Tanzania

My Reflections Working with SPECT

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When I started working with SPECT as a research assistant in Tanzania, I was given the opportunity to challenge myself and expand my knowledge into many new areas. Professionally and personally my experience is with environmental issues, as I have my Bachelor of Environmental Studies, so it was interesting for me to learn more about the healthcare sector. Since my time with SPECT I have become increasingly interested in healthcare, particularly because I had such a wonderful learning experience. Over the course of the summer, my primary duties were to help with translating between English and Swahili and assist SPECT facilitators with training activities for both the Fundamentals of Sterile Processing course and the Training of Trainers course.

During our time in Tanzania, SPECT has made a significant impact on the ten hospitals that we worked with in the Mara and Kagera Regions. One nurse told me: “Staff members are happy with the visible results and changes that have been made since the training”.

As I was visiting the hospitals, prior to assisting with training sessions, I observed many sterile processing practices that I learnt were putting staff at risk of causing infections to patients and themselves. A few of the situations and stories I found most interesting, which I’d like to share with you are as follows:

  • Often, staff would store food and sometimes take tea in the sterilization room. Most rooms were not well organized since sterilization staff did not have the training to know that poor organization increased the risk of infection. I also found sterilization staff did not realize how important their positions were in the hospital.

  • Big brushes that would be used to clean floors, walls or clothes were used to clean instruments.

  • Clothes used to wrap instruments had lint and holes in them. The lint would stick on the instruments during sterilization and the holes allowed microbes to contaminate the sterilized instruments before use. Gauze was also used to tie wrappers, increasing the potential of contaminating the instruments.

  • Instruments looked clean on the outside but had rust on the box locks and serrations. There were also many instruments that were not functioning. 

  • There was no one way flow of instruments, increasing risk of cross contamination and infection.

  • The sterilizer chambers and the rooms (walls and floors) were seldom cleaned.

After assisting SPECT with their sterile processing training, I visited the hospitals again for follow up assessments. I was impressed by the changes that had been made by staff.  One nurse told me “Instruments appeared clean, shiny and attractive compared to the previous; even the doctors and other staff members are impressed”. Other changes that I’m pleased to share include:

  • Some hospitals had stopped using Chlorine to wash instruments and were using just water and soap and had also trained other staff working in the operating theater.

  • Sterilization staff were using smaller brushes (like toothbrushes) to wash instruments and big brushes were now used to wash clothes, walls and floors.

  • Instrument packages were neatly tied for sterilization and storage.

  • Sterilization staff were now following processes learned in SPECT training, cleaning decontaminating, sterilizing and storing instruments in an organized fashion.

 
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During my time with SPECT, I was able to witness significant changes this training program had on hospital staff. Firstly, the training reminded staff that their jobs are important. The course emphasized the importance of sterile processing and this helped to communicate the importance of the staff’s role in this process. Secondly, it renewed their sense of fulfillment in their positions. I noticed staff worked hard to initiate these changes during our follow up assessments and were proud of what they accomplished. Lastly, I was able to recognize a shift in mindset focused on keeping patients and staff safe. It was apparent that hospital staff looked favorably on their training and were ready and willing to make changes to positively impact the safety of patients, themselves and other staff members.

Theresia Maduka, SPECT Research Assistant

Education and Empowerment

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To me, this picture expresses a perfect moment. It was the moment when this nurse realized he can clean his instruments to a higher standard, and against all odds, it is possible.

So often, we forget that knowledge is power. If we’re always taught to follow blindly with what we’re told, and not encouraged to think outside the box, why would we ever change the way we’ve always done things? I’m sure all of us can relate this this. We’ve all had that job where we were basically told to just do what we’re told.

During my management studies, the term ‘growth-mindset’ came up again and again in discussion. The term describes an optimistic and encouraging way of thinking that encourages the development of basic skills and knowledge through hard work, dedication, and the belief that growth is possible. Quite simply, if you think you can do something, you are far more likely to take steps to succeed.  Whereas, if you (or someone else) tells you that you can’t do something, then you’re far less likely to achieve those very same goals. Think back to when you were faced with a difficult task. Sitting in the corner and complaining about the situation probably did you little good. But taking a deep breath, telling yourself you can handle this, and planning a course of action to tackle the situation probably turned out quite well! Perhaps even, at the end of the day, the task may have ended up being far less daunting than you originally thought. In my personal experience, a growth-mindset is not only empowering – it works!

This week, I assisted SPECT with delivering Sterile Processing Fundamentals Training in Bukoba. Thirty-eight nurses from across the Kagera region of Tanzania attended the five-day training course that was grounded in theory, supplemented with demonstrations and in-class activities. As someone who isn’t educated in the health care industry, my role was to support the educators by completing daily administrative and financial tasks, while assisting with the general organization and coordination of the event. Working behind the scenes allowed me the perfect opportunity to really observe the course, educators, and participants in a truly authentic and unedited manner.

