Once more unto the Breech...

I see you stand like greyhounds in the slips,

Straining upon the start. The game's afoot:

Follow your spirit..
[Willie Nelson, I think ..... or was it another Willie?]

First Week at Mercy

I do look forward to returning to Mercy... and I do not like the overnight flight; and now everything stops in Trinidad, so adds another couple of hours.  Initially, I was excited as I had the row to myself and it seemed that everyone had boarded - wrong.   A rather large woman (How large you ask? Well not to make any politically incorrect statements, let me just say that she had her own personal seat belt extender) sat on the aisle seat and the middle seat as well.   The flight was fine except for being held captive for over an hour in Trinidad while they cleaned the plane and changed crews.  Funny, the crew needs to get off and stretch, but the passengers can stay.  

Waja was at the Guyana airport to greet me and I arrived at Mercy with little fanfare, but did receive a warm welcome from everyone I met.  I headed to the flat to meet my new roommate Dr. Edi, a Cuban dermatologist, who is working here at Mercy.  I had even brushed up on my Spanish - which is still atrocious.  However, there was no sign of Edi. He is staying in the Team House. I wasn't disappointed as I do like to be alone much of the time.  I took the bedroom that I had last year.   Then, the first thing I noticed was that there was NO shower downstairs -- until I saw that they had not closed off the second floor as they said they would, so the upstairs bath was still there... and working.

Maintenance fixing the doors, new locks, including the front door,
repairing screens, replacing lights, etc.. Great work

Actually, the whole flat had been painted [including the light switches which were somewhat stuck initially] and two extra bedrooms were now on the first floor.    Not bad: they are a good size and nice new doors and spiffy locks though no one actually checked to see if the doors closed.   Small problems, and the guys from Maintenance fixed almost all of them on Monday:  I was impressed. The flat is very adequate for a slob like me, but I will need to up my game as my niece, Doctor Emilee Flynn, is arriving on early Tuesday Morning.   (More later about Emilee.)  The fridge is the same manic-depressive one there for years - sometimes it freezes everything and sometime it cools nothing.  It seems like home to me, like I belong here.

 Church on Sunday

I decided to get to Calvary Lutheran Church on Sunday as I did not get there last year and they even put me up in their manse several years ago.   They are without a minister and wanted to know if I needed a job, so I wasn't expecting many at church.  However, it was pretty crowded and with lots of young people and lots of people who remembered me.  I remembered them, too, but their names have long since disappeared.  Surprise: it was National Youth Sunday Service... The youth were energetic and involved; it was great to see for the first hour, less so the second hour, and by the third hour I might have faked an injury, but I was warned that they wanted to welcome me in the announcements at the end of the service ......

Do you know how some sermons are memorable - some for the right reasons and some ..... Well, there was a seminarian from Jamaica Seminary here for the youth and he delivered the sermon. When you are beginning your talk in the third hour -- wellm even Billy Graham would have trouble.  

He chose a sermon text from Ephesians 5,3  "But sexual immorality and all impurity or covetousness must not even be named among you, as is proper among saints."  However, he kept referring to it as sexual immorTality, and I do have to admit it made the sermon more interesting.  And when he was describing the woman who had bled for years in Luke 8, he said that the reason she was unknown was that, "she was probably wearing a hoodie."   A smile-filled sermon.  

I started with my first class as if I had just finished the last one the day before.  (I do admit that I sometimes get a little worried that I may have "lost it" over the intervening months and no one told me.  Luckily for me, with friends like mine, they would be lining up to tell me.) 

Here are my bright and eager students.

Changes at the Hospital

There have been lots of changes.  I guess the most important overall is that the "new" CEO Dr. Bridgemohan resigned in order to start a venture with some family members.  He had brought a new enthusiasm to the hospital about patient volumes, new services, etc.  We wish him well in his new venture.  Helen Browman is back as Acting CEO while the Board begins a search for a new CEO.

