The gals have much better titles than I do. The past few days (Monday through Wednesday) we have been at the Princess Mariana Hospital. This trip has focused on interdisciplinary education and practice, but this week the PTs, SLPs, and AUDs have been separated.
The PTs have been treating patients in their outpatient sector (from home) and in the inpatient portion of the hospital. The Mariana Hospital calls the inpatient side, or the acute care side, the ‘wards.’ There is the maternity ward, ortho ward, medical ward, pediatric ward etc. Each ward has a male and female side. Each ward is a small building connected to each other by walkways. Its definitely a different setup than we are used to in the US. The PTs here work on both the outpatient side and the acute care side daily to get some variety and stay keenly fresh and aware of what is happening on both sides of treatment. The schedule on the outpatient side is kept by written books. The craziest thing to me is that each patient is responsible for maintaining their own medical records. This means that the patient transports their medical records with them at all times!! This presents several problems: the obvious is the patient could lose their medical records and all their referrals and past medical history. Second, the therapists have no idea what they are about to encounter until the patient walks through the door. Third, hand writing is not a strong suit for any of the doctors here so it is very difficult to read the writing in the patients’ charts. Another difference is the ‘screening’ process. Screens exist in order to avoid 6 months to a year wait for the referral process. Patients would get a PT referral, but PT would be filled and the patient wouldn’t be able to be seen for a long time – up to a year. The people of Botswana came up with the screening process. The patient can walk in, be screened, and given some home exercises until they are given a proper evaluation a couple of weeks later. The system is way different, but it gives the patient something to work on until they can be given a proper evaluation.
The SLPs have had an interesting experience at Princess Mariana Hospital. They only encountered outpatient clients, as they received no inpatient referrals during the two days they were there. There were only 2 practicing SLPs at Princess Mariana- one who prefers to work with children and one who prefers to see adults. Our SLPs had the pleasure of working with Miracle, only seeing children in the outpatient setting Monday and Tuesday. Sadly, the other SLP, Anita, was out of town. The SLPs got to see clients from 8am- 2pm on Monday and Tuesday and then Miracle took them on a tour of the hospital Tuesday after seeing patients. The highlight of those two days was seeing a little boy whose family drove 8 hours just to see our students and have their child evaluated. This couple lives near Gaborone, but was on vacation up north in Botswana. They had learned we were coming to Gaborone and decided to make the 8 hour drive back to see the SLPs while they were still here. It was amazing to hear how involved the parents were, vigorously taking notes and writing down strategies Lauren and Morgan had to offer! Hearing stories like this gives us a great sense of satisfaction that we are making a difference.
The Audiology students were able to participate in evaluations for all ages and a hearing aid fitting while at Princess Mariana. The patients and practice here had many similarities and differences to the United States. It was comforting to see the parents being so involved and caring for their children, a common theme across our experiences in Botswana. The patients were so grateful to get help and understand what was going on they took any and all advice given to them. The hearing aid patient was so appreciative of their new ability to hear with better quality and clarity. They gave our audiology students and the Botswana audiologist profuse thanks. We learned that sometimes less information is more with the hearing aid patients and may need to modify our process at home in the states.