This is Neriah.
Full name: Neriah Grace Lowry (or “Nia” for short).
“Neriah” is Hebrew, and means “Light of God“. We pronounce it “Ner-ee-ah”.
She was born at 7:30pm on 20th January 2013. She weighed 7 pounds 9 ounces.
Her hobbies include avoiding accidental injury from her boisterous older brother, submitting to being sniffed suspiciously by dogs, and throughout remaining surprisingly content. We don’t know much else about her.
The right decision for the wrong reasons.
There has been an awful lot of discussion about the decision not to allow women bishops in the Church of England. I’m going to be nice and controversial here: I think its the right decision.
The problem with this debate is it misses a much deeper argument. It’s not “should women be bishops”, it’s “should there be bishops”, and “who should be leaders”.
A little background
Before I wade into this, let me just state my conflicts of interests and biases.
I grew up in the CofE. It’s traditional ways and general dullness convinced me of the irrelevance of Christianity at an early age. I became an agnostic/atheist around 14, and stopped going, alongside pretty much all my peers.
Thankfully, aged 17, a friend took me to a free church where I was shown how much challenge, excitement and goodness there is at the heart of the Gospel. The process has led me to feel very concerned at how badly the Anglican church misses the point, and misses people in the process: I’ve been fortunate – very few of my peers have returned to the church we grew up in.
Unbiblical and unnecessary
To those of you who have no idea what the whole “ordained” thing is about, or the church thing in general: I apologise for all the jargon. I also apologise for the very religious sounding nonsense that is all over the news at the moment – sadly, it’s basically nothing to do with Christianity.
Basically, a church is a big group of people, who generally meet together regularly. We believe God loves us, and we try to love him and each other.
Like any big group of people, a church needs people leading them. In the old school out-of-touch, irritatingly-religious churches, this is usually an ordained “priest”, who wears a special dress, and is the only one allowed to bless bread and wine, and perform a number of other activities. In the New Testament, its pretty clearly pointed out that “priests” are no longer needed: we are all part of the priesthood, we can all have relationship with God.
But you are a chosen race, a royal priesthood, a holy nation, a people for his own possession, that you may proclaim the excellencies of him who called you out of darkness into his marvellous light.
1 Peter 2:19
I feel the Anglican church is trying to find some solid ground for building change to the church leadership. But the biblical foundation for their current setup, well, isn’t there. Which makes it pretty hard to argue the biblical plus sides either way.
If you’ve seen Rush Hour, there’s a bit where Carter (seen right) is talking to his cousin, Luke, who is a gangster.
Carter: Why you didn’t come to church sunday?
Luke: I had some things to take care of, but I made the night service, though.
It seems ridiculous to think of a guy who bunked church in the morning, to participate in criminal activities, making sure he attends an evening service, as if such a superficial action can make up for an otherwise wrong lifestyle. To me, it seems similar to have raging arguments about the best way to have a sort of “super ordained” clergy, to reign over the other ordained clergy, when the New Testament blatantly doesn’t condone the whole priest thing anyway!
The damage we fail to mention
When it comes to Bishops, as in those with the special hats and colourful robes and special shiny sticks (see above): its just a load of tosh. Not only is it unbiblical, but it’s ridiculously alienating. Say you had no idea about Christianity, no idea about God, and you went to church to find out more? And you went to church and saw a man who looked like a cross between a Panto Dame and a extra from Star Trek. It’s not exactly going to encourage you to look into the sayings of Jesus more, is it?
So, that’s my conclusion. Women Bishops? Nope. Male Bishops? Also no. Let’s have a few overseers in each area, which is what the Bible told us to do, and lets #BanTheBishop!
CMF Conference: Day Three
Six hours sleep, and the clocks going back, brought us to our final day at the conference. Following a prayer meeting, discussions over breakfast involved a fairly detailed discussion of New Zealand humour, and a discovery of a fellow Black Sheep lover in Pete Saunders!