However, the bigger news from a selfish perspective is that the walkway from my flat to the hospital was raised a good six inches... so maybe I won't need to put my wellies on when it rains.

The Main Entrance walkway is much higher.

The school walkway, Sister Sheila Way,is now elevated a whole 12".
but it does mean that you have to step down and then up...

 There is a nice outdoor patio eating area for the cafeteria and numerous baskets of plants make it an attractive area for eating and chatting.   I will surely come back if the next improvement is a Pub.

Doing it in Reverse

When I go home after three months here, I almost always get a respiratory infection.  This year I decided not to wait and got one right away.  I even went to Emergency here at 3 am on Friday morning.  I got great care, an xray and some medication, and I was back in the flat by 4 am.   I have not been feeling up to par and the doc said "Don't go spreading your germs around!" so I didn't get to a big meeting on Thursday nor to my girls at St Ann's ..... I have been in my flat all the time, except walking over for meals.   But I am well looked after as everyone from the Board Chair to some of my old Bosco boys who volunteer here knew I was in Emergency.  And my neighbour, Dr. Devi keeps checking up on me, including bringing me her honey and  lime syrup to sooth my throat as well as a few mangoes.   I think I am getting better and have Sunday to recover before the big event on Monday night.  You will have to come back next week to discover what or who the big event is.

Have a good week and thanks for reading.

A Third Gone - And I Guess That Means A Third to Go

No I haven't Failed Maggie's Mathnasium Class*
I do know that I won't reach my beloved wife and my home for another 55 days, between finishing here and stopping a week in Florida with siblings .....  But time as a construct in my mind doesn't go always by hours and minutes... When I first arrive in Guyana I always believe I have soooo much time to do everything that I have envisioned with no sweat (always wrong on the no sweat part).  However, after the first month I know that I must carve out some of the wonderful things that I want to do and keep focused on my primary tasks related to my nursing students and my St Ann's girls.   The days will start to pick up pace; and, I will be leaving before I realize it.
* Maggie is my youngest sister and runs a Mathnasium school in Waterbury, Connecticut.  If you do go there, do not ask for the family rate - it is double!

The PBL Course

The students are well into adjusting to the different learning modalities involved with Problem Based Learning.  When Tony Carr and I first started teaching this way at Mercy we were really worried because it was going to be so different from anything they had ever experienced.   But each year, they take to it like ducks to water and with enthusiasm -- if not always with compliance.   They have been involved with an educational system that told them what the answers were to the questions the teachers would be asking on exams.  So a method where the student is responsible for their own learning...  Somehow, it works!

Each PBL part has two sessions connected with it.  In the first, the students meet in groups of 4 or 5 and read a the "problem story" page to see what they already know; then they start identifying issues from the story that they would like to understand better.  These are then divided up and off they go to start researching (well, maybe there is a FaceBook break or a stop for food) in order to teach their small group batchmates in the next session.

I have added a little incentive to the process.  They are supposed to send their work out by email to everyone in the class before the next group, and almost all the students do -- except it was often happening 1 minute before the session ..... not really helpful.   So now I award a couple of marks if the research reaches everyone before 8:00 AM on the session day AND if it has reference links AND relates how their new knowledge helps them to understand the developing account of the problem.   (I have had to threaten only one or two students with jogging around the block if they don't get it straight.)  Then I give them additional suggestions and a few more questions.  (What I wish I had realized before I started all this was how frickin' long it takes me.)



Then, in the next small group session, each student takes their turn teaching the others what they have learned and what all of them need to know.  They answer questions from the others and do additional research if they can't answer them.   After that session they have a small exam on 4 questions that they may have researched - or not!   (One of the tutors scores the exam with comments that encourage more learning.) 


Immediately after they finish, we give them some of the answers to the exam, so they have some immediate feedback.  I am positively amazed at how they study the answers and often argue with the tutor about why they think their own answer was correct.

