO Safe Childbirth Checklist within their facility. The finished questionnaire was a 14-question survey that asked about current labor, delivery, and postpartum practices, how they perceived the WHO Safe Childbirth Checklist as well as any past experience in using it. The results of the survey from all participants showed very receptive attitudes towards the use of the WHO Safe Childbirth Checklist. Every midwife believed the Checklist should be used with every woman regardless of the level of perceived risk during labor and most saw it as a great guideline to help them keep organize, with one suggesting that could also be a good tool for new staff members to be trained with. Seven total births were able to be observed and monitored using the WHO Safe Childbirth Checklist Observation guide from beginning to end. Midwives were also left with the WHO Safe Childbirth Checklist and KIHEFO has begun attempting to use this tool consistently throughout Kirigime Health Centre.

Greatest Public Health Lesson

The greatest public health lesson I learned was how to improvise.  In an academic setting, a majority of our time is spent cutting and pasting together different parts of “evidenced-based research” and adapting this pre-done and test research to our programs’ individual needs.  In the real world, that’s not exactly how it is done or how new work is created.  In contrast to that style, a majority of what we were doing was creating our own mechanisms and then testing them without a long drawn out period of research on topics that do not exactly match what we were trying to accomplish.  We observed and listened to the community and implemented programs and services that were based solely on their wants and needs.  When a program doesn’t work then you scrap it and move on to the next, but you don’t waste time trying to implement things that don’t necessarily make sense for your context or waste time to pick apart research that doesn’t actually apply versus developing process and interventions from scratch and just giving them a try.

Favorite Memory

In Uganda one of the main forms of public transportations is boda boda’s which are like motorcycles that function similar to taxi cabs.  I desperately wanted to take one but there was really no need in Kabale because I could essentially walk anywhere I needed to go to town and I didn’t really know how to direct the driver or how to negotiate prices. (I later learned how to do this in a different city) So my idea was I would get someone I know to take me on their boda first so I would be comfortable.

I was very close to many of the people and family members who worked for KIHEFO, including the doctor who founded KIHEFO (Dr. Geoffrey Anguyo’s) nephews.  So I begged and pleaded with his youngest nephew to take me on a boda up to this lake where we would all hang out on weekends.  He abhorrently refused due to fear that I might get injured because the roads up the lake are incredibly windy and steep.  I proceeded to beg him explaining that I already signed all the agreements that if I die it’s my fault.  He still refused.  So I resorted to pleading with his older brother and cousin to convince him to take me.  They said yes we can get him to do it and if he still refuses we will take you ourselves.

He finally agreed to take me that following Saturday.  We left in the morning and I was so excited wrapped in a scarf with sunglasses on to protect myself from the dust.  Within literally 10 minutes of being on the boda we have to pull over, do to some metal cover scraping in some place it shouldn’t.  So he rips off the metal piece and explains that it’s fine we can keep going.  We continue to travel, at grandma pace, so slow that children are running at the side of us because he’s afraid somehow I’ll get scared.  About 15 minutes into the ride we are on the winding dirt roads up the hills when a speeding Matutu (which is like a taxi-van) runs us off the side of the road.  So in order to keep us from skidding out, he purposely makes the bike tumble into the ditch.  We get up and I am completely fine besides some very surface scratches and he has ripped his pants, scraped his knee and cut his hand.  Clearly, at this point, he is very upset because literally, his worst fear has come true.  I ensure him that it is completely fine and in fact, I’m glad we fell because now I am no longer nervous about what falling feels like. As I climb back onto the boda, I place my bare leg directly on the exhaust pipe, instantly searing my skin.  I don’t say anything because he is still very upset about the fall.  When we finally make it to the lake we are dirt covered, he’s slightly bleeding, and I’m severely burned.

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