Seminar - A challenge to care: the Christian doctor as leader in the ever-changing NHS
Some of the changes we face in the UK:
- Change in PCTs -> CCOGs
- Increased litigation
- More complicated treatments
- More IT
- Budget cuts
- Change in clinician/patient relationships
- Ethical changes
- Unhappy doctors
Some research has been done, showing that doctors now have slightly lower workload, much higher pay, yet are much more unhappy. The loss of autonomy, greater external scrutiny, working to guidelines all seem to affect clinician happiness.
What difference does our covenant relationship to God make to our practice as medical doctors?
There is a change in secular understanding of work:
- Classically, Greeks and Romans believed work was a curse.
- In the middle ages, there was a secular spiritual dichotomy – it was seen as more holy to be doing a spiritual job.
- In the Reformation, it was understood that all work can be done to the glory of God.
- In the Enlightenment, a humanist “God helps those who helps themselves” attitude.
Work was created by God in the beginning…
“The Lord God took the man and put him in the garden of Eden to work it and take care of it.”
Why do doctors go into Leadership?
- Change things
- To help
- Against their will
- Buggin’s Turn
- Stop someone else doing it.
Why should Christians get involved with NHS leadership?
- God’s calling
- Esther + Mordecai
- Ethical stance
- Opportunity to protect the vulnerable – both staff and patients
1. Management is a means of common grace
“Let everyone be subject to the governing authorities, for there is no authority except that which God has established. The authorities that exist have been established by God.”
2. We are called to be salt and light in every area.
3. Nehemiah is a great example: he saw the need, heard the call, already had a good job, but took the risk. He dealt with injustice and gave leadership and direction to hopeless people.
4. Jeremiah is another.
“Work for the prosperity of the city where I have placed you”
5. Moses father in law gives an example of the benefits of delegating tasks.
What are the dangers of being involved with NHS Leadership?
- Getting caught up in a powerful and at times ruthless culture.
- Anger. Ephesians 4:26
- Letting Management or the Trust become an idol. Exodus 20:3-4
- Getting the work/home/worship balance wrong.
How should the Christian approach Medical Management?
Do nothing from selfish ambition or conceit, but in humility count others more significant than yourselves. Let each of you look not only to his own interests, but also to the interests of others. Have this mind among yourselves, which is yours in Christ Jesus, who, though he was in the form of God, did not count equality with God a thing to be grasped, but emptied himself, by taking the form of a servant, being born in the likeness of men. And being found in human form, he humbled himself by becoming obedient to the point of death, even death on a cross.
Really putting the patient and other people first is a servant hearted process: its a radical change of view. Personal convenience, professional status and power have to be abandoned.
Bible Teaching – Faith at Work in our Attitudes
After a final coffee/tea/squash blitz, and the discovery that Vicky Lavy bruised her hand during the slapping game last night (hardcore!), it was time for our last teaching session with Steve Burmester.
“Who is wise and understanding among you? Let them show it by their good life, by deeds done in the humility that comes from wisdom. But if you harbor bitter envy and selfish ambition in your hearts, do not boast about it or deny the truth. Such “wisdom” does not come down from heaven but is earthly, unspiritual, demonic. For where you have envy and selfish ambition, there you find disorder and every evil practice.
But the wisdom that comes from heaven is first of all pure; then peace-loving, considerate, submissive, full of mercyand good fruit, impartial and sincere. Peacemakers who sow in peace reap a harvest of righteousness.”
James talks about how our community shapes us. The TV series “UP” followed some 7 year olds, then reviewed them every 10 years. The children have grown into adults so very shaped by the social situation they were in at that tender age.
In his time as a pastor, Steve has seen many people growing up. But it is those who surround themselves with a like minded, gracious and loving community who grow and mature to match that setting. Our primary witness as Christians should be through the community we share together.
The guiding principle of Hell is “I am my own”.
Steve takes a lot of funerals, mostly for non believers. About 5-10% of them choose to have the song “I did it my way” – an attitude that is counter to the servant hearted, subservient way of the Kingdom.
Saying “I am free to be myself, and owe nothing to anyone else” is the natural desire to please oneself. But Christian living is about the righteous rubbing together of lives. In the aftermath of the Welsh revival, pubs were empty, and prisons had to shut, because lives were changed. The end of revival is caused by spiritual pride.
