This article was originally written and published by VEGA Member VSO International here.
Seven out of ten child deaths in Malawi are due to preventable causes such as malaria, diarrhoea, pneumonia and malnutrition.
Malaria and pneumonia alone account for nearly half of those deaths.
Through the Tropical Health & Education Trust (THET) programme, nurse trainer Briony Jenkins is sharing vital paediatric nursing skills with students at Nkhoma Hospital to improve nursing standards and care for children.
Why did you choose to do VSO?
I met a VSO volunteer on my travels about ten years ago, who told me all about her placement. It sounded like a very positive experience, which is why VSO came to mind when I was considering a career change ten years later.
I decided I wanted to do something completely different and build on my experience as a nurse, so I applied to do VSO. Six months after applying I was on my way to Malawi.
What health issues do children face in Malawi?
Children are admitted to Nkhoma Hospital with a variety of common problems, including malnutrition, hyperthermia and dehydration. But around 70 percent of the children on the paediatric ward come in with malaria.
Most of them will have suffered symptoms and won’t have eaten food or drank water for a number of days before being brought to hospital, so they often require emergency care.
What were some of the skills gaps you observed in nursing students?
I join nursing students on placements in the paediatrics ward, spending a few hours with them each morning and afternoon. By observing the students, I can see which skills need developing, like the early detection of serious conditions.
I found that one of the key challenges for students was that they had perfect book knowledge of what a fever was, for example, but were failing to interpret warning signs on the ward.
So what did you do?
I created a learning tool that helps student nurses think about every vital sign they record. It prompts nurses to recognise high, low and normal temperatures and consider whether they are signs of malaria, hyperthermia, malnutrition, or something else.
Giving students the ability to interpret data better helps take the load off the qualified staff, which in turn helps to improve care for children on the wards.
Do you conduct all your training on the ward?
I’ve also spent a lot of time working with student nurses on improving their skills in a safe environment.
For example, I run training sessions in the clinical skills lab on topics such as paediatric resuscitation. I invite doctors to provide training in identifying warning signs, in order to minimise the number of children who go into a full respiratory or cardiac arrest. The lab is equipped with resuscitation dolls modelled on different aged children, and we re-enact real life emergency scenarios to give the students practice at responding quickly.
What is it like working with Malawian nurse students?
At first they were a bit unsure of us, but together with a few fellow VSO volunteer nurses we made an effort to get to know them and develop freidnships with them. We sometimes go to watch the nursing college football team play at the weekends. It’s important to make the nurses feel comfortable with us so that they feel open and able to ask lots of questions; they’re much more engaged now than when we first arrived.
Last year before I came, some of the student nurses failed to pass their exams and had to re-sit, but after the training and support over the past year all of the students passed their end of year exam and moved into the third year. I was so pleased to see that the training and words of encouragement had paid off.
What have you gained professionally from your time in Malawi?
Qualified nurses in the UK are expected to mentor and be responsible for student nurses, so the experience I’ve gained training and mentoring nurses here in Malawi will prove invaluable. I’ve developed skills that would normally have taken me years, and I’m much more confident now.
Because hospital resources are quite limited in Malawi, I’ve also learnt a lot more hands-on practical skills and I’ve had to apply my skills and knowledge in new situations.
What about outside of work?
I’ve had the opportunity to travel, meet local people, eat local food and learn a new language. As a result I have gained more confidence personally too. It’s a completely different experience to the one I would have had spending a year in the UK.
Would you recommend VSO to other people?
If someone asked me if they should do VSO I would say definitely, especially to those working in the medical profession.
I respect the fact that VSO places professional volunteers to share their skills and experience, because I think this is a sustainable approach.
If you’re open minded and enjoy working with people, then I think you will really enjoy and benefit from doing VSO.