ELECTIVES: MORE THAN BUSINESS AS USUAL – SANDRA’S EXPERIENCE

“Chebet, kuja nikuulize swali,” Nasi (short for Nasimiyu) said to me on my second day – could have been third, my memory betrays me sometimes.

“Unatumia maandazi?” she asked politely.

“Yes,” I answered with a giggle.

And just like that, friends, I was added to the list of partakers of the daily tea and andazi in our Community Pharmacy, which I’ll talk more about later on in this article.

We have three rotations for our electives, alias the fourth term or attachment, and all three have had one thing in common – 10 am tea! I am an avid tea lover, so this makes me happy. Anyway, this article is not about tea, so let’s get into the meat of the matter.

Each rotation in this experiential learning period is one month long.

ROTATION 1 (INDUSTRY): CKL AFRICA LIMITED, formerly known as Coopers

We reported on the next day after finishing our end of fourth year exams. When we got to the location, we were directed to the head office, where we found our preceptor, Dr. Charles Ndung’u, the Company Pharmacist. We held a short meeting with him in which we talked about our goals and terms of engagement. CKL Africa manufactures products for animal health, but the manufacturing principles are quite similar to those for human health products, so it is not uncommon to find student pharmacists rotating in industries that manufacture animal health products.

I started with the warehouse on my first week, followed by the manufacturing plant, then finally the quality control laboratories. If I could describe each of these sub-rotations in one word, I would say the warehouse was chill (the informal meaning), the manufacturing plant was busy, and the laboratories were engaging.

My favourite thing about this rotation was how the names sounded familiar. I come from a county where farming and livestock keeping is a major socio-economic activity, so I had already seen or at least heard about some of the products manufactured by the company.

The employees there were very friendly, always meeting us with a wave, a smile, or both. The environment was green with big trees and well-manicured grass lawns. Once we even had a mentorship meeting under a tree and I just loved it! I also got to try a wild fruit that grew in the compound. Lunch was provided for the employees and students on attachment (I know students feel me on this one).

Our preceptor had prepared questions, which we were to find the answers to as we went about our days at the company. We then put together PowerPoint presentations with our answers and presented the same to him in one of the boardrooms on one Friday afternoon.

Nairobi’s traffic jam was a pain in the neck, especially on the way back because we would leave during the rush hour.

ROTATION 2 (HOSPITAL): TENWEK HOSPITAL

I had never been to Bomet before this rotation, so it was exciting to experience a new locality. When I was choosing the hospital to go to, I wanted somewhere I wouldn’t need to rent a house for the period of the rotation. I settled on Tenwek partly because I knew that the hospital, based on availability, offers accommodation to students on attachment. Unfortunately, just about a week or two before my reporting date, other students reported for attachment and the accommodation spaces filled up, so I had to sort myself.

By the time I got to Tenwek in the early afternoon hours, I still had no confirmed house or room. Nonetheless, by around 6pm, I was settling into a self-contained room in a family’s home (separate from their main house) close to the hospital. It was quite challenging to find a vacant self-contained bedsitter for rent near the hospital, and this is a potential area for investment by the hospital or other entrepreneurs. It would take me roughly ten minutes to walk to the hospital every morning. Tenwek is hilly and green, which means some nice views but also some uphill trekking.

The fact that I knew some of the MO interns and MOs who were alumni of the University of Nairobi gave me a soft landing. They gave me the tips and tricks for a pleasant stay, and we also spent several lunch hours together. On one rendezvous with my friend, Dr. Dorcas Kimutai, she pointed out some areas I shouldn’t forget as I learn about what being a pharmacist in a hospital setting looks like, especially because the rotation period was short, and it would be wise to prioritize some areas. She made me realize the importance of learning how to maneuver the managerial aspects of the job because in a few years, those responsibilities could fall squarely on my shoulders, and at least knowing what to expect would be beneficial.

I was lucky to find Vanessa Chelang’at, a Pre-intern Pharmacist who was volunteering at the hospital at that time. Our mutual friend, who linked us up, had told me that we are quite alike and after my stay there, I could not agree with him more. We became friends quickly, and she taught me how things work at Tenwek. The staff were friendly, which made it easy to develop good rapport with them. Once we were casually discussing having lunch on the weekend, then somehow, that turned to lunch in Kericho, which is about an hour away from Bomet, so it became a mini road trip!

My days usually started with ward rounds, which sometimes would run till a few minutes to lunch time. I would spend the afternoons at one of the pharmacies (in-patient, out-patient, theatre, Renal and Oncology unit, maternal and child health unit, or antiretroviral drugs pharmacy). On some days, Vanessa, my supervisors, and I had sessions where we would do topic presentations or case presentations, and on other days we would hold drug reconciliation discussions. As the Pharmacy department, we had weekly internal CMEs during which I learnt about pharmaceutical waste disposal among other topics. I also appreciate the fact that drugs were available, and in a wide variety. Reconstitution of some oncology drugs and extemporaneous compounding of others was done routinely, and I’m glad I got the chance to experience these.

My experience was not without lows. There were moments when I didn’t have answers to questions I was asked, and I felt inadequate. In such moments, things moved on eventually – they always do – but for me, the embarrassment lingered. However, I stuck through it, and I am glad I did so.

Dr. Maryanne Favour, the Chief Pharmacist at the time and someone I look up to, did a splendid job at mentoring me. I remember times when she would sit with me in her office and we would talk about the profession: the gaps, the opportunities, our roles, and the best parts of it. From our interactions, I learnt diligence and built my self-confidence. From Dr. Samson Juma, the deputy chief pharmacist at the time, I learnt pragmatism in the practice of pharmacy, and the importance of setting the pace in terms of order.

ROTATION 3 (COMMUNITY PHARMACY): MALIBA PHARMACY

Remember Nasi? This is where that conversation happened.

I chose this pharmacy because I had been there before to buy drugs and I liked the service I got. The other good thing is that an expansive range of drugs are available and at fair prices. My supervisor, Dr. Jim Onchuru, was an alumnus of the University of Nairobi who graduated a few years ago, and this became good common ground for building rapport. He is a sharp Pharmacist from whom I have learnt the art of delivering patient-centered care in a kind and careful way. I admire the knowledge that the staff have acquired and mastered over years of working in a community pharmacy set up, enabling them to respond to patients’ needs quickly and appropriately. It’s true that clinical pharmacy is not confined within hospital walls, it extends into community pharmacy practice; I saw it here. Since this was in my hometown, it was a joy to serve people that I know when they came in to buy drugs.

I also laud how procedures are followed rightly, for example, controlled drugs will be dispensed after a valid prescription has been presented and photocopied for record keeping. The inventory control was spot on and worth a hail; very rarely did we get drugs expiring on the shelves or in the stores, and the tally between physical stocks and those in the system was commendable.

I appreciate that I was received cordially by everyone, starting from the director, Mr Isaac Njoroge; and taught gently and with patience. I left Maliba with a full heart, and cake!

CONCLUSION

In general, I felt valued and appreciated, something I don’t take for granted. Twice, I had farewell celebrations at the end of my rotation. Importantly, I have expanded my network. I am fortunate that my supervisors became more than just that; they became my mentors and friends. They have continued to guide and advise me even after my electives.

Personally, I have gained confidence in myself with regard to the practice of pharmacy. Electives give a glimpse of what three of the sectors in the Pharmacy profession really entail. The experience can give a hint on what ignites a fire in you and therefore shine a light on which path you might want to pursue.

Keep an open mind and always endeavour to have a good time!

SANDRA C. AIYABEI

Pharmacy student,

University of Nairobi.