1. Brianne Black, PhD(c), RN University of Iowa/ University of the Gambia

2. What Can I Do in the Gambia World Cup 2010 Visit the Beach Weddings Historical Sites Tourist Locations Try the local dishes Shop in the local Markets MAKE FRIENDS!

3. Gambia

4. Health Clinics: Hands on Care 4 weeks Both inpatient and out patient wards Specializes in women’s and reproductive health One physician and 2 nurses provide consultations HIV clinic and counseling Community health nurses make home visits Motor bikes, motor bikes, motor bikes!

5. Hands on Care: HIV Counseling Attended HIV counseling sessions The session were completed in their native language (Wolof), but I was still able to engage in the emotional experience. Witness numerous families and couples receive an HIV+ diagnoses. Counselor would translate post counseling session

6. Hands on Care: Community Health Language Barrier Scope of practice for nurses in the Gambia is more complex than that of nurses in the US, as Gambian nurses are expected to diagnose and treat. unable to participate in direct patient care. I was able to “trek” to the homes of locals and observe the nurses

7. Hands on Care: Outpatient Clinic Every day 50-100 women and children lined up outside the clinic and would wait for hours to see the doctor or nurse consultant I was able to shadow one of the nurse consultants Prenatal Visits STD education and treatment Pediatric check ups

8. Research: BAFROW 4 weeks The Foundation for Research on Women’s Health, Productivity and the Environment (BAFROW) BAFROW research headquarters BAFROW president expressed an interested in submitting a grant application I prepared the concept paper using pamphlets and information given to me by the president and vice president of the organization.

9. BAFROW Community Outreach I attended a 3 day workshop in Mandinaba, The Gambia where rural women were taught basic principles in female genital mutilation and obstetric fistulas These women were then expected to return to their local villages and share the information with the women in the community

10. Staff Training: BAFROW Clinics Shadowed at the community clinics on Mondays Noted that pain assessment and management was greatly neglected by health care providers in the Gambia Offered to provide a staff training/in-service on the BASIC principles of pain assessment and management

11. BAFROW: Staff Training: Basic principles in pain assessment and management A total of 9 staff member attended the training Interdisciplinary participants Nursing Orderlies Pharmacist Laboratory Scientist Housekeeping Most of the staff members who attended admitted to having never received training on pain assessment and management.

12. Staff Training Agenda What is Pain? What are the types of pain? What is persistent pain? How should nurses assess pain? What are some approaches to managing pain? Why is all of this important?

13. Any Questions?