One More Week and I am Ready - to Go!

          Next Saturday at this time I'll be jetting home via Toronto and I am looking forward to it.   It does seem that my three months here is just about the right length: I have told the students everything that I know; chicken has become a four letter word; and my patience - while improving with age - has pretty much evaporated.  The cafeteria opens at 8:00 or so the sign says... at 8:55 this morning there was still no sign of life!  ... despite the choruses of  "Just now, Father."  The noises of construction generators, cement mixers, electric saws, trucks, fade into the background noises - until they stop, and then you realize the pleasure it is when you no longer bang your head against the wall.    I know that Tony and I will run to the finish this week, making the most of our remaining time -- and if I were leaving this week, I'd probably have had these feelings last week!

          I thought that you might be interested in how the students reflected on their morgue visits.  This is pretty typical :

 

          We have started our last PBL problem, "Sabrena", which we finish on our last teaching morning, Thursday.  I think that I have convinced Tony that we do not have to include that day's exam in their final marks set for that afternoon. [Say a prayer that his neurosis doesn't get the best of him and me!]

          Tuesday morning, we had guests from the National Commission on Disability come to do a presentation on the recent act and its implications for everyone in Guyana; they also offered very practical advice on how to deal with people with various disabilities.  [I had mentioned about not waving to my one-armed brother when he is water skiing.]  I had prepared the usual certificate for our guest presenters and had listed their presentation as "Increasing Sensitivity to the Needs of the Handicapped"..... an insensitive faux pas...  I was going to just rip up the certificate, but they took it ..... and I promised to say disabled the next time.  

          The act is in some ways paradigmatic of Guyana.    It is an excellent and progressive piece of legislation with almost no chance of ever being implemented .....  For example, when the "kokers" [See Endnote: Now I feel like a professor.] didn't close one morning, I had to wade through 6-8" of water on my way to class --  all wheelchairs would have needed pontoons!   Oh well, the intent is excellent.  And all the speakers were excellent; the students learned much.

         That afternoon, we did our OSCE [Oral Structured Clinical Exam]  They worked in groups of 4 and had 5 new problems at five different stations with ten minutes to discuss each problem, including feedback from the examiners.  We had three faculty who enjoyed the experience -- so who knows, maybe they will try PBL.....  I can dream!  The student teams did very well and received good grades at all stations.  One staff examiner thought that they should really know more if they were going to be RNs, but she changed her mind when she found out they had begun their education less than three months ago.   They have done very well.

          I was preaching last Sunday for the Annual Harvest Home Services at Epiphany and King of Glory churches.  I was supposed to do Ascension Church as well, but that one got cancelled.  [I guess they had a better offer.]   I had a good time and talked about "gratitude" at Epiphany and I did a Reverse Offering.  I passed around the offering plate and everyone took a quote about gratitude - no money and no sweets!  Hey, at least I liked it .....

         Then Kampta and I walked over to the bus in the West Ruimveld Market [Pics in the slide show.]  It is a very advanced Drive-Though Super-Market!   When we got to the West Bank there was no one at the church.  It seems that the government party was having a big rally with speeches and free stuff and entertainment and free transportation at the same time as MY service.   Well, Harvest Home got postponed for a few weeks and I got to talk to the remnant!  

 Yes, that is a floor mop, but to be fair Aunt Glory did clean the altar before the floors.

          I did a talk about how the Guyanese and the Israelites had similar histories.  The first lots of Indentured Indians came to Belle Vue where King of Glory is located.  It was also one of the worst plantations for Indians.  One official wrote in the same year they arrived:

"The spectacle," he writes, "presented to the observer, in the sick-house was heart-rending! The house itself was wretchedly filthy, the persons and the clothes of the patients were filthy also; the poor sufferers had no mats nor mattresses to lie on; a dirty blanket was laid under them and their clothes wrapped together formed a kind of a pillow.

In one room where there were raised boards for the accommodation of seven persons only, eleven were confined -- four of them lying on the floor. The squalid wretchedness of their appearance, their emaciated forms, and their intense sufferings from disease and sores, were enough to make the heart bleed! In the second room were found a worse class of patients. The scene in this chamber beggars description; out of the five confined there, two were dead, and one of the remaining three cannot long survive; should the others ultimately recover, it will be by a miracle -- their bones appeared ready to protrude through their skins! (these three died shortly after.) When the magistrate inquired by signs of the miserable creature who appeared to be near death, what food he was allowed -- he pulled out some hard brown biscuit from under his head, and exhibited it!"

          In the liturgy that day, we were celebrating the land that the Lord had given, and rejoicing in it.  The human spirit has amazing resiliency!   And those adults in worship would have known family who were indentured there! 

With the political rally happening at the same time, I did wonder about the similarities between religion and politics:  both seduce believers with promises for the future that one never lives to see!   At least with religion, they tell you that!