In all, there are over 120 set of marks.

This is a mark/exam-obsessed country; marks determine who gets into everything, from the best Nursery Schools to University .....  I tell them I don't really care about a grade; I care whether they think they are learning something.   They seem to have a hard time adjusting to that!   One student was so upset with doing poorly on a small exam (I have no big exams) that she wanted me to let her study and then give her another exam.  "Nah, you don't need to do that.  What mark would you like?"  She said, "10 out of 12."  "Okay then take your exam and write better answers on some of your missed questions until you have 10 out of 12 correct.  I'll change your mark now, so I don't forget.  And please tell all the other students they can do the same."  "Rev John, you are crazy."

One day last week, the classroom was being used for something else, and the students were going to do nothing, so I sent them home with the task of learning simple brain surface anatomy.  I told the director they would study at home ..... so they left hours early.  On Monday, I gave them a simple exam on the anatomy of the brain.. OMG! The class average was a 3.2 out of 12... a new low.  They wanted me to give them the test again. "Okay, no problem."   I even gave them the same  diagram of the brain that they would be tested on .... and I would replace their old mark with the new one.   Some of the traditional tutors thought I couldn't/shouldn't do it...  But it really doesn't matter how you make ice -- wait for February in Canada or get some from your freezer.   I want them to learn ..... and they did, with much better (though not perfect) marks.  I offered to buy pizza (my usual bribe) next time if the class average is higher than 10.0 ..... and if their individual marks aren't as good as the second exam I'll give them their first mark!  They are still thinking about that one.
One student actually wrote how much she likes learning this way:  she can't wait for the next page to see what happens to the people in the story.     Can't get any better than that.

Another Mercy Person... 

Desmond always wears the boots, hat and coat...

The exclusive interview cost me
two pones and a drink

Desmond Jacobs

Desmond is the "baby" of four and was born in New Amsterdam, Berbice He loved playing cricket and football.  He came to Kitty, in Georgetown, when he went to school.  Desmond still lives in Kitty; he is married and has two children, Adrian and Jenny, and seven grandchildren.

Desmond is a newcomer to Mercy Staff who just started in June of this year.   He has had a long history with the Guyana Police Force.  When  I asked him what rank he had, I think he said "General".  His official title here is less assuming:  "Groundsman/ Gardener".   This suits him well; in talking to him, you can see the satisfaction he receives from keeping the gardens and the grounds clean..   Desmond said, "Mercy is a nice place and I want to do my part to keep it nice, and make it better for others."   He works hard all day long in the hot sun of the yard... and in his boots!

When I asked him what he wanted to share with my readers, he said, "Work hard. Save your money.  You will need it when you are old."   "Anything else, Desmond?"   "Come on down to Guyana and see -- and go to our many beautiful places like Bartica and Mabaruma."

And where are you going to be in ten years?  With true Guyanese concrete logic, Desmond says, "Don't know yet."    "Okay, so where would you like to be?"  "Relaxing. Home"

On a side note:  Desmond has no internet access, so he wanted me to print an actual picture.  I walked down to the local photography place and their machine has been busted for over a week and ..... Nothing more.  That is it .....  Just:  it is broken! 

And a Special "Encore" Appearance, Benji
 

Benji wanted an action shot!

Sylvia, the Birthday Girl

The nursing students hosted a surprise birthday party for Sylvia on Monday before class. (They have the same educational principles I do, including almost anything is better than class!)   They had gotten two big chocolate cakes and cokes with a real plate for Sylvia...napkins for the rest of us ..... and sung a rousing round of the Guyana Happy Birthday song.   She was surprised and thrilled and they enjoyed it too.   Though they worked hard at making all their touching speeches last, we started class only a little late!

What a Surprise... Thank you students.
You even designed the blackboard
and look at those lovely cakes.
And the traditional Guyana speeches ..... 

