On Tuesday, July 8, five faculty members from different universities in the United States arrived in Botswana to attend the International Faculty Development Seminar (IFDS), titled Turmoil and Tenacity: The Progress of Public Health in Botswana. For ten days, they listened, shared, and learned about the Botswana public health care system. Further, they engaged with local experts through panel discussions, presentations, site visits and excursions. All left with a broader understanding and appreciation of Botswana--its culture, landscape, and public health challenges and successes.
From L to R: CIEE Gaborone IFDS Leader Dr. Marape Marape, IFDS Participant Gabriela Soto Laveaga, CIEE Gaborone Program Assistant Tanya Phiri, CIEE Gaborone Resident Director Basetsana Maposa, and IFDS Participants Ryan Saylor, Gayl Crump Swaby, Monica Melton, and Shiko Gathuo.
Here's what's in this issue:
Orientation: Public Health in Botswana
Understanding the HIV/AIDS Response in Botswana
Processing the Experience
ORIENTATION: PUBLIC HEALTH IN BOTSWANA
After a long flight, IFDS participants arrived in Gaborone. CIEE staff welcomed them with a dinner at Gaborone Sun's Savuti Grill. Although the participants were exhausted, everyone was excited for the week ahead.
Tanya, Monica and Dr. Marape
Gabriela, Basetsana and Gayl
Basetsana and Ryan with CIEE Gaborone Intern Gaone Manatong and CIEE Gaborone Program Assistant Amelia Plant
Orientation began on Wednesday, July 9th. Participants toured the University of Botswana (UB) in the morning and were given a lecture on the Historical Perspective of Botswana and Southern Africa by Dr. Gumbo, a lecturer in the UB History Department.
The lecture sparked great discussion about Botswana's political present, past and future. Participants left with a better understanding of the role of the government and its political figures in Botswana society.
The afternoon began with a bus tour of Gaborone by Moabi Mogorosi, a local filmmaker. After dinner, they watched "Hot Chilli," a traditional Setswana love story based on a traditional folk story, directed by Mr. Mogorosi.
The next day began with overviews of the health care delivery system and health care financing in Botswana by Dr. Malebogo Pusoentsi from the Botswana Ministry of Health and Dr. Howard Sigwele, economist and consultant, respectively. The rest of the day was spent at site visits to Princess Marina Hospital, the National Health Laboratory and a clinic in Molepolole, a nearby village.
Princess Marina Hospital is the largest referral hospital in the country. It provides specialized care to patients referred from district and primary hospitals and clinics. Participants toured the hospital and learned about the services provided in the various departments.
From there, everyone headed to the National Health Laboratory, one of the government-owned laboratories in Botswana. Participants learned about the role that the NHL plays in the fight against infectious and chronic diseases as well as its quality management system.
In the afternoon, participants toured a village clinic in Molepolole to compare the urban and rural public health care delivery systems.
These site visits and lectures provided important introductions to the public health system in Botswana. With this information, participants were prepared to delve into deeper issues surrounding the Botswana public health care system, such as HIV/AIDS, TB, and human rights.
UNDERSTANDING THE HIV/AIDS RESPONSE IN BOTSWANA
The next 6 days were jam-packed with site visits, panel discussions and great meals. Each day introduced a new theme to the seminar:
Day 4, Fri July 11: HIV and AIDS Response in Botswana
Day 5, Sat July 12: Challenges of Developing a Human Rights Approach to HIV Response
Day 6, Sun July 13: Botswana History, Royal Family and Lifestyle
Day 7, Mon July 14: The Role of Traditional Medicine in Botswana Health Care System
Day 8, Tue July 15: Pediatric and Children HIV Care and Treatment in Botswana
Day 9, Wed July 16: The Relationship Between Tuberculosis and HIV in Botswana
Each day had some major highlights. Day 4 featured a panel discussion on the Overview of the HIV and AIDS Response in Botswana and Challenges to the Public Health Sector featuring Oscar Motsumi from the Botswana Network of AIDS Service Organizations (BONASO), and our own IFDS Leader Dr. Marape Marape and Resident Director Basetsana Maposa. This presentation highlighted Botswana's early response to the epidemic, the national ARV Treatment Programme, and the role of NGOs and international partners in the national response.
BONASO is the umbrella body for AIDS service organizations in Botswana, thus coordinating the the civil society response to HIV/AIDS.
Experts on the intersection between human rights issues and HIV/AIDS came to speak to the participants on Day 5. They included Mr. Olebile Machete, Director of Childline Botswana, Mr. Uyapo Ndadi, a human rights lawyer, Mr. David Ngele, founder of the Botswana Network of People Living with HIV/AIDS (BONEPWA) and Mr. Tshiamo Rantao, Board Chairman of Botswana Network on Ethics, Law and HIV/AIDS (BONELA).
BONEPWA and BONELA are two of the seminal human rights organizations in Botswana. BONEPWA is well-known as an advocacy group for HIV-positive individuals, by HIV-positive individuals. BONELA focuses on many issues concerning the intersection of human rights and health, such as the equal access of health care services by homosexuals.
Later that afternoon, participants visited the Botswana Harvard AIDS Institute and laboratory.
Botswana Harvard Institute is a partnership between the Botswana government and Harvard University. Its primary purpose is to conduct research and assist in education and M&E around HIV/AIDS and other sexual reproductive health issues.
Ryan, Shiko, Gayl and Gabriela in the Harvard Institute Lab
On Day 6, everyone departed for an overnight in Serowe to tour Sekgoma Memorial Primary Hospital and the Institute of Health Sciences. Serowe is the home of the Bangwato tribe and is one of the largest villages in Botswana. The participants were happy to get out of Gaborone and get a chance to see more of the country.