          I did a lot of Genealogy look-ups in earlier years, but this year I got one request from a big donor to Guyana Christian Charities, so I had to suck up and go do some research.   It is a good thing I knew at least that they were Catholics from Georgetown because it is impossible to get any research done at the Registry Office.  It is even worse than a few years ago!  I did find one link that I was looking for and that helped them find the grandmother's half brother in England... who is still alive.   I love happy endings -- and before I get any more requests ..... I quit!  I am leaving on a high note.

          Another high note is that we had a "boys' night out" - except that Marysia came along!  Women constantly boggle my mind.  Tony and I had tried to take Marysia and Claudette out to dinner to say thank you for all that they had done in the PBL programme.  They both told us that no thanks were necessary and they didn't need to go out to dinner.  Marysia's husband Ian had wanted to go out drinking with me, so I got him invited when Bhiro and a Cuban Cardiologist were going out on Thursday.   I told Marysia to invite Ian -- and she couldn't believe that SHE wasn't invited.   Now this was the same woman who earlier didn't want to go out at all !   So we invited Marysia in order to preserve Ian's marriage -- or at least some of the matrimonial benefits.  Lara, the cardiologist, made my night:   he knew Ché Guevara,  my hero from university days!   

          And when I tried to pay (as Bhiro had picked up the tab the last time) he said something like, "It is my honour to recognize you who came here as volunteers to help Guyana."  I was very touched.  And it was probably a good thing as a few of the crowd drank a lot of some 25 year old rum.   I still got a warm welcome from Faustina who had my Parbo opened before we sat down.  [Yes, another sign it is time to go -- she might yield to temptation next time.] 

        Tony couldn't make the Mens' Night because he was getting revived.  The church that he attends was/is having a series of Revival Services and he wanted to help the choir and the keyboardist, a piano student of his.     I did go to the opening night of the Revival as it is Tabitha's church and she is always most welcoming to me each year.    Their founder, Joshua Daniels, is 80 plus and still going strong.   However, his understanding of Christianity is much closer to Tony's than mine.   [It actually may be closer to almost everyone's view of Christianity than mine.]

          And now it is close to lunchtime!  Thanks for reading ..... and remember, there are more pictures in the slideshow above.   This is probably the last blog from Guyana; I'll do a final one after I am home.
Endnote:  On the advice of my editor.   Kokers are dams that control the flow of water into the city from the back dams/rivers and then on to the ocean.   The ocean ones are open at low tide; however, it opened at high tide and since the coast is below high tide levels.... flooding!   And in most places this is still done by hand!

  

Rains-Runs-Reflections-Repentence-Remedies

Do you remember the picture of Tony huggingly hoisting Ms Williams in the air?  (I understand that his wife still remembers... and I can't repost it- something about false representation.)  Well, he damaged his shoulder and was in considerable pain.   He has his arm in a sling and this has drawn much sympathy from all his admiring young women - until I tell them that it happened in a rum shop brawl when he fell off the wagon!   (I love it when people believe me.)   There may be a moral here for all old guys:  It is either "The gods answer wives' prayers quickly" or "One should act one's age".  I think that the former is a better moral truth, as it is impossible to believe that we "old men" could act our age.

This was my excellent sling that was later criticized as, "What idiot made that?"

As for me... I did have a case of the "Georgetown Stomach" that came and went over a few days.  I self-medicated by popping a few Immodium a few hours before I needed to go farther than ten metres from my namesake.   [No picture included here either.]  And yes, I know it's not the best treatment, but it worked.  Now, I am not sure this offers any moral lesson as my indiscretions tend to be along  the lines of Jimmy Carter's  -- though come to think of it, those did lose him the White House.   Do you ever wonder why it is easier to see moral connections in others' actions than our own?    Another kindness of the Creator.

Our friend, Deacon Kampta Karran, who is famous for his creative ways to get favours out of us for the Lutheran Church here in Guyana, asked if he could present to our students.   He wanted to know if we were interested in having them explore "Bush Medicine" and its relationship with "Western Medicine".   Sure; and besides, any presentation by someone else is one less for us.   Kampta is Guyanese and he related to each of the students in a way that Tony and I will never match no matter how many more years we return.   He demonstrated his Oxford training and his breadth of knowledge of the subject.  The students loved it and him.  And now I know something about  na-jaar,haz-lee, suk-an-tee, na-ra, hook, chat-kay, gan-daz.   Almost all the students knew most of the diseases and remedies he named.  This medicine is alive and practiced.