Cuba and Guyana
I have talked before about the role that Cuba provides in health delivery here in Guyana. There is a bilateral agreement between Cuba and Guyana; the Cubans supply doctors, from Family Docs to almost all Specialties.  These doctors come here for two years and have left family back in Cuba.   If it weren't for Cuban doctors there would be no medical services in the interior of Guyana.

Cuba gives scholarships to 50 Guyanese students a year to study medicine at the medical school in Havana.  Last year, the first set of Guyanese students graduated with their MD diplomas and are back serving their people here in underserviced areas -- which basically is the whole country when you come to think of it.

I have attached a TED video about the medical school in Cuba.  It is not long and worth a look. http://video.ted.com/talk/podcast/2014P/None/GailReed_2014P.mp4

An old Friend and Colleague Stopped by 


Erv Janssen, a retired child psychiatrist from Tulsa, Oklahoma, was in the country for a week celebrating the opening of the Lutheran Music Academy in New Amsterdam.  I will need to do a whole story on this amazing school -- later.

Erv has been coming to Guyana almost twice as long as I have.  He started with medical missions, then it was with construction crews... and finally, in his last reincarnation, as a music enthusiast.  He has re-started the Annual Guyana Music Festival that brings together choirs and musicians from all ten regions for a juried show at the Cultural Centre.   He has also encouraged Professors Michael Murchison and Eric Sayer from St Olaf's College in Minnesota to supply music graduates, and the Lutheran Church in Guyana to provide the space for the school, at their headquarters in New Amsterdam.
It was good to just sit and chat with a friend.


Enough .....  Actually MORE than enough ..... Stop.

Thanks for reading.  John

Peter Puts Pen to Keyboard ...and Remembers Guyana

The Difference a Year Makes

Just over one year ago, I knew about Rev. John O'Connor by reputation alone.  I knew he was an ordained Lutheran pastor and a former chaplain.  I knew that he had an interest in doing ministry in Guyana- some kind of ministry.  But the one time we communicated by email, he was in the process of moving back to Ayr, ON from Nova Scotia.  We agreed to get in contact with each other when things were more settled.

About one year ago, John and I finally met for coffee.  He shared about his chaplaincy work in the past and about his annual teaching experiences at St. Joseph Mercy Hospital in Guyana.  About three months every year for the past 10 years!  I shared about my one trip to Guyana, representing the ELCiC at the 2011 annual church convention of the ELCG.  I also shared about being in ministry at Maranatha Lutheran in Waterloo and about being a family physician working on the Specialized Mental Health Unit at Freeport Hospital.  I tried, somewhat ineffectively, to explain my odd dual calling to both ministry and medicine.  We talked briefly thereafter about the possibility of doing some work together in Guyana.  My response was muted -- where was the possibility to make a lasting difference??

In February, John and Anne joined Maranatha for our annual Black History celebration.  We didn't have much time to connect in person that day, but I believe that you can tell a lot about a person by how they lead a service and by how they preach.  Wasn't sure what John thought after that day, but was pleased to be invited to go for coffee again...

By spring, 2012, conversations with medical colleagues at Freeport led to a first meeting of our current Guyana group- Sujay Patel( Freeport psychiatrist), Ram Kalap ( Guyanese born chaplain at Homewood), John, and myself.  We talked about the idea of a medical contact-making trip to Guyana sometime in the next year- most likely when John would be back in Guyana between Sept. and November.  We talked about a needs assessment and we talked about meeting people.  We talked about who might support a trip like this with more than kind words and best wishes.  We talked about the realities of family life in Canada and the need to plan a trip only if we would truly follow through on a commitment to go.   We were blessed to receive concrete support for this trip both from Bishop Michael Pryse of the Eastern Synod and from Homewood Health Centre in Guelph.

In September, Sujay and I booked our tickets together.  Within a week or so, Brenna and Ram had also committed to an October trip to Guyana.  The Fellowship was established!  But what would we find and what might possibly develop?    Read on!