Spiritual pride is knowing others faults better than your own. Its an air of disdain or contempt towards others.
Pride quickly leads you to separate from those you criticise, or who criticise you.
A proud person is dogmatic, and sure about every point of belief, and cannot distinguish between a major and minor point of belief, because everything is major. Pride loves to confront to win, or doesn’t confront at all because they can’t be bothered.
A proud person is often unhappy with themselves, or self pitying.
Humility is not thinking less of yourself, but thinking of yourself less.
The opposite of pride is humility. As James 4:6 says - “God opposes the proud, but gives grace to the humble”. In Numbers 12, we see two people acting out of pride, against Moses, who is humble.
James refers to us as “adulteresses”, referring to the image of the Church being the metaphorical bride of Christ. In being selfish and self centred, we violate our relationship with God. When Jesus, who acted only to remain close to God, God chose to cut him off, and its that sacrifice, the ultimate in giving oneself, we can access the grace.
There was a man in the First World War. he was wealthy, and an art collector. He had one son, who was drafted and sent to the front line. Sadly he was killed. Another man, who had been in the trenches with the son, came to visit the old man. He said, I’m no artist alike the painting you buy and sell, but I want to give you this picture which I drew, of your son. The old man was touched, and kept the picture.
When the old man died, they decided to auction all the art in the home. They got everyone together at an auction house. They announced that they had to sell the drawing of the man’s son. We cannot move on until we sell this piece. No one wanted to buy it. Eventually, hesitantly, one old man bought the painting for £10. The crowd breathed a sigh of relief, now they could move on with the auction.
The auctioneer closed his book. I am afraid that the will states, that whoever bought the painting of the son, gets all the fabulous masterpieces.
We must accept the Son, in order to receive all the riches of heaven. Do we have the humility to take up his yoke?
We closed with communion, reflecting on 1 Corinthians 11:
Let a person examine himself, then, and so eat of the bread and drink of the cup. For anyone who eats and drinks without discerning the body eats and drinks judgement on himself.
And that was it. A final pile of food was shovelled in at lunch, and many sad goodbyes. Then, once I had finally accepted that Beth probably won the chocomilk drinking competition, Beth gave me a lift home.
It was a wonderful weekend, full of passionate, loving and exciting individuals, filled with a desire to help others, make the NHS awesome and share a crazy amount of love to the UK. Hopefully, it’ll encourage me to be more like them.
CMF Conference: Day Two
After a night spent weeing the remnants of my chocomilk binge last night, I got up in time for the 8am prayer meeting in the chapel. Still bleary eyed, I followed this with a painfully substantial breakfast, which, although lacking in vegetarian sausages, made up for it in sheer volume.
We also got to meet the CMF Junior Doctors Committee, and had Vicky Lavy nagging us once again to grab a wheelbarrow, and buy as many books as physically possible from the CMF bookstall.
Bible Teaching – Genuine Faith
Nourishment over, we settled down to listen to Steve Burmester teaching on “Genuine Faith“. We was introduced with a question, due to his background in pharmaceuticals: “What is your favourite drug name?” The answer? “Raloxifene”. Doesn’t it roll off your tongue beautifully?
95 year olds were asked what 3 things they would change if they could live again. They said: 1. they would slow down and reflect on things more, 2. they would risk more, and, 3. they would do more that would live on after they died.
In James 4, he talks about the brief nature of life: “What is your life? For you are a mist that appears for a little time and then vanishes“. The passage makes it clear that we shouldn’t boast and be proud of our own achievements: its pointless. If we feel that we can plan everything of our lives, we will be disappointed – look at the recession. As James says: “Why, you do not even know what will happen tomorrow“.
Just as the old people said in point 2: Risk. As one person said faith is spelt “R.I.S.K.”. It is the perseverence and steadfastness of going through trials that helps us to build our faith, that helps us to put our hope in God, rather than our own plans. As James 1 shows us, its not that we can’t plan, but we shouldn’t put all our hope and security in a future that we can’t predict. We shouldn’t think we can forsee and prevent all difficult times, but instead trust that the God who loves us will see us through the hard times.
