The "Last Post"... till I am back home

This Week's Pictures

I still can't get that slide show working 

So click on  This Week's Pictures.

I have a Dilemma about Returning Home

This morning when I went to get an egg sandwich for breakfast... I saw to my amazement the "Donut Lady" had returned after a year's absence. Fresh, still warm, large, sugar ones.  And during my last week... Oh the Agony!

The First Year's Turn to visit the Morgue

The 2016 Survivalists of Rev John's Trip to the Morgue

After our visit being cancelled last week because there were too many medical students, we returned on Wednesday.  But when we got there -- more medical students.   When Dr. Singh arrived on his motorcycle he saw me ..... He would take care of everything.  I hoped so, as I wasn't leaving this time.   He was a man of his word and arranged to have one body brought in to an adjoining room where my students were also led.    Here the associate pathologist also a Singh ["Singh" is like "O'Connor" -  dime a dozen name] -- first name Yogeshwar [not a dime a dozen name].  I'll let one of the students tell you about the visit:

"My first experience at the morgue was terrifying.  I have always been afraid of dead bodies, not because they scare me but because of the fact that I know that I am going to die someday.  Seeing them makes me wonder about my life and when it is going to end.  This is the scary part because, I don’t want to die.  I don’t want to leave this world and my family and friends.

But being at the morgue today helped me to appreciate life a whole lot more.  It made me realize how meaningless riches and popularity and material things are.   It was difficult looking at the body just being butchered like an animal or some piece of meat.   I thought about the fact that he had a family and how they must feel knowing that he is gone, but I also felt good that they were not there to witness such a gruesome thing.  

Other than what was going on inside me. I was afraid that the smell would get to me, but it didn’t.   At one point I was afraid to look at the face of the corpse, but thankfully I had my friend to help calm me down and I started to relax and that is when I got curious and wanted to touch.  Even though I knew it was a dead body I kept looking for some sign of life.  Personally, I find it hard to understand what it means to be dead. 

Other than my personal fears, the trip to the Morgue was good.  The pathologist Dr. Yogeshwar Singh was a great teacher.  He took time to explain lots of things to us, even though I can’t remember half of it.  When the organs were being removed from the body, I somehow started to feel a pain in my heart; I thought that I would faint.   I wondered if he was feeling any pain.  Even though I am curious, I don’t think that I ever want to go back to the morgue, much less witness another autopsy.   

I must say thanks to Mercy School of Nursing for giving me such an experience.  It has taught me a lot and I plan to share it with my family and friends.  I want to help someone else to appreciate life and their loved ones a little more than they do right now."

Speaking of Scaredy Cats  Frogs and Rev

Bad Selfie with Gecko

A few weeks ago, one of those salamanders or lizard things dropped down from the ceiling on my head...  and I was just a little jumpy.    These geckos are all over and more a nuisance than anything else.   However, early this morning as I lay sleeping, I felt something walking over my ear and when I went to brush it way - it was pretty big - a frickin' frog.  Now I did scream "a little", but I think that I may have had just cause.   We both lived.  I caught the frog and put him [although I guess it could have been a her] outside.   And I live on the second floor ..... now I have "The Celebrated Jumping Frog of Mercy Hospital".  Sorry Mark Twain.

Final Exams - a Time for Massive Prayer

Singing to the End - and a new adventure.

This is the time of year that my freshman class of 2013 finish up and prepare to write their National Final RN exams... three days all together - two written and one practical.  As tradition would dictate, on the day before, the whole school assembles and wishes them well with prayers and advice.. and we send them on their way to do battle!  In some ways it is had to believe that it has been over three years since they first stepped into my classroom.

                                                              Singing every day.

Leave it there for Just Now

I heard it said that in battle, you need to leave everything and everyone where they die... However, Guyana has taken that message to heart even in times of peace. Stuff just stays where it stopped or was left. A few examples:

Storage?

Never know when you may need it.

But Officer, I only went for gas.

I may be next!

And my famous "Guyana 911" ambulance of 2010 - still there!

Great News Finally

The first classes for the Master in Medicine - Psychiatry were held.  I got the honor of teaching in their second class.   Now I hold the title of "The Absolutely Best Foreign Professor". [Remember Raj?] There have been so many people who worked hard to achieve this, especially Drs. Bhiro Harry and Jorge Balsiero... and our Canadian Mental Health Team Members... who are even more excited about participating in the future.  They are already planing their February and September trips in 2017.  Ask about how you can join them.  There are four doctors who have been helping in the Psychiatry Department at Georgetown Public Hospital for a few years and hoping that the residency would finally start... and now they will get credit for all their hard work.

I met with them in a state of the art multimedia centre at Georgetown Public Hospital... equipped by a Canadian company.  I forgot to get the benefactor's name, as I am not above groveling to get a smaller one at Mercy SoN.   It is also equipped with a phone line that kept ringing on the screen... and I couldn't figure out how to answer or stop it!

New Residents: Drs Vanetta, Elizabeth [Head Resident], Stephan, Old Fart, Meena

And before I forget...

I had a good visit with Raymond Jagessar, who is now a Full Professor in Chemistry at UG... and a "good" Lutheran.   We shared a drink [Ray's was coconut water; mine wasn't] with good memories of Pastor Dick Young who has vanished into the Oregon hinterlands.

And when I was in New Amsterdam I had a quick visit with the  Lutheran Music Academy there.  I had a lively and enthusiastic conversation with the three new volunteer music instructors, Lauren, Sandor and Kirsten.   They conduct music lessons for the surrounding community and at all different levels of ability.  The founders of the school are Eric Sayre and St Olaf's College in Minnesota - along with the support of "Good Ol' Dr Erv."  Click on their link if you are into music.

Lauren, Sandor, Kirsten the 2016-7 Music Teachers

Several weeks ago, I had the privilege of presenting Dr. Tony Carr's and my programme of Problem Based Learning to Director Tabitha Mallampati's class on teaching theories.   It also gave me the chance to reflect on the strengths and weaknesses of how the Mercy programme has been evolving.  These insights are for another time.

There were some Mercy Grads who showed up to hear me again.

And yes, Sister Barbara McLean, I did get to visit with Malinda and make sure she was eating... And I forgot my camera ..... I also forgot my camera [well, actually I did have my camera, but I forgot that I had it] when the Mercy Corps Volunteers had me over for a wonderful team-cooked meal in their nice, but wireless, wireless home...  I am sure I am forgetting stuff, but this will have to do for a few weeks while I finish here and travel to Florida to see some family and then to my Canadian home and my wonderful wife and children and grands.   Till then, thanks for reading.  John

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