Monday, October 21, 2013

Studies Abroad

Studies abroad

Mary MacKay
The UPEI team of Vanessa Dennis, third from left, Alicia MacDonald, Sydney Abells, Jennifer Whittaker, Megan Ellis and Danielle Perry spend 90 days each in rural Kenya participating in health and agricultural projects to increase food security and health of Kenyan women and children.

UPEI nursing, biology and Atlantic Veterinary College students reflect on their 90-day internships in Kenya

This was the second study time round in Kenya for Dr. Shauna Richards, who was involved in ongoing projects that are a partnership between Farmers Helping Farmers (FHF) and the Atlantic Veterinary College (AVC) in Charlottetown.
This time her research focused on whether improving the nutritional content of cow feed and fodder is a cost effective way to boost milk production.
“All of the projects have the goal of improving dairy farming but the fourth year rotation is about practising clinical medicine, so treating sick animals and dealing with certain types of diseases that we wouldn’t see, normally. But this project was specifically focused on improving milk production through nutritional sources,” says Richards, who is now a grad student, studying for her masters of science.
“It’s not just trying to improve one thing, it’s trying to improve a whole system of milk production, which affects more than just one farmer. It also affects the local economy there to have a better milk producing system.”
FHF has for many years worked closely with Wakalima Dairy Group, which started off as a co-operative of small individual farmers  who would pool their milk daily to sell to a processing plant.