How we deal with success and wealth is just as important as how we deal with hardships. Indeed, in the West, we need to learn this lesson more, since we have so much wealth, so many gifts: so many opportunities to bless others, or temptations to feel that “I have worked hard, I have earned this, this is all mine!”
Albert Einstein is travelling across America on a train. The ticket inspector comes, and asks for tickets. Einstein can’t find it anywhere, he is looking in all his pockets, in his coat, but simply cannot find it anywhere.
The ticket inspector says “It’s fine, Mr Einstein: you are a very famous person, I’m sure you bought a ticket!” She walked on, but on looking back, saw Einstein on his hands and knees looking under his chair for the ticket.
She returns, and says, “Mr Einstein, its fine, we know who you are, you don’t need to worry.
Einstein looked at her, and said “I thank you, but I too know who I am. But what I don’t know, is where I’m going…”
Our identity is important, and it is valuable to know who we are. But we shouldn’t be distracted by that into thinking we are in control of every tiny aspect of our lives.
Seminar – Miracles of healing: happening in Britain today?
Our first seminar of the weekend, with Andrew Fergusson - is on whether we see healing in the UK. He is the author of “Hard Questions about Health and Healing“, and a former GP. He mentioned the excellent price that we can pick up the book for about 8 times – I suspect Vicky Lavy had a hand in this…
We went round the group of 20 of us, and it appears that almost every church has some form of regular prayer for healing in church each week, with many having organised healing ministries.
Andrew pointed out that this has changed. 20 years ago, far less churches practiced prayers and ministries for healing.
Margaret had a serious cancer, causing terrible pain in her leg. Medication wasn’t happening. A pastor laid hands on her and prayer, she felt something like “a jolt of electricity” in her leg, and then from that moment until she died a year later, she had no more pain in her leg ever again.
What is that? Is it a miracle? It didn’t cure her cancer, but at the same time, her severe pain stopped permanently.
The dictionary defines a miracle as these below. Is it 1, 2 or 3?
- An event contrary to the laws of nature and attributed to a supernatural causel
- Any amazing or wonderful event;
- A marvellous example of something “a miracle of engineering”.
We can look at some examples of healing, for example Luke 5:12-14; there are a number of apparent likenesses between most biblical miracles:
- Obvious examples of gross physical disease.
- At that time incurable and most remain so today
- Physical means almost never used
- Cures immediate
- REstoration complete and therefore obvious
- No recorded relapses
- Regularly elicited faith
- Verification without publicity.
There is an important element here: as doctors, and as Christians: truth matters. We should not leave our scientific, analytical minds at the door when we look at healing. Evidence matters.
Andrew feels he has never seen reliable evidence of a person having an amputee regrowing a limb, the blind seeing, the dead being raised to life. As he says, “By the dictionary definition, we haven’t seen valid evidence of a level one miracle“. He has seen many, many stories of difficult to explain solutions, and release of pain, or wonderful improvement in health.
As a last, very deep point: If we are going to have a theology of healing, we need a theology of suffering.
Bible Teaching – Faith at work in our actions
After an unendingly vast lunch, and a 2 hour walk, it was time to move on with the afternoon, and our next session with Steve Burmester, on the topic of faith at work. After only about 5 hours of sleep last night, and a fair amount of exercise, I was barely awake – a feeling familiar to me from the Developing Health course.
Many people, on deciding to go paragliding, get right to the edge of the cliff, before deciding they don’t want to go ahead.
James is looking for this doublemindedness in people. The desire to do something good, against the desire to behave badly.
In James 2:1-4, he says “For if a man wearing a gold ring and fine clothing comes into your assembly, and a poor man in shabby clothing also comes in, and if you pay attention to the one who wears the fine clothing and say, “You sit here in a good place,” while you say to the poor man, “You stand over there,” or, “Sit down at my feet,” have you not then made distinctions among yourselves and become judges with evil thoughts?”
