On Tuesday the internet connection in the hotel goes down and the only place I can get a connection is to sit in the lobby or on the stairs to the hotel sweating profusely. We visit the psychiatric out-patients and my group see three people – one a young woman behind a veil with depression and obsessive compulsive disorder being treated with anafranil and risperidone, a second a woman with epilepsy whose main problem is the stigma of having the condition and the third an ex policeman whose main problem appears to be anxiety who is being treated with olanzapine. We go back to the University and as part of Dr. Cant’s “Amazing Exploding World” the fuse box outside the teaching room explodes and bursts into flames just before prayers. Dr. Cant is seen wrestling with a fire extinguisher (empty) whilst the locals look on sipping tea. After prayers we relocate to another room arranged like a boardroom and continue the afternoon lessons.
Wednesday brings visitors – His Excellency the Governor of the province of Gezira no less arrives to hand out a few certificates and make speeches followed by various other local dignitaries. He is an impressive man who trained as a psychologist with a PhD in brain science. The students complain that the ceremonies have taken away from teaching time which gives us an opportunity to point out the important roles doctors have in advocating for their patients at a political level. I give an impromptu lecture to the medical students in the afternoon – the main theme being that you can’t be a good doctor without knowing about psychiatry. In the evening Tom and I cross the Blue Nile to the east bank on a local boat – then come back again and have our last meal at the Istanbul.
And so to the last day – we finish with a mixture of topics – medically unexplained symptoms, bed wetting and principles of drug prescribing in mental health. Then redo the KAPS the attitude survey and course evaluation. Lots of handshakes and photos at the end then all pile into the mini bus and a mad drive back on the near death slalom course which is the three hour drive back to Khartoum. A brief stay in the Burj Al Fateh Hotel and up at 3am with neither myself or Tom having slept and to the airport – the usual border crossing hassles and then on the long flight home.
So was it worth it. The teaching was arduous – 60 hours face to face time in two weeks - and I feel I have been here for two months rather than two weeks. We know the students have doubled their knowledge of psychiatry during each week but to make this sustainable there is a need for the system to align with the goals of teaching, for example having psychiatry questions in student and post graduate exams, getting the sheiks “inside the tent” rather than outside and so on. Of course it would be better to have Sudanese psychiatrists teaching Sudanese doctors which will probably happen over time. However the ones I taught with had never done any teaching before and seemed to appreciate the support from the volunteers. Also there are only about 40 to 60 in the entire country with most leaving for higher paid jobs elsewhere – mostly Saudi Arabia and the UK. Personally although I have done a lot of teaching in the past it increased my confidence in doing teaching with short preparation time; it reminded me of the importance of lesson plans and the unimportance of PowerPoint in learning; I got some useful tips from the other volunteers; but mostly as always I admired what could be done with so little in resource poor environments.I hope to be back.
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