The team, The CEO visit, The birthday, and Work

While working in Macedonia, I have had the privilege of working with the ProjectHOPE team established here. Learning from them has been an incredible experience. The atmosphere generated here is one that is professional, organized, fun, and exciting. Everyone works so well together and helps each other in anything that needs to get done. It is a really fun experience working with a team where even though everyone has a specific title, the jobs overflow for everyone to review, help with, and work on. This makes the dynamic very positive. This team has taught me a lot about teamwork, communication, and organization. Learning how to be independent in making decisions, while also, knowing how to include everyone to keep everyone informed and updated has been extremely valuable for me. Just for the few weeks of being here, I have gained confidence in myself with knowing how to work with a team effectively, efficiently, and in a fun manner.

The Strategic Medical Re-Supply Program is designed to help countries improve the quality of patient care, as governments transition their health care systems to meet global health care standards, by providing donations of priority medical materials to a network of partner health care facilities and by creating training platforms for professional development of health care providers. Through knowledge, equipment, and support, this program will bring in the infrastructure needed to improve the care, treatment, and overall well-being of the community. By including the Nursing Mentorship Program, the course based off of PALS, and the Infection Control Database, we will be further able to share our knowledge with the hospital staff members here. The idea of sharing knowledge instead of just teaching or educating is another important aspect to the programs at the Pediatric Clinic. The staff here is incredible at what they do. They have many techniques and skills that USA nurses may not be as advanced on. Due to this, it is the sharing of knowledge that is critical to making these programs successful.

The past few weeks have been absolutely crazy. It began with my mom and brother coming to visit me! We met in Croatia and had an incredible time seeing the old town of Dubrovnik and spending some down time at the spa. After a few days of relaxation, we all flew back to Macedonia and to the beginning of a very work packed week. For the first time ever, the CEO, Dr, John Howe, came to visit the Project HOPE program sites and the team. In preparation for this, the team here worked really hard to make sure everything was in perfect order. Meetings for Dr. Howe with the Minister of Health of Macedonia, the President of Macedonia, and the Vice President of the Prime Minister were all set up. Dr. Howe is a man in his 70’s who continues to travel all over the world visiting Project HOPE sites and making connections and developing relationships between Ministers and Country officials. He really showed how grateful and impressed he was with the team here and showed his great appreciation for the hard work the team does. It was such an honor for the team to host him in Macedonia and thank him for everything that he does for the organization.

The last event of the day was a round table meeting where the Minister of Health, other government officials, and the Director’s of each hospital we work at were there to introduce one another, begin creating more personalized relationships, and to have a dialogue about the relationship between Project HOPE and Macedonia. At the end, yours truly, was asked to present the Pediatric Concept to everyone and discuss the programs that we want to implement!  It was so nerve racking but so much fun! I could not believe how much confidence my team had in me to present the information. It was such a rewarding experience and I felt so empowered at the end. I have to give a huge thanks to my team here for putting their trust in me! They rock!

So during/after Dr. Howe’s visit, a volunteer named Jennifer who is a Pediatric MD in the army, was here for two weeks. She is super cool! The first week was designed to have her go to the clinic and talk to the physicians in the immunology and pulmonology departments. Jennifer is also a Pediatric Advanced Life Support Instructor, so together we put together the Pediatric Life Support Course. This course is one of the three programs that we want to implement at the Pediatric Clinic. It was really an amazing experience getting to work with Jennifer. We had so much fun together and she is extremely knowledgeable in her field. We have almost completed the course so now we are adding the final touches and then will hopefully be sending it to the Director of the Hospital for approval!

The day after Dr. Howe left, the team and my mom and bro went to a little lake town called Ohrid to celebrate Johnny’s and my birthday! I am so lucky that we got to spend it together even in Macedonia!! For our birthday dinner, we had traditional Macedonian music and dancing which was SO MUCH FUN and then went out to hit the town! It was honestly the best way to turn 23. Thanks bro and mom!!! The day after our birthday we went on an awesome boat ride to an old and beautiful church! The boat ride was absolutely beautiful! The water was perfect and everyone was enjoying the chance to relax. It was really really fun and I have to thank everyone who was apart of it who made everything perfect.

First Week at the Hospital

Blog #2 - First week at the University Clinic

I have been working in Macedonia for the past two weeks as so far things are incredible!! The program I am working on is called the Strategic Medical Resupply Program. The goal of this program is to provide medications, equipment and training to hospitals in Skopje. Currently, the hospital that we are working with now is the University Pediatric Clinic (their word for hospital is clinic) in Skopje. This Pediatric Clinic is in the public sector of the health care system here in Macedonia. It is the most advanced Pediatric Clinic in Macedonia so they receive many cases from all over the country. For the past week, I have teamed up with another volunteer, Janet Kinney, and we have been visiting each department in the Clinic to talk to the Chief of each department to learn about what they do, and what they need for equipment and education.

We have learned that there are 18 departments in the Clinic. Each department consists of about 5 or 6 Physicians and a few nurses. One of the busiest departments is the Clinic is the Intensive Care Unit as they receive about one child a day. For education, physicians go through 4 years of general medical school and then they have another 5 years of specialized training to become a Pediatric Doctor. After that, the doctors have some continuing education to keep their license. For nurses, however, they go through nursing school in high school and then they have 3 years of training in college (which technically is optional). After that, there is no continuing education. Due to this, most of the nurses have not had any training in a very long time. This is where we have identified the best way to help. After meeting with each department, Janet (who is a retired Neonatologist, has had training in Infection Control, has worked for the CDC, and who is currently a General Pediatrician) and I have come up with three different ideas to help the nurses improve their education.