A church invited a guest preacher. The day for the service arrived, and the congregation filed in. There was a tramp, sat at the back of the church, smelling of whiskey, and they sat far from him, leaving him two empty pews to himself.
It came to the point where they were looking around, wondering where the guest preacher was, when the tramp got up, walked to the front, and put on a dog collar, and preached from James 2.
If we treat people wrongly, we treat God wrongly: James 3:9 – “With [our tongue] we bless our Lord and Father, and with it we curse people who are made in the likeness of God“. Another passage talking about our double minded behaviour.
Every human life is a reflection of divinity, and every act of injustice mars and defaces the image of God in man.
Martin Luther King, Jr
Just treating someone with inequality, is that it is sin. And thus no better than any other sin.
Lance Armstrong was struck off recently for taking drugs, but the excuse that many cyclists used is that “everyone else was doing it”. Unfortunately “everyone else does it” is no excuse.
Speak and act as those who are going to be judged by the law that gives freedom, because judgment without mercy will be shown to anyone who has not been merciful. Mercy triumphs over judgment.
- We all need mercy.
- We need to show mercy to others.
- This triumph is available to us all.
Pete Saunders started talking next to update us on the work of the Christian Medical Fellowship. We started with a video about CMF. Well, we would have done, but there was a technical glitch, so here it is below:
There are currently 4000 CMF doctors, and 800 CMF medical students. It is not a London office, but a national fellowship. They link with churches, hospitals and individuals.
STAT is “Short Term, Able to Travel” – who are people open to Teaching, Specialist service, Locum support, Emergency help in International work.
CMF are involved in about 100 conferences, including:
- CMF Student conference
- CMF Graduate conference
- International Christian Medical Dental Association World Congress
- Christian Nurses and Midwifes Student conference
- Where is my Neighbour? conference.
Find out more at the CMF events page.
CMF works to protect those who lose their jobs for protecting moral values, those of concerns about Euthanasia, Abortion, and Faith at work.
Seminar – Time Management, Jesus Style
Richard Vincent was leading the seminar, my final study session of the day.
What are pressures on your time?
- No choice – things I need to do
- Things I should do
- Things I want to do
- Prioritising between them is a varied process
- How they make you feel
What can we learn from Jesus?
“Early in the morning, while it was still dark, Jesus got up, left the house and went off to a solitary place, where he prayed. Simon and his companions went to look for him, and when they found him, they exclaimed: “Everyone is looking for you!”
He guarded his quiet time. We all shared our experiences of the difficulties of setting aside time each day, but once interesting fact: we all really enjoy doing it, yet still find it really difficult to set down to it. It is a battle.
“At daybreak, Jesus went out to a solitary place. The people were looking for him, and when they came to where he was, they tried to keep him from leaving them. But he said, “I must proclaim the good news of the kingdom of God to the other towns also, because that is why I was sent.”
He established priorities. We live unhelpfully busy lives. We also don’t find solitude enough, especially with the intrusion of smart phones and the internet.
“Just then his disciples returned and were surprised to find him talking with a woman. But no one asked, “What do you want?” or “Why are you talking with her?”.”
He made time for individuals. It can be harder to take the initiative, rather than just see friends that opportunities naturally present each other.
“For we do not have a high priest who is unable to empathize with our weaknesses, but we have one who has been tempted in every way, just as we are – yet he did not sin. Let us then approach God’s throne of grace with confidence, so that we may receive mercy and find grace to help us in our time of need.”
He did not sin. Hopefully our understanding of grace is that that we can show it to others equally well.
“Then Jesus said to them, “The Son of Man is Lord of the Sabbath.”
He rested. We need to plan time off, and have a Sabbath attitude in each day, even when that isn’t possible.
After this, we spent the evening chatting, playing Cranium and “Table slap”, making awful medical and Christian jokes, and I finally went to bed at 2:30am, after a long discussion about how to improve the Malaysian health care system.