If you have followed this blog over the past two weeks, you will know exactly how much has been accomplished between Oct 23 and Oct. 30.  Thanks to John and to Dr. Bhiro Harry, we have safely explored Georgetown, Suddie, New Amsterdam, and the village of Fyrish.  We have visited the Georgetown Public Hospital,, St. Joseph Mercy Hospital, the Suddie Hospital, and the National Psychiatric Hospital.

Brenna brought her Second Year
Class's Mascot - Flat Stanley 

Can you find Flat Stanley?

 We have met and shared in mutual reflections on mental health care in Guyana with the first year nursing class at St. Joseph Mercy hospital.  We have connected with Pastor Moses, president of the ELCG at Calvary, and with Pr. Vivian  (and her husband, Eric, fellow Canucks from Lunenburg, NS) at Ebenezer Lutheran in New Amsterdam.  We worshipped at Ebenezer on Reformation Sunday in the 270th year of the existence of the ELCG!  And we learned that it was at the 2012 Closing Service of the ES Biennial Convention ( hosted by Maranatha at Waterloo Lutheran Seminary with guest preacher, Pr. Paul Moonu, president of the ELCG) that Pr. Vivian first heard her call to serve in Guyana!

Do Ministers of Health Give Official blessings?

Canadians [plus a lone American] meet with Minister of Health Hon Dr. Bheri S. Ramsaran.  [l-r Dr. Bhiro Harry, John, Rev. Dr. Dennis LeBlanc, Brenna Patel, Dr. Sujay Patel, Minister, Rev. Ram Kalap, Dr. Shanti Singh, Director for the National AIDS Programme Secretariat and Rev. Dr. Peter Kuhnert  

Today, our final full day in Guyana, we met with the Minister of Health, Minister Ramsarran.  He talked passionately about his hopes for developing the mental health care system in Guyana.  He talked about the opportunity of having 100 medical graduates repatriating to Guyana within the next year after training in Cuba, and the need for someone to guide them in nurturing a passion for and skill in providing excellent mental health care.  He talked about the possibility of future partnerships  and invited us to contact him when we had more details to provide.  This afternoon, we met with a reporter from the national television channel, NCN, Ms. Samuels.  She had first approached us with the idea of an interview after worship at Ebenezer!  The ministry gave its blessing and the interview occurred today.  Sujay spoke eloquently about opportunities for partnership and for training family physicians and nurse practitioners and for bringing allied health professionals to train local trainers in Guyana.

Following the meeting with the Minister, the team was still exchanging ideas
in the waiting room of the Ministry of Health

Autographs are now $100 each.

Tonight, we enjoyed our final meal together with Dr. Bhiro Harry, with John and his old classmate Dennis, and as the Fellowship quartet. We reminisced about the amazing and blessed events of the week and we began to dream about what might yet be.

TV Stars in the making.  We all gathered
to see the Canadians on the Six O'Clock NCN News

If you can't wait till the full length movie comes to a theater near you:  Click Here.

Good bye... till we meet again.

What difference can a year make?  A mere 365 days?  Some would say not a lot.  Of course, others would say the entire world can change.  It certainly has for us.  How will this adventure continue?  Today, I can hardly say.  But then, of course, that's the story for next year.

Thanks to you, John, for the opportunity to guest-blog for you.  You and Bhiro have been gracious and thoughtful hosts and exceptional planners.  I am grateful.  Our team is grateful.  

Thanks for being a blessing.    Peter Kuhnert

Peter Kuhnert is a Medical Doctor and Lutheran Pastor.  Back in Ontario he is the pastor of Maranatha Lutheran Church in Kitchener and the medical doctor on a specialized geriatric mental health programme at Grand River Hospital. 


