I'm unavailable (unavailable)
Dem no dey see me (dem no dey see)
I'm unavailable (unavailable)
Dem no dey see me (dem no dey see)
***
Whatever motivated Davido to repeat this line over and over is the same thing making me write at this moment.
If you're a subscriber, you'll know it's been a minute since I last updated this newsletter.
If you're new here, this is Últimos Días, the newsletter where I write about the ups and downs of my last days in medical school. You can keep up by subscribing.
Usually, I rant. On other days, I'm chill and I write about fun experiences and lessons.
Today, I'm at a crossroads and I want to go down memory lane. This means that whatever I'm writing about may or may not make sense in the end.
I'll leave that for you to decide.
Rural Posting
One of the major reasons I struggled to write in the last month is because of my rural posting.
Rural posting is one of the requirements for getting my license as a medical practitioner. It is usually organised by the community medicine department.
During rural posting, we are expected to go to a rural community and spend some time conducting household surveys to enable us to make a community diagnosis and come up with interventions that will improve the health of the community.
The rural community we went to was Kegbara Dere (K-Dere) in Gokana Local Government Area of Rivers State, Nigeria.
Being in a rural environment was an exciting experience and one I would love to recount here.
Amongst the numerous experiences, I’ll share a few:
Household numbering
Household surveys
My birthday celebration
Medical outreaches to the rural communities
Household numbering
To enable us conduct a proper study of the community and come up with a proper community diagnosis, we had to determine the number of households.
This process required us to first make a map of the community. For this, my class was divided into four groups - North, South, East and West. A community guide was assigned to each group to facilitate the process.
We were all expected to depart from a central point and head in the directions matching our group names. I belonged to the North group and I joined my group to tour around the community while drawing a map in the process.
At the end of the process, all groups came together to harmonise the map and form a map of the K-Dere community.
The next day, we set off to number the households. A household refers to a social unit of people who live together under one roof and share resources, even if they are not related to each other. It should be differentiated from a house which is just a physical structure that may contain one or more households.
Household surveys
At the end of household numbering, a study population size was established and we were expected to return to these numbered households and carry out a survey using an interviewer-administered questionnaire. The software used for this was the Open Data Kit.
The survey assessed the following for each household:
Household details
Environmental health conditions
Child health/morbidity
Morbidity and mortality information
Ownership and use of insecticide-treated nets
Non-communicable diseases (for persons 18 years and above)
Health service information
Household earnings and wealth
Household expenditures
Adolescent reproductive health
This process was the longest and most distressing of all for me because of the study method.
Moving from one household to another and studying a total of 20 households for my pair was both physically and psychologically draining.
However, it was an interesting experience and great exposure to the world of academic research.
My birthday
If you ask me about my favourite experience at K-Dere, the most likely answer I’d give you is my birthday. This is because I got to celebrate my last birthday as a medical student in a rural way.
It was Monday, 29th May and it started as a rainy day. One fun fact about my birthday is that there’s always a downpour. It’s safe to say that even the heavens honour my day.
With the rains, most scheduled activities for the morning (household surveys) had to be halted and I spent over half of the day indoors and idle on my phone replying to numerous birthday wishes.
The rains stopped around 1 pm and that gave me time to think about how to celebrate my big day considering I was not in the city. The thought of having palm wine and drinking goat meat pepper soup was the most dominant.
I set out with my friend, Brown to the neighbouring village, Bodo in search of palm wine and goat meat. We were able to get both including ingredients to prepare the pepper soup. We also got other things we could use to host a party in a rural way.
The pepper soup was prepared by my best girl, Sheila who possesses magical powers when it comes to culinary skills. Brown and I set up the party venue. Everything was in place and the party commenced around 10 pm that night.
The party held under the tree at the centre of the compound. Here's what the tree looks like…
There were four long benches arranged like a rectangle with a table at the centre. This was where we put the palmwine, drinks and other edibles.
Music played as people gathered to sit. They were offered drinks so they could settle down before the MC (Josh) took charge.
We played games, danced, and had a lot of fun. This went on till 1 am the next day when the peppersoup finally arrived.
The party went on till 2 am when a resident doctor chased us back into our rooms, lol 😂.
I stayed up for an extra 2 hours responding to the remaining birthday wishes I received.
When I look back, I can say I enjoyed my birthday. A befitting last birthday as a medical student.
Medical outreaches to the rural communities
A medical outreach can be defined as the collection of activities carried out by a group of people, mainly health professionals in communities or areas of need. People in the target communities benefit during these medical outreaches.