CMF Conference: Day One
As you may remember, this summer I went to the 2 week Christian Medical Fellowship’s Developing Health course, and blogged fairly extensively about it (read all 11 posts here…)
I had so much fun that I thought I would attend the CMF Junior Doctors conference. Entitled “Faith at Work”, there are a range of seminars covering a wide range of topics, and some central teaching looking at the book of James. Plus hanging out with lots of similar minded junior doctors, and eating too much tasty food.
Yesterday was the first evening. After nearly 5 hours on the train, and 3 different connections (Boston is annoyingly out in the sticks!), we arrived at the delightful Hothorpe Hall near Market Harborough.
There wasn’t a huge amount of action on the first evening. Lots of chatting, some fantastic dinner, and a great introductory talk from Steve Burmester, our speaker for the weekend, on the Book of James.
He mainly focused on the disease of having a divided heart. Breaking it down medically, he showed us the symptoms of a divided heart: anger, a loose tongue, etc. The treatment is not to try harder, to continually berate ourselves, but to allow more of God’s grace to flourish in us.
The evening was rounded off with myself and my friend Beth had a drinking competition. Of Chocomilk. After 6.75 cups each (don’t ask about the arguments that led to that exact measurement) and a tie-breaking run round the entire building at half past midnight, it was time to go to bed.
See you all tomorrow!
Coupled with this, my phone contract was up for renewal at the end of September. For a few extra pounds a month, I can join the world of up-to-date shiny new devices.
It would seem that my path forward is simple – but I’m hesitating. You see, I don’t want to be the person that buys something *because* its new and shiny. I don’t want to join the cult of new. I’ve got an 8 year old car, a house that needs doing up, and one of my dogs is starting to show a few hints of arthritis; I love old stuff!
I also love efficiency. I see technology as tools, tools for me to get stuff done. For the first time since becoming a doctor, I got my own room this month; and I’ve loved setting it up just right, so that I know where urine specimen bottles are, so I can maintain eye contact with patients whilst typing, so my every motion can be as effective as possible, giving me time to do the important stuff.
Generally, I like my technology new, because new tends to be faster, tends to be more efficient, allows me more time to get stuff done. But my current phone browses the web, checks emails and takes decent photos. It turns on quickly, it loads information fast: I don’t believe that my workflow will be sped up by a new phone.
I’ve been distracted by newness. As Robert Murray McCheyne said:
“Sit loose to this world’s joy, time is short”
Inspired a little by my friend Jon, who recently downgraded from an iPhone 4 to an old, non smart Nokia, I’m going to skip this upgrade, and be content with the incredible phone I already have, and maybe try to rely on it a little less.
Day Eleven: Final Bits
Our last day of the course, and the morning prayers were tinged with sadness. It’s been a fantastic two weeks, and I’ve made lots of genuine friends. I’m really going to miss going back to real life…
Claire Fuller gave us our final topic session of the week, based on many years of experience in both the UK and East Africa.
The WHO is working with the Gates Foundation to run a Global Burden of Disease statistics measuring. 600 million cases of scabies worldwide. In the developing world, skin disease is the second commonest reason for attending primary care – but people are still far less likely to attend if they have a rash compared to other types of pathology.
As in many other areas, traditional healers cause many problems – their treatment for lymphoedema is to puncture the legs multiple times to let the fluid out. Sadly, this leaves the door wide open for infection.
Important features to have.
- Suitable location for skin examination
- Satisfactory light
- Examine patient all over – check mouth, nails, scalp, feet, genitalia.
- Distribution of lesions.
The problem is, because don’t want to strip off because the clinic is full of people and no privacy, but then you take them down to the cupboard, and its too dark to see.
Bacterial skin disease
Very commonly this will be impetigo – yellow crust to blisters, generally around nose and mouth.
- They need to wash the skin – with clean waters and disinfectants. Remove crusts, debris and necrotic tissues.
- Apply antimicrobial preparation – herbal, honey, hydrogen perocide, chlorhexidine, topical antibiotic.
- Oral antibiotics – flucloxacillin, erythromycin.
Eczema is very common in the developing world. Can be especially aggressive in African skin. Rather than simply affecting the flexures, it can affect the whole trunk, and can cause very high levels of inflammation, which leaves hypopigmentation after resolution.