"Some Unknown Reason"
A student reflects on her visit to the "Berbice Madhouse"

Upon entering, I saw several persons going about their daily routine as they talked to themselves, which at first seemed very amusing until it actually hit me that these people are really ill and society has shunned them because of an illness which is beyond anyone’s control.   As my tutors and fellow batchmates enter the first ward on the hospital ground, I started to panic for some unknown reason.   Rev Dennis, introduced me to a patient by the name of xxxx who was very wonderful, she told me about her morning and was packing to leave the premises  as she indicated that her relatives are coming to take her home.  When xxx left me, I stood in the corner and observed every detail of each patient within my view and tears came to my eyes as I stood helpless just looking on, how these patients lost their husbands, siblings, children and friends all because of a mental disorder.

Beverley Ponders the Experience

I have been home a week now and am having some difficulties adjusting back into my old life.My heart is full of love and joy for my family, especially my darling baby grandson Kalin 

Beating the drums because his Baba is home

...but at the same time I feel a deep sadness at having left my wonderful freshman students at St. Joseph’s Mercy Hospital School of Nursing  in Guyana.

When I left for home last Friday, the class gave me a poem that I would like to share.

“ Slowly the leaves of memory will fall

I will pick them up and gather them all

Because today, tomorrow and ‘ till my life is thru

I will always cherish this friendship and you”

Thank you Ariel, Vikram( Vicky), Niravana( Nir), Shellon (Gravendande), Kenishia (Neshia), Bibi, Hakeema (Keema), Marissa, Lisa, Keisha, Lavetta (Lovie), Zoanna ( Zoey), Vansessa, Jonice (Jon), Michelle, Telisha, Nikita (Nikki) and ALeea (Leea) 

"Don't go.  Send Rev. John instead."  I know they didn't mean it.

I will always remember you and our shared learning experiences. Please continue to fight for your dreams.

Thank you also Rev. John for inviting me to be part of your very important work not only with the students but also with the children at St. Anne’s Orphanage who clearly adore you. 

My visits with the children and Sister Leonie filled me with admiration for the courage of these little children and for the love and dedication of those who care for them.

Sister Leonie says. "Great having you around Beverly."

Out and About in three weeks...

This drinking water stream outside Linden
inspired my un-inspiring sermon from Amos,
"Let justice roll down like waters and honesty like an ever flowing stream. "

to a $2.50 market lunch

Enjoying the beauty of a resort

the sweat of the Cane Factory at Wales

Some Reflections

The greatest difficulty for the first time volunteer is getting information about  Guyana, that you can trust. It would be helpful if volunteers received a little on safety, customs, clothing restrictions, food etc. that apply to the area where they will be spending most of their time. Being a volunteer is very different from being a family member visitor and there are marked differences between the concerns of male and females as well as age related concerns.

My expectation of myself was to be useful and not a nuisance. However, not really understanding the cultural norms and expectations, I initially felt very insecure. Although I have traveled extensively on my own both in the Americas, Europe, Australia and Asia, the difference in coming to Guyana was determining what information was true and what was media or protects ourselves against lawsuits hype. If you are a young perky woman and males shout rude remarks from passing cars, your danger alert is much different than when you are an older unperky woman, struggling along the road side careful to not trip over chunks of broken pavement. Both situations can be potentially dangerous but  for a quick mugging the older person is an easier target. So strategies for personal safety are different . I found it difficult to determine how to keep myself independent yet safe.

So I arrived a nervous wreck. Lucky John!  The first week was tough getting settled, heat, humidity, and the brightness of the sun made me feel out of sync time-wise. At breakfast time it seemed to me that it was noon because the sky was so bright. I had a couple days of feeling “punk “ off and on  but John graciously gave me the air conditioned computer room ( there are no computers—they mysteriously disappeared) for my tutorials. I got accustomed to the climate differences quite quickly.

