Seed Updates and Reflections 2016

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Stories from the Field: Malawi: Patient Centered Improvements Mindy Weschler, a Nurse Educator in northwest Malawi, grew concerned when she noticed that her students were caring for patients after surgeries with very little treatment for the pain they were experiencing. She witnessed patients undergoing painful dressing changes and basic procedures without medication, and it motivated her to help mobilize the students, faculty, and staff to address the basic human right to compassionate and dignified care. There were many reasons patients’ pain was going untreated. Students and clinicians had not been taught the complexity of pain or pain management, had cultural beliefs that often led them to accept or ignore pain, and did not have the tools to manage it. As well, the hospital’s system for safeguarding and managing pain medications made it difficult for staff to even access medications. Patients were accustomed to just bearing pain without complaint. Mindy helped mobilized her students and her faculty and hospital colleagues to assess and treat pain management through a practice improvement initiative in this busy district hospital. Today the entire process for pain management is being conducted more effectively. Clinicians are actively assessing pain and using an evidence-based pain management protocol. The hospital agreed to redesign the procurement process for medications and made medications safely more accessible on the ward. Students are participating in the evaluation of the initiative. And, most importantly, patients are benefiting. MALAWI by the numbers 11 Volunteers 5 Sites 14,653 Service Hours 64 Courses 2,913 Individuals Trained 3 | Seed Global Health | Updates and Reflections
Liberia: Caring for Fistula Patients Each year between 50,000 to 100,000 women worldwide are affected by obstetric fistulas, a hole created in the birth canal caused by prolonged labor without adequate medical intervention. Women who suffer from an obstetric fistula often lose their baby. In addition to the suffering from a lost child, they frequently are burdened with fecal and urinary incontinence and the painful humiliation and stigma that accompanies it. If left untreated, obstetric fistula can lead to chronic medical problems and even death, but surgery can normally repair the injury. Dr. Corrine (Cori) Maund had never encountered a case of obstetric fistula until she arrived in Liberia as a Physician Educator. During her time there, the hospital hosted a “ fistula campaign,” in partnership with visiting surgeons providing free surgery to women living with obstetric fistulas. “I have learned so much about fistulas since arriving in Liberia and as I learn I am reminded of the need for a strong healthcare system that can meet the needs of women,” says Cori. As she cared for the women recovering from surgery, she heard their painful stories of pregnancy and birth that lead to their injury. As Cori recalled, one her patients’, Garmai’s, baby died during her pregnancy. Garmai was left with a fistula the entire length of her anterior vaginal wall and was uncontrollably leaking urine. She was abandoned by all except her mother. Though Garmai had a difficult surgery to repair her fistula, it did not resolve her symptoms entirely. “I had to tell her that the surgery didn’t work, and she would need another,” explained Cori. “We cried together. It took her a long time to recover the hope she put into the surgery, but with love and support from her mother, her fellow fistula survivors, and me, she stayed positive and recovered well.” Understanding first hand that teaching and training the next generation of obstetricians and fistula surgeons is critical to the health of mothers and babies, Cori has remained in Liberia for a second year. She will continue to provide education and training to future health care providers, and ensure more patients like Garmai get the care and treatment they deserve. LIBERIA by the numbers 8 Volunteers 8 Specialties 2 Academic Partner Sites 4 | Seed Global Health | Updates and Reflections
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Seed Updates and Reflections 2016

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