During our stay in K-Dere, we carried out medical outreach programs in three villages of Gokana: K-Dere, Nweol and Bomu.
The outreach in K-Dere was organised as part of our final year class activities and was the first outreach conducted. We were split into different teams and I served in the protocol team to maintain order throughout the outreach.
The outreaches in Nweol and Bomu were organised by the Local Government Chairman as a way of giving back to his people. I served on the protocol team on both occasions.
One of the fun experiences I've had in medical school are medical outreaches. Yeah, I should write about that soon.
End of Rural Posting Test
One common thing with every posting we do in medical school is a test at the end of that posting. Rural posting was not left out.
After our return from K-Dere on 9th June, we were expected to conduct a data analysis on the data we had collected from the households to arrive at a community diagnosis and create intervention plans. This was to be presented as a report to the department on 26th June.
The end-of-posting test was scheduled for 27th June. This gave us ample time to use for the preparations.
The first thing I did was resume my study group. We met every Monday to Friday from 9 pm to 12 midnight and every Saturday at varying blocks of 3 hours (10 am - 1 pm, 3 pm - 6 pm, and 9 pm - 12 midnight).
It was a do-or-die affair to enable us to prepare well for the test which was going to be the last continuous assessment for Preventive and Social Medicine (Community Medicine) before our final exams.
The study group enabled me to cover a lot in a little time and also made me confident to take on the test.
We had the presentation of the rural posting report and then the test. Both were good enough.
My class had a movie night to enable us to wind down and relax our minds before we take on the battle ahead.
Personal Challenges
The month of June took a toll on me. From resigning my position at my workplace to the lack of motivation to do anything not related to my academics to health challenges, I went through a lot.
Leaving my workplace
First off, leaving my workplace was quite an emotional pull. It's my first time doing such and I did it for reasons that “actually” make sense.
As I approach my final exams, I am trying as much as possible to be in the headspace to retain as much information that will be required to make me pass.
This involves me reducing most of my commitments to zero for my only commitment to be my academics till I achieve my main goal for the year - becoming a medical doctor.
That's why I had to leave and I have become at peace with myself for that decision.
Unrealised goals
However, what affected me mentally was the fact that my head couldn't stop coming up with ideas and thinking of the goals I set for myself in June. It affected me because I couldn't execute them and it made me feel less of myself on most days.
This is an excerpt from a previous post on what I was supposed to achieve:
I’ll have you know that most of these were not achieved. I was filled with some regrets because of this.
In my thoughts, I imagined what would be different if I had people who could just execute and all I had to do was manage them.
Amid these bad feelings, I took solace in the lessons that were there to learn.
While I may cease a lot of operations until I'm done with my exams, I would strategise properly with my time off so that once I succeed, I’ll resume my plans immediately.
Bad health
The last major challenge I faced was that of my health. I'd love to say, “Health is wealth”, but I believe you already know that. Instead, let me repeat the words of Austen Nnadi who said, “Health is life”.
I fell ill 5 days before the end-of-posting test. It started with fever and a very bad headache. I was also weak and lost my appetite.
I visited the hospital and got admitted and managed. Got discharged the next day and felt better. However, a day later, I could no longer keep any food in. I threw up whatever I ate.
This continued for 2 days and I had to manage myself with Lucozade boost and other liquids like tea so I could maintain my energy until I was done with the end-of-posting test before I went back to the hospital with the new complaint.
I was dewormed and also given some anti-ulcer medications. With progressive adherence to my drugs, I got better and stronger.
Health is not just wealth. Health is life. Pay attention to it.
The Journey Ahead
At the moment of writing this, I have started my clinical rotations in Surgery.
I would be here till the end of July before I switch to Internal Medicine in August .
After this, I'll write my end of posting tests in senior medicine and senior surgery before proceeding to write my final MBBS exams.
The end is near and very visible. However, I must use the time I have before then to make sure I have all it takes to cross the finish line.
One of the measures I'm taking is to make myself unavailable to a lot of stuff.
The only things outside academics capable of getting my attention this moment are learning, planning and strategy.
I would postpone execution till I'm done with exams. The only exception is if I have someone I can delegate execution to.
My No. 1 priority is my exams. For this, I have resorted to follow up with my study group on all occasions, attend all clinical activities, read at least one thing every day no matter what.
I'd be reviewing, modifying and intensifying my efforts in any way that seems right.
So help me God.
That will be all for this issue.
See you in the next!