Accommodations were rustic but being born and raised in western Canada, ( western Canadian women are tough) the living conditions were similar to those that I have experienced in my cabin in the bush in Northern Manitoba /Ontario. I love it there in spite of the limitations. At my cabin, there is now a shower that sometimes trickles a little water on you but it beats bathing in polluted lakes thanks to the granite industry. Granite countertops anyone? Bugs and critters are your neighbors and unfortunately, here in Guyana, I had to kill three of my cockroach neighbors, Marvin, David and Jack. I have my standards and they were just getting too friendly. John said I didn’t have to drown them in insect repellent. To each his own.

We ate at the hospital most times. The food was tasty but sometimes I needed more protein. I really enjoyed our trips outside the city. We visited a sugar cane factory and saw the most beautiful bauxite mine. I couldn't resist giving one of the hospital glamour girls a shot about the potential for lung disorders due to working in the factory without a mask. John dragged me away from her while I was screaming and ranting. Administrators are the same the world over I guess. So are old broads.!

I didn’t go into the jungle, no time and it really wasn’t a priority for me. I’ve been to the jungle in Brazil and I really wanted to see how people live in Georgetown. The city is a tragic postcard of colonial rule. It was like looking at the wrinkly face of an old woman and failing to see the beauty and gentleness in her eyes and the strength of her aging spirit. Colonial times must have been spectacular from an architectural perspective. All the buildings are  wooden with intricate wood designs and inlay. Unfortunately, most of them are rotting away but they still retain a certain beauty. There are still beautiful churches and  Hindu temples that are colorful and well maintained . When you consider the shameful history of the country , the energy of the people is short of miraculous. When “ nothing ever gets done” or when things “change without rhyme nor reason” its hard to remember that this is a society in which people have an inheritance of slavery and oppression. Consequently, there is still a somewhat fragile infrastructure and as a result there is dirt and garbage everywhere-----.But, the sun shines, people smile and the music is joyful and uplifting.

I met some really nice people. The security guard at the hospital grounds loved reading romance novels and some days we chatted about romance and real life. She felt badly because she was working and couldn’t go walking with me and she felt it wasn’t safe for me to walk alone. I walked around the hospital area and felt o.k. When I asked my students about walking alone, one of them very politely said to me” But Mam, look at your hair, nobody has hair that color.” We laughed and joked about store colored hair.

So I tagged along after John. He was thrilled, I’m sure, especially after we had a talk about stride length differences between a 6 foot male and a 5ft 5inch female. Fortunately, being a physio I had the “facts” at my finger tips. I’m leaving out the part that I’m a dreamer who like to look at absolutely everything as I walk around.

The course for the freshman nursing students is excellent and John works 24/7 to make everything work for the students. I found the approach to sometimes be very doc oriented and Tony is a hard act to follow. But it all worked well for me because we focused on a team approach with emphasis on nursing goals. I found the exam a day very different from what I was used to as a PBL tutor but I understand the need in Guyana for continuity across programs. I tried a few tricks with my students which seemed to work well for us. After tutorial and before going into the exam room, we did some breathing exercises and then I told them to grab a brain and turn it on as they went through the door to do the exam. A small joke but  they laughed and rolled their eyes. Maybe it  worked  because they did well in the tests even if the questions hadn’t been fully explored in the tutorial session.

 I was very impressed by the student’s desire and the sacrifices they made to learn. Their ability to quickly synthesize information and apply it to the problems was outstanding. It was a far cry from some students I had at home who would file a complaint if a tutor gave them a grade of an A instead of an A+ even though they had tried to pass off work done in another course .

The amount of work John puts into organizing ,planning and designing the course is incredible. The creative way he present ethical issues to the students so that concepts are presented and discussed in an atmosphere of fun is impressive. I learned a lot.

The last two weeks past very quickly and before I knew it, it was time to go home.

Epilogue
Years ago, a Physio pal told me that the only reason for our lives was to help each other along life’s journey. Thank you very much ,John, for giving me the chance to not just “talk the talk” but also to “walk the walk” even though my steps were very small and the distance traveled very short.

"Some tastes remain on the tongue a long time."

All the best to everyone.

Beverley