The first idea is to have a Nurse Mentoring Program. This program would involve bringing in general or specialized nurses that would work the day or night shift and would mentor and teach and learn from the nurses at the Clinic. The idea would be to make this a long term program where different nurses are coming in and working with each department in the Clinic. By bringing in a nurse that would work the shift with the other nurses we would be providing a resource for the other nurses to gain knowledge and expertise.

Since there is a large need for education, another idea is to design our own course that is based off of the Pediatric Advanced Life Support (PALS) curriculum. This course is required by everyone in the States who works at a Pediatric Hospital. It teaches resuscitation, drug administration, identification of respiratory distress/arrest, identification and treatment of shock, identification and treatment for cardiac arrest, and more. Our goal is to create a course that would be required by everyone to take before being hired as a standard hospital training. This would then unify the nurses abilities and make a stronger nursing staff. In order to keep this sustainable, we would like to make the course a "Train the Trainers" program. This means that we would teach the course to a few nurses who would then teach it to other nurses who would then make another nurse the point person so that the education continues over the years. 

One of the meetings we had was with the Chief Nurse. She is also the only person in Macedonia who has had training in Infection Control. She is an incredible person and has been working really hard to bring in protocols and knowledge to the Clinic in order to reduce the spread of Infection. Unfortunately, since she is a nurse and not a doctor, most people do not believe her or take her seriously. Due to this, one of my goals for the 3 months that I am here is to help her establish a database where we can record what infections occur, where they come from, how serious they are, etc. Hopefully, this will then allow her to create proof that the infection control is very poor in the hospital and that many deaths and suffering can be prevented by simple protocols (and a lot of money for the hospital can be saved). I am very passionate about helping her with setting this up and with getting protocols that the nurses and doctors will live by. 

For providing equipment to the hospital, most of the equipment they need is very standard - bedside monitors, portable suctions, nebulizers, medical pumps, and ultrasound transducers are some of the most common. It really is amazing at how the staff is able to operate and save so many lives when they lack so much basic equipment.

As for everything else here, I am really loving it! Last weekend I went to a small town called Ohrid. It is absolutely beautiful. It is a little quaint town on a lake and is AWESOME! There are 356 small churches in the town and visited a few. One was from the 13th century and the art work inside it was original and really cool! Other than that everything is amazing. The people are really fun and I love the city! 

First Week in Macedonia

Blog Entry #1:

The first few days of being in Macedonia have been amazing. The flight was exhausting but very easy. I landed and was welcomed by the team manager Katerina and the Medical Advisor Dako who are on my team. I was then taken to my very cute apartment and was given a few hours to settle in. It was Dako's birthday so that night I joined the entire team for a big dinner celebration. It was a lot of fun. The atmosphere here is amazing. Everyone is extremely welcoming and the team acts like a big family. They eat every meal together, work together, hang out after work...etc. I am very excited to be apart of the team.

Skopja is incredible. It is a beautiful city and everything is very close together. My apartment is 3 blocks from the office, 2 blocks from Katerina's house, and about a 10 minute walk from downtown. The downtown is under a lot of new construction but what has been done so far is amazing. Marble bridges with statues and fountains everywhere. It really is beautiful. The food here is also really good. Basically every meal consists of meat, cheese (and I mean a lot of cheese), and bread. There are also some tomato, cucumber and onion salads that are delicious. Everything here is made in the country so it is all very fresh and organic.

So far I have met with the Pediatric Director at the University Clinic in Macedonia. She is an incredible doctor and has traveled all over the world performing different procedures for pediatrics. Katerina, Vlako and I met with her to talk about the Medical Resupply Program and about having other USA Pediatric doctors come next week to observe how the clinic is run and to work with them in getting anything they need to advance their level of care. ProjectHOPE, the Director, and the Ministry of Health is working to get equipment from USA hospitals that is either outdated for the USA or is not needed. The skill base of knowledge from MD's is very good here, however, the equipment needed to use those skills are not available. Getting those pieces of equipments is what I will be helping ProjectHOPE with.

Next week I will be assisting a USA Pediatric Doctor who is arriving on Sunday by sitting in on meetings with different departments in the Hospital and by talking to staff members about what is needed for Neonatal Surgery, Pediatric Care, and Emergency Pediatric Care. I am really excited to be involved in this part of the program as it will expose me to how the health care system works here, as well as, what is needed here to advance the level of care.

Two nights ago I went to a soccer game with the team which was a blast! It was a friendly game - Macedonia vs Bulgaria. The atmosphere is so much more exciting than it is in the States! Everyone is cheering and drinking. We won by 2 points which made the stadium even more energetic! This weekend I will be going to a Basketball Game on Saturday night which is supposed to be really fun. Basketball seems to be the biggest sport here as the team is doing the best in the league. Sunday I have the opportunity to shadow a Neurosurgeon who is working on the Program with us and he has invited me to come and see how things are done in the Neurosurgery department and in the ED. I am SO EXCITED!!!!!!!!

Well that is it for the first week. Everything is really fun here and I love the people I am working with! The city is a great place to be and I am really happy to be here!!