McGill nursing students near end of their study exchange

Our time here is coming to an end.

It has been quite a journey and we have learned much about the friendliness and caring nature of the people of this region. We have also learned of the desolate conditions in which they diligently perform their work with the limited resources they have.

After spending the month of September working in the hospital, where we were confronted with the scarcity of supplies and medications, we went out to the surrounding villages to engage in participant observation of the home-based care services offered to the community by the CHAKUNIMU organization.

This organization offers home-based care services to HIV/AIDS patients and by word of mouth, they also offer care to any other patients in the community that may have conditions needing medical treatment. They operate solely through the use of volunteer peer health educators and service six villages in the Njombe district, encompassing a total area of approximately 40 sq. kilometres (or more).

It may not seem like a large area to cover, but as the road conditions in these villages are deplorable and access to motorized vehicles is close to non-existent, most peer health educators provide these services by walking over 20km a day to reach their patients. Those who have the resources have access to a bicycle, however as the area is hilly and ditches carved by the rains punctuate the paths, they still easily spend half their time pushing their bicycle up hills or through muddy valleys.

We spent 5 weekends in the villages collecting data based on these home-visits for a patients' needs assessment. While the results have not been finalized yet, the preliminary results show that the most pressing need in this community is financial assistance and transport help.

Some patients spend up to 8 hours a day walking to the hospital because they don't have the money for bus fare into town and the medications they need (HIV antiretroviral drugs) are not available at their village dispensary. They then get to the hospital only to find out that the CD4 machine needed to assess their HIV status is 'broken', and spend another 8 hours walking home.

A day of work lost, with no results to show for.

Other patients are looking for income generating projects because they don't have the money to send their children to school or buy food to supplement their diet of subsistence farming. Some houses are 'lucky' to be located within 20 meters of a water supply, but many others walk up to 1 hour to get a single bucket of 'clean' water.

In addition to collecting water, the children and women of the household also collect fire wood to fuel their mud stove. It is not uncommon to see in the early morning or late evening, women and children transporting either buckets of water or stacks of firewood neatly arranged on top of their head on their way home.

My experience here has been unlike anything I have ever experienced, and I do not know if I will ever again get to experience such genuine kindness and hospitality as I have experienced living with my host family in the villages. My short time here has taught me that despite the many needs of this community, there is a willingness to share and that we have much to learn from each other.

Amy Low