Kampta "curing" Stanton of something

Now rain is not a news item here (nor for that matter in Pubnico either), but you have to remember that I now live on a construction site and because of the climate changes here the seasonal rains now come much earlier and more unpredictably.  The construction team has lengthened their 7am to 5pm six-day schedule to a 7am to 10pm one in order to get the building completed enough to work indoors so the rains don't interfere with the construction.   Tony and I admire their commitment and can cope with two gas powered concrete mixers serenading below our windows from 9 to 4, but starting on Sunday at 7am stretched our powers of appreciation.  I told the foreman that I had read lots of Guyanese history and even the slaves got Sunday off!  He assured me that the workers did get an overtime differential though he refused my request for similar payment to Tony and me.

 The rains have reduced our pathway to a pond of various depths from 2 to 6 inches.  We do have a pair of boots between us - mine.  However, Tony is more sensitive to germs, bacteria of all kinds, positive and negative, fungi, worms etc., so he got the boots and I walked barefooted.   Tony assured me that "if" I got to the kin-dom, I would get a bigger reward.    And he does let me wear the boots when I go get our supper for both of us on account of his shoulder.

I have been reflecting on our PBL experience this year and I can't help but feel extremely blest in almost every aspect of the programme.    When I first heard that Mercy had accepted 24 students (the final number came out to be 20) I could not figure out how Tony and I would get the small groups managed without killing ourselves.   And then by one of those coincidences that go by many names - fate, grace, luck - a nurse from McMaster, Marysia Donnelly, was to be here with her husband, Ian, who was a VSO/CUSO volunteer -- she was just an accompanying wife and got hold of us wondering if we had anything useful for her to do -- and did we ever!  She has been a tutor with us faithfully and skillfully since the beginning - and it looks as if she may make it to the end!

Marysia Donnelly received the Best Tutor Who is a Nurse award.

 And some of you may remember a doctor that I had met last year who was wanting me to lead a Catholic Youth Leaders session on sexuality -- until she heard me voice some slightly unorthodox views.   This doctor was also the first Dean at the new Medical School at University of Guyana, and had implemented PBL there after training at Maastricht University.  Claudette Harry also had a work history that took her all over the Caribbean.  On a whim, I emailed her and asked if she wanted to give us a hand; she has responded by giving us her whole self.   She has been a tutor all semester; this is a job she has added to an already full schedule.  Now I wouldn't call her an "old woman" as that has the wrong connotations, but she has retired more times than you can count on one hand.   And she doesn't even take naps like me ..... Amazing.

Claudette Harry stares in disbelief at a student answer.

Now these two would be blessing enough, but the individual netbooks and the additional computer cafe have been such a wondrous contribution that a comparison between last year and this year is almost impossible.  It is also impossible to name all the donors -- nor would many want to be identified -- but your generosity has made a huge impact.  All of you who contributed should have received a thank you letter from one of the students.   If you haven't received one, I hope it's the knowledge that we are grateful that counts -- and I have brow-beaten them all about sending them.   We will blame it on the post offices.

All of the computers are still in the possession of the students; some have needed some repair and a spare part. We may have one that the company is willing to replace though we would need to send it back to Hong Kong ..... So the company will let us try to fix it here without voiding the warranty -- nice.  And then if we can't, we'll send it back.

 

The students have taken to the netbooks like ducks to water... well there are a few Luddites who are moving slowly.   However, most do their research on their netbook and maybe half have net access at home or at a hotspot.  The upper classes use the cafe ones and never cease to remind me that I did not give them a netbook, but their death threats on my life have lessened.    And don't worry, I do not plan to come back begging for next year's first year students ..... I hope to be able to secure a grant from a foundation as we can now demonstrate effectiveness!  So if you know of such a granting agency, let me know.   And thanks for making this year possible.

The students have become skilled searchers and able to differentiate between good information and the wackos.  (Their increased efficiency also allows them more time on Facebook as an added bonus for them.)   They have started sharing information with each other from their research via email distribution lists, have used their netbooks in the small groups to show diagrams such as anatomy to illustrate their learning, and submit evidence to us when they feel that they did not get full marks for an exam answer and we are wrong.  By the way, we are never wrong; however, we reward their assertiveness -- and acknowledge that occasionally maybe they gave a slightly better answer.

Jomol demonstrates the intricacies of a knee joint.

I could go on, but I am getting Butt Fatigue... a sure sign that this blog is long enough.   We have had some disappointments but they are small compared to the good things.   And it is a good thing if you have read all this... Thanks, John.

I am sure you can identify with this unnamed student.

Must be half way by now....

I must admit that I don't really count the days like someone else in my family; I just know that it must be past the midway mark because I am running out of stuff that I know!   I am always confused as to whether the time goes by slowly or fast ..... All in all, it does go by quickly as Tony and I seem busier and busier every year ..... especially if I let him alone for any length of time.