Often needs emollients and dermovate.
Scaly round rashes on arms or trunk related to ring worm. Can be treated with topical antifungals. However, tinea capitis – affecting the scalp – will need systemic antifungals. (See image above on right)
Pyoderma, scabies and renal damage
There is an established association between scabies and pyoderma. In those with scabies + pyoderma, 5-10% will have visible haematuria: so it should be treated.
80% of dermatology consists of 8-10 common diseases. If it smells like pyoderma, it probably is.
Medical implications of skin-lightening products
These can cause local damage, with inflammation and awful stretch marks. In Malawi, around 5-10% of people attending our clinic had problems related to these creams.
Patients will deny using the products, so you have to say “I’ve heard that people who use these creams get these problems”, letting them save face.
Having a skin disease is a risk factor for having HIV, from evidence in Tanzania. Multiple dermatoses is quite specific for low CD4 count. In one study, 88% of adolescents with HIV had a skin disease.
The best way to treat the HIV associated dermatopathology such as Kaposi’s Sarcoma is to treat the HIV.
- Treat underlying cause.
- Keep clean without dirsupting healing (antiseptic soaks, water fit for drinking is fit for wound case)
- Treat secondary infection
- Greasy covering prevents adhesion and good for pain relief.
- Compression is very helpful.
Removing suspicious lesions
Skin swells and becomes woody and hard. Smells insanely awful. Basically an end stage lymphoedema.
Usually can be dramatically improved with frequent washing and antiseptic. Get children to wear shoes, prevents the condition occuring.
Our scheme in Ethiopia has led to all who are treated being invited to join the team to teach others. 30,000 have now been treated in the scheme!
Teaching… a workshop
Our closing session was from Vicky Lavy, talking us through the wonderful art of teaching, a key tool for all of us, especially in the developing world.
Many of us have done a fair amount of teaching. As a group we came up with lots of words beginning with E, about the important things that teaching needs to achieve:
- Effect (on patient care)
- Everlasting (sustainability)
What makes a good teacher?
- Clear + interesting
- Love for the subject
- Knowledge + Preparation
There are millions of different teaching styles: Participation, Lectures, Scenarios, Practicals, Groups, Role play, Mentoring, Informal, Teach others, Drama & Song, Quiz, Stories, Bed side, Shared consultations, Video, Books, Online, Visual stuff, Thought exercise, Buzz groups.
One week after a lecture, evidence shows that people often only remember around 20% of the information.
Some of these are very effective in developing settings, others not so well. Generally, developing world cultures are used to very didactic of teaching, which means they can learn by rote, but are not well versed in problem solving.
However, once they get used to small groups, which can take some time, they find them useful also. Good to tell people they can use their own language in the groups.
“I was doing some teaching in china, and trying to ask questions, and just getting blank faces. However, over the 3 days, the group slowly opened up, talking about patient cases. By the end, I found they were very engaged.”
- Dealing with wrong answers - Important to a) not embarrass people, but also b) correct dangerous treatment ideas.
- Breaking up teaching sessions is valuable - to keep people awake. Having a buzz group session between talks is helpful. A buzz group is where someone turns to their neighbour and briefly discusses an issue
- Visual aids – showing pictures, to tell stories. One teacher on this course has showed us the manacles used to hold psychiatric patients to the wall. That kept us awake!
Case example: Teaching student nurses in Uganda about immunisation within 1 hour
We broke into lots of pairs and tried to come up with teaching sessions. Then fed back to the group. Huge variation in styles and approaches. Some groups taught basic practical skills, some came up with dramas, some had very ambitious plans to teach a much more holistic community engagement approach.
Ian’s closing remarks: God did not make us to cope with burdens on our own. Jesus sent people out two by two, not individually. We need to share our burdens together.
We then all held hands and closed in prayer together.
And that’s all folks. Sad to feel we are at an end, but I’ve definitely never enjoyed a medical course, or generally teaching so much. I’d like to give some huge thanks to Vicky and Ian, and the whole of the CMF team. Bless you all!