“They got bigger and bigger as time went on with help from Farmers Helping Farmers and now they are an actual business because they just got too big to be a co-operative anymore. There are over 6,000 farmers selling their milk every day and they have two bulk tanks like they would have here for cooling milk. . . and they are starting to build a processing plant so they can process and sell their own milk,” says Richards, who was worked in Kenya with two veterinary students from Vets Without Borders.
Most farmers have one cow but not more than five so that alone was a different experience for this Canadian veterinarian.
“I really like working on the scale of smaller farmers because you get to work with them on a more individual basis and they work with their cow on a more individual basis too. It’s their livelihood and it’s a really important part of their farm,” says Richards.
Most cows are fed locally grown forages and a small amount of grain.
The research focused on whether higher feeding of grain will improve milk production to a point where the monetary return outweighs the added expense.
“We wanted to see if purchasing these (locally produced) feeds was economical for these farmers. . . . We wanted to make sure that they’re going to be able to make money with the additional milk that their cow is going to produce when they buy these feeds,” Richards says.
“They all know that feeding more feed is going to help their cow but they’re quite concerned economically because buying that bag of feed means money from somewhere else. . . .”
This year’s study involved feeding measured amounts of the locally grown forages and purchased feeds to the cows and keeping track of the milk being produced.
While the actual statistical verdict is still out because the full examination of the data will not be complete until early in 2014, there was a pilot study done last year by a graduate student from the University of Nairobi, which is also a partner on the project.
“And based on (that) pilot project we’re optimistic that it’s going to be beneficial,” Richards says.
“It was really great to be out in the field and working with farmers, and especially because we got to go back over and over to these farms again to see them. So it was nice because we got to build an actual relationship with them, it wasn’t just a one-time visit.”
The opportunity to travel and to do research was a dual draw for UPEI biology students Alicia MacDonald and Jennifer Whittaker, who were in Kiirua for 90 days conducting research that focuses on factors that contribute to respiratory problems in women and children.
“I think my favourite part was being integrated right into the community,” says MacDonald, who spent much of her time with a test group of 45 women assessing the value of more efficient cook stoves in reducing the exposure to wood smoke.
“I don’t have the results yet because (the data is) getting analyzed now but we’re thinking from the comments that the women made and from the testing that the chimneys are having an effect: that their cough is significantly less, that their eyes weren’t bothering them, because women are typically in a cookhouse between three and six hours every day. . . . They cough a lot and it’s a major cause for COPD (chronic obstructive pulmonary disease),” MacDonald says.
This final round of data will be compared to a study that was conducted two years ago just after the installation of the energy-efficient stove and chimney systems, which were donated by FHF.
“They are very happy with the stoves. We never heard a complaint from any of the 45 women,” she adds.
While MacDonald was focused primarily on indoor Studies
... Cont. from C1
air quality, Whittaker directed her attention to the great outdoors for a baseline study to determine the level of air pollutants, such as the exposure of road dust on children walking to and from school.
“My (research) is on outdoor air quality,” she says.
“Basically there are a lot of dirt roads in the area where we were so my supervisor was thinking that was probably a high source of pollutants, especially for the women and children there because they’re constantly walking back and forth, they spend most of their time outside and there’s a lot of open air fires. So I was setting up the baseline data for the amount of pollutants that were in the air to see if it’s worth studying to see if there is a significant impact on their health.”
Whittaker placed a series of eight air samplers along the road to calculate the total particles in the air to compare with research that has been done in other areas and World Health Organization guidelines.
She also made note of the amount of pedestrian and vehicle traffic at certain times of day.
Her work will provide the baseline data from which future UPEI biology students can make comparisons.
Both UPEI students adapted quickly to their unfamiliar surroundings and made do surprisingly well without their usual easy access to the lab, the Internet and uninterrupted electricity.
“We learned very quickly to always have our laptops charged because at least if we lost electricity we could use them for a little while,” Whittaker laughs.
“The hardest hit was not being able to just be able to search for (information) when I wanted it. If I thought of a question usually you just go to your phone or your computer and just Google it right away. And so I had to write things down so I’d remember to look things up when I had the Internet or stay up till the middle of the night when the Internet was working a little bit better.”
Fourth-year UPEI nursing students Danielle Perry and Vanessa Dennis explored avenues of a whole new working world during their internship working at a small rural hospital in Kiirua.
The UPEI students’ focus was on sharing best practices in the areas of immunization, maternal child health and more.
“The health care is very different from here. They don’t have as many resources as we do, (but) a lot of the doctors are really smart and very creative. Here we would have everything, so if we wanted to put a catheter in we would have a catheter, if we needed drains, we would put drains in,” Perry says.
“But there, sometimes they had to use catheters for drains (for example). They were just really innovative. So if they had one piece of equipment they could use it for five different things where we would have the specific tools for each.”
The mental comparisons didn’t stop there for Perry, who did a rotation in Charlottetown in maternity and surgery before she headed to Kenya where she did a month of each there.
“It was just hard to see that some people couldn’t afford to get the surgeries because almost everything is out-of-pocket there. Because you have public insurance and private insurance and not a lot of people can afford the private, so most people had to pay out-of-pocket for their surgeries and they couldn’t afford it,” she adds.
“Room-wise there’d be six or seven people to a room, whereas here people complain if there are two people in a room. . . .”
Working alongside the Kenyan medical personnel was an amazingly unique experience for both.
“I got to scrub for a lot of surgeries, which I wouldn’t have got the chance to do here,” Perry says.
“Even when you’re a registered nurse (here) you’re allowed to scrub in and pass utensils but you’re not allowed to assist in the surgery, whereas in Kenya I was passing tools, I was using retractors, I was assisting in the actual surgery. I even got to make a few little cuts, which I would never get to do here.”
Perry and Dennis did presentations to hospital staff about Canadian standards of practice in the areas of post-surgical care, for example, and procedures like transurethral resection of the prostate, which is being implemented in Kenya in the coming year.
“We did some education sessions (at a local clinic where they also worked) and through working with them the whole summer we got to find out what their core beliefs were,” Dennis says.
“So then we found out how they believe that they shouldn’t breast feed a child while they have mastitis, but we’ve been taught through best practices ways that you should for multiple reasons. So we taught them that they should do this and made a point to connect with as many people related to that enforcement that we could (to share that information).”
This on-the-job training venture was like nothing Dennis could have ever expected.
“I learned so much. The thing that I really enjoyed was getting to do procedures and skills and different things there that we would never have the opportunity to do here as student nurses,” she says.
“I got to conduct births, help women deliver their babies, whereas here that’s not something the nurses do unless they absolutely have to. It’s something for the OBGYN or the doctor. But there the nurses do that. The nurses have a broader scope of practise and I was able (with training and guidance) to be included in a part of that."