We are doing a few classes for the anatomy teacher to demonstrate that our PBL approach can work with any topic.  We are focusing on the knee.  And we are using me as proof that you don't have to be a "content expert" to be a good tutor in PBL.   (The last time we sang the "..... the knee bone is connected to the ...", I sang, "ankle" ....... clearly not an expert in the human skeleton ......)  We conducted a contest with a prize for the best group drawing and labelling of a picture of the knee.  The contest was fiercely fought and and rather well done.  (But at one point I did sit there wondering to myself, "Has my life come to this?")  

The two groups competing on opposite sides of a board.

"Are you sure that that goes there?"

Actually, both Tony and I are aware that we have way more things to share than we have time left in terms of class hours still scheduled.   This isn't a bad thing, just frustrating; and I imagine that even if we stayed through Christmas (just checking to see if our wives are reading;we are not staying), we would still have a few things more we wanted them to learn.   So, instead, we have been picking extra times in the week to inflict ourselves on them.   At 3 pm on PBL days, I have started doing some presentations on ethics principles, so that at some time in the future some of the words look familiar.   And it almost makes me feel better ..... but I have to encourage the students to be much more assertive.  In the case I used for "Autonomy", a 50ish woman with MS refused a soft diet and risked choking and aspirating and they agreed that she had a right to do this --- unless the doctor said it was in her best interests to have the soft diet and then we could make her!  UGH...

We have continued to go "live" to provide some variety to our pbl classes.  We brought the students up to interview a woman who has schizophrenia and epilepsy.   As with the recent dengue patients (and hopefully even with our "paper people"), the experience of the person with a disease makes it more vividly memorable.   The patient was chatty and freely talked about people poisoning her, a wonderful personal history that was entirely un-factual and the stuff of textbooks...   Then Tony conducted a continued learning session in the hallway about the conflicts in medication for epilepsy and schizophrenia.  And I talked about the difficulties of nursing chronic patients of any kind - especially those without any social supports.   Nursing, maybe more than any other profession, puts Rogers' "positive unconditional regard for all persons" to the test. 

 For the first time in a number of years, I didn't get to St. Ann's this week... I wimped out.   I started as usual on Tuesday after class on my bicycle ...... when the skies opened and I just got to the front gate at Mercy and headed to the little building there.  (It still says "Snack Shop" and also that it sells phone cards ......  However, it has not done so in my nine years -- maybe it will be a snack shop again one day, so no sense taking down the signs, eh?)   Well, an hour passed with torrential rains persisting and when it finally settled into normal rains, the street were flooded with several inches of water.   As I was already wet, that wasn't the problem -- the problem was going to be the cars on the road with all that water!  So I am becoming more and more Guyanese - the rain here is used the same way as snow in Canada.   I'll blame my lack of daring on Anne, to whom I had promised not to do anything "exceptionally stupid". 

When you are below sea level the water has no place to go.

Next Tuesday is a major holiday here -- Divali, the Hindu festival of lights.   Sister Barbara has arranged that the girls go swimming at a private pool, so I will go to supervise!  I am adding some St. Ann's pictures because Tony and I were over on the weekend to get their old computers connected to the internet... and some of the girls took my camera.

The construction noise continues, six days a week, and once they were here till 10 pm.  I tried to include a sound track of the noise, but lacked the skill..  So if you can imagine two large gas-powered cement mixers that are slightly old right under my window, going from  7 am till at least 5 pm .......  It is a constant roar and your brain gets it into the background after awhile, but it is only about an hour after the mixers are turned off that my brain becomes silent!   (And I thought living in the Bourda Market last year was noisy!   Even the dogs barking at the mango thief were quieter.)   The noise is either here or outside patient rooms... so "through suffering to glory!"   (I have suggested moving the concrete mixers permanently to outside the patient rooms as an efficient way to cut down on their length-of-stay stats!) 

Almost everything in the construction work is done by hand; there are about 30 or so workers, most of whom are "unskilled muscle" and young.  I can't help looking and wondering what they are going to be doing when they get to forty - let alone sixty......

We had a field trip to the Amerindian Museum on Tuesday, and it was one of the best conducted tours that we have had in years.   A young man there, Yannick, did a superb job in detailing all of the artifacts... So good in fact that a few nurses were appreciating all of his assets .......

Yonnick and his new anthropologist.

We get out and about... University of Guyana to see Raymond in Chemistry and Sekhar and Stephanos in IT; out to dinner with Mercy CEO Helen (I had prawn curry with french fries and it was a national "faux pas" -- even the chef came out to see if I was sure that I didn't want any rice with the curry!  He knew it was a tourist, eh?)  and other small adventures...

Anne is on her own adventure in Calgary with our daughter, Sara.  It reached a new low for us here, 23.5C (or for the Americans 74F) and people were wearing jackets.   I imagine it was a bit lower in Calgary, although Anne tells me that even there it's only light-jacket weather so far, in the daytime at least.

This is enough for the week; thanks for coming on my journey with me.