Sekgoma Memorial Hospital is one of the largest state-of-the-art and busiest district hospitals in the Central district. In the tour of the hospital, participants saw firsthand Botswana's efforts in ensuring that high quality health care is provided in a village setting.
In the Institute of Health Sciences, participants visited the hospital education center for nursing, midwifery, and health education students.
Day 8 brought the focus to pediatric HIV care and a return to Gaborone. The morning began with a panel discussion featuring Dr. Marape Marape and representatives from two organizations doing groundbreaking work on support for HIV-positive children and adolescents. Lila Parvey came to speak about Stepping Stones International, a Mochudi-based NGO that focuses on building life skills for in- and out-of-school orphans and vulnerable children. Edward Pettitt described programs at the Botswana-Baylor Children's Centre of Excellence, which provides anti-retroviral treatment (ARVs) and other support for HIV-positive children and their families.
After the discussions, the participants visited Baylor's new teen center, called the Bristol Myers Squibb Phatsimong Adolescent Centre, located across the street from the current Baylor Children's Centre next to Princess Marina Hospital. The Adolescent Centre is a new addition to Baylor and developed out of the need to provide more services to HIV-positives teens. HIV-positive youth have unique difficulties in completing schoolwork and navigating other life challenges.
Gayl, Gabriela, Monica, Tanya, Basetsana, Ryan and Shiko with a Baylor teen at the Baylor Adolescent Centre (face cannot be shown due to privacy reasons)
Day 9 was the last substantive day before the closing workshop. The morning began with a panel discussion on the State of Tuberculosis in the Era of the HIV/AIDS Epidemic in Botswana. Dr. Chawangwa Mudongo from the Botswana/UPenn Partnership and Dr. Dipesalema Joel from Baylor came to discuss the dynamics of HIV and TB coinfection. Botswana/UPenn is a partnership between the government of Botswana and the University of Pennsylvania to promote clinical care, education and research on HIV/AIDS.
The day ended with a tour of the National Tuberculosis Reference Laboratory.
Although the visits and panel discussions were educational, the learning did not stop there. The participants had a wealth of cultural experiences that enriched their time in Botswana.
As part of their bus tour of Gaborone on Wednesday, July 9th, the participants explored the National Museum, which has been officially opened to the public as of 1968. It features exhibits on human evolution, local culture, and political history of Botswana.
Touring through the National Museum
An exhibit of traditional baskets and pottery at the National Museum
In between the panel discussions and site visits, the participants had some delicious traditional food. On Thursday, July 10th, they were treated to lunch at Botswana Craft. They ate seswaa (pounded beef), phaletshe (maize meal), koko ya Setswana (Tswana chicken), morogo wa dinawa (bean leaves), and other western foods such as rice, chicken stew, lettuce, and a variety of cold drinks. Botswana Craft also sells local merchandise and souvenirs that are crafted not only locally but also in the region. The participants got the chance to look around and purchase what interested them.
The Courtyard at Botswana Craft, taken from the Botswana Craft website
A nice break from all of the academic information came when the group went to Serowe. In addition to the hospital visits, they got a chance to relax and enjoy a bit of village life. Upon arriving in Serowe on the morning of Sunday, July 13th, they visited the Khama III Memorial Museum. In addition to providing a wealth of information on the Bangwato tribe and the first President of Botswana, Sir Seretse Khama, the museum boasts old photos depicting the development of the village of Serowe. It is also a great place to buy inexpensive local crafts.
Gayl, Ryan, Dr. Marape, Shiko and Gabriela enjoying a museum tour amongst exhibits on the San people, or bushmen
One of the special aspects of the museum is its proximity to the Serowe royal cemetery. Sir Seretse Khama and his wife Ruth Williams are buried in the Bangwato royal cemetery along with other important members of the Bangwato tribe. After the museum tour, the participants headed up the hill to pay their respects at the cemetery.
Climbing up to the Serowe Royal Cemetery
After the Bangwato royal cemetery, participants enjoyed a game drive at Khama Rhino Sanctuary, a community-based wildlife project in operation since 1992. They boast over thirty rhinos and a variety of other animals.
Shiko, Monica, Gabriela, Dr. Marape, Gayl and Ryan in the safari vehicle
Between the site visits, panel discussions and trip to Serowe, the participants got a well-rounded Botswana experience.
PROCESSING THE EXPERIENCE
Although the IFDS participants only spent ten days in Botswana, they left with a better appreciation of Botswana, its culture and public health system. But their time could not be complete without a closing workshop to help process their experience.
Dr. Marape and Basetsana led the workshop, which used participatory techniques to encourage the group to view their experiences from varying perspectives. They first discussed the "what?" of their time in Botswana - the places they went; the things that they did.
Participants gained a unique perspective about Botswana. Two memorable quotes about the experience were, "Botswana. So much more than HIV/AIDS," and "Botswana like home: Transformation in process."
The closing workshop then moved on to the "so what?" - making meaning out of their experiences.
One participant said the experience was, "As I expected, but way better!" Another said their learning outcomes were, "Riches harnassed. Lives saved. Stereotypes challenged."
Lastly, they answered "now what?" by brainstorming how to translate their experiences back to their home universities.
Participants were already planning to incorporate the Botswana experience into their academic studies. One said that they wanted to "educate more people about Botswana and somehow integrate into my own research to continue to come here." Another hoped "to write a case study of Botswana in my next big research project."
All in all, the participants had an amazing experience. They will all be missed!
Until next time, sala sentle (stay well)!