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This brings me to this perfect moment. It’s rare to witness the exact moment someone feels empowered. The moment their perspective changes and you can see their entire outlook transform. I suppose educators often witness these moments, but this was the first time I was fortunate enough to observe such a perfect moment in real life.

Christina had just completed a demonstration on proper cleaning techniques when Cletus volunteered to replicate the demonstration. After explaining the set up, he grabbed a needle holder from the surgical set (pictured on the left) and began cleaning it. It’s certainly worthy to note that this particular surgical set came directly from a local hospital’s sterilization department and had already been cleaned, sterilized, and approved for surgical use. Quickly, Cletus set to work following a newly introduced 3-step cleaning process, complete with proper tools and techniques. Every swipe of his brush removed more and more debris, and little by little the instrument began to shine like new. As the enthusiasm in the room grew, he completed his 3-step process and proudly held up the finished product (as pictured on the right). Sitting silently away from the crowd, it was easy to see the light in Cletus’ eyes grow and the smile escape from deep in his soul. He took an instrument that he’d used so many times before and improved it to a standard he had never considered possible three days ago. As the rest of the participants cheered, his smile grew, his pride in his work grew, and undoubtedly, his confidence in his professional abilities grew.

As a strong advocate for education in all its many different forms, I’ll leave you with this quote from a man that is wiser than I could ever hope to be.

“Education is the most powerful weapon which you can use to change the world” – Nelson Mandela

Renata Mrema                                                                                                                             SPECT Volunteer                                                                                                                             

Achieving Good Health and Well-Being Together

When I first approached SPECT with my interest in volunteering in Tanzania, I never could have imagined just how much I would learn during such a short period of time and the extent to which my experiences on the ground would not only inspire me to remain involved in the organization but also make me feel proud of the tasks I was able to help with, no matter how small they felt at the time.  

For those who don’t know me, my name is Renata Mrema and my professional skills certainly aren’t based in the health care field. I’ve lived many lives, flipping between industrial operations, to the corporate world, and finally resuming my role later in life as a management student. Through my studies and life experiences I’ve found my passion in environmental, social, and cultural sustainability, with a focus specifically on tourism.

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Through my university studies I was introduced to the United Nations Sustainable Development Goals (SDG) and undertook a seminar to promote these goals as a SDG ambassador. While I think we can all agree there are many global challenges that numerous organizations are working tirelessly towards finding solutions for, the complexity and gravity of these challenges can be overwhelming to say the least. The SDG’s aim is “to set of goals to end poverty, protect the planet and ensure prosperity for all” – a end goal I’m sure we can all get behind (https://www.un.org/sustainabledevelopment/sustainable-development-goals/). One tactic that the SDG team encourages is for the public to select a goal that resonates with them, and to take steps, no matter how small, to help achieve that goal. In the past, I’ve always selected goal #13: Climate Action because I felt that I can wholeheartedly take steps towards achieving this goal in my personal life and I felt confident in my abilities to make a difference with this goal. As someone who is not educated in the fields of infrastructure, education, health care, or engineering I felt I was unequipped to contribute towards any of the skills-based goals and that they were simply out of my reach. It wasn’t until after my time volunteering with SPECT that I realized I can take steps to help with other goals too.

During SPECT’s Training of Trainers (ToT) course and regional hospital tours in the Mara Region I realized that SPECT is very much aligned with the SDG’s and fighting tooth and nail on a daily basis for goal #3: Good Health and Well-Being. As a long-time follower of SPECT’s work, what I failed to recognize is just how crucial the organizations work is to the sustainable development of not just specific countries, but to everyone globally. Their work affects everyone – people of all ages, all genders, and all socioeconomic backgrounds.

I’d like to share two of the UN Good Health and Well-Being targets with you and I’m sure you’ll see the obvious alignment between SPECT’s mission and what the UN SDG’s are trying to achieve:

  • Substantially increase health financing and the recruitment, development, training and retention of the health workforce in developing countries, especially in least developed countries and small island developing States
  • Strengthen the capacity of all countries, in particular developing countries, for early warning, risk reduction and management of national and global health risks

For more information on this goal, I urge you to explore the UN Sustainable Development Goals website as listed here: https://www.un.org/sustainabledevelopment/health/.

I realize that by volunteering with SPECT I have only contributed a small fraction to the overall SPECT story, but for myself, this experience has had a profound effect that I believe I am just beginning to grasp. It has opened my eyes to the impact team work can have and that there is really a role in this organization for everyone. While I may feel that I cannot contribute much beyond organizational and administrative duties, knowing I can take this task off the shoulders of those who are more equipped to directly impact the health care of a community is a worthwhile cause that I cannot downplay. We all have unique strengths and abilities, and when we work together we can make improvements in leaps and bounds in areas we couldn’t have imagined possible on our own. Volunteering with SPECT has truly made me believe that with hard work, dedication, and team work, no goal should ever be seen as off limits or unachievable.

Renata Mrema                                                                                                                              SPECT Volunteer