When the going gets tough

Following a mission to Sudan cut short by the pandemic, AWB volunteer Tag Elkhazin has some advice for AWB volunteers facing the unexpected.

March 2020. The World Health Organization had just declared the rapidly spreading coronavirus a global pandemic. As borders closed, scores of foreigners stranded abroad, on beaches or business trips, scrambled to get flights home. Having arrived in Sudan on March 2, Tag Elkhazin, an AWB volunteer at University of Bahri in Khartoum, was in a difficult position.

Sudan had only recently emerged from the brutal 30-year dictatorship of Omar al-Bashir, who was overthrown in a military coup in 2019. With Al-Bashir gone, the country was in the midst of a halting transition to democracy.

Tag’s AWB project at the university was progressing despite a rocky start. He was developing a manual for the university’s Centre for Peace and Development Studies to provide training, coaching and advisory support in community-based conflict resolution and political settlement.

The recent assassination attempt on Prime Minister Abdalla Hamdok was yet another reminder of the necessity of the project he had undertaken.

Tag is an internationally recognized expert on the Horn of Africa and a senior fellow at the Norman Paterson School of International Affairs at Carleton University in Ottawa. A scholar and a practitioner, he is equally comfortable working with battle-hardened fighters as Armani-suited officials. Decades of experience, contacts in diplomatic and government circles, and good-natured doggedness, helped Tag navigate what appeared to be a chaotic situation.

In the midst of a gasoline shortage that paralyzed the city, he secured enough fuel to get around. Provided with a dilapidated office, he hired workers to refurbish it. Meetings with elusive government officials were set up with a few phone calls. AWB took care of all the unforeseen expenses.

“Catherine (Catherine Cripps, AWB Volunteer Coordinator) would check on me two or three times a day,” says Tag, who was on his first mission for the organization.

When the Government of Canada called for all Canadians to return home, AWB moved quickly.

“I had two tickets, one in First Class just in case I didn’t get a seat in Economy Class,” said Tag, recalling the emergency evacuation.

A volunteer’s health and well-being are AWB’s top priority.
While Tag’s mission to the Republic of the Sudan was not a typical AWB assignment, his experience highlights the qualities AWB looks for in volunteers: he is passionate, has a high level of expertise and is committed to building the quality and capacity of higher education in the least developed countries.

“Number one is resilience,” Tag adds. When a volunteer steps outside their academic world to work in the global south they should expect a few surprises and setbacks, some of which will undermine a project, but he adds, “If there is a glimpse of hope we should follow it.”

Tag’s advice for AWB volunteers

Ground intelligence is crucial. It is important to understand the political, cultural and social environment ahead of time, but once you arrive, get comfortable with uncertainty. “I always use the iceberg model: Eighty percent of reality is hidden from you,” says Tag. “You need to be prepared for that.”

Be sensitive to cultural differences. Tag suggests taking the time to learn about the local culture and acceptable behaviour for foreign visitors. Knowing a few rules of etiquette can help a volunteer avoid awkward situations that could sour relations with colleagues.

Recognize when it is time to go home. “Think: Why am I here? Do the people I am with need what I am going to deliver? In most cases, the answer is ‘yes’”, says Tag. “But,” he adds, “an academic volunteer is not expected to tolerate the same level of risk as a humanitarian worker or a highly paid consultant.”

No effort is wasted. Doing the best you can under difficult circumstances is a reward in itself. “Despite the disappointment, I did manage to get quite a bit of work done. I came back with 30 to 35 percent of what I went for,” says Tag. “Had I been able to stay the additional three weeks, I would have completed the job.”

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About Tag:

Dr. Tag Elkhazin is Adjunct Professor at Carleton University, Ottawa, assigned to the Institute of African Studies. He is a Senior Fellow with the Norman Pearson School of International Affairs, a member of the African Study Group of Ottawa, and member of the Board of Directors of the Archaeological Institute of America – Ottawa.

Tag trained and worked in Sudan, Sweden, Germany, Saudi Arabia, Ethiopia, Kenya, Eritrea, Nigeria, Chad, Canada and the United Kingdom. He is a member of the International Institute for Strategic Studies (IISS), London, UK.

Dr. Elkhazin has been a regular coach training and teaching Interest-Based Conflict Resolution with the ADR Chambers and Stitt Feld Handy Group of Toronto. He is the author of several articles and assessments on conflicts in Sudan, South Sudan, IGAD/CPA, water/Nile waters, civil society, peace and conflict resolution. Tag developed his own hands-on module of “political settlement” between rebel groups and incumbent governments.

In April 2018, Dr. Mary T. Wall went to Gorkha District Hospital, Nepal, as an AWB volunteer with the District Hospital Program (DHP), a collaboration between Patan Academy of Health Sciences (PAHS) and AWB. It is supported by the Society of Rural Physicians of Canada and was designed by Dr. Karl Stobbe, a member of the PAHS International Advisory Board, together with his colleagues at PAHS. The aim of the collaboration is to have physicians support the students on rotation in their clinical work and mentor the graduates on effective communication skills. At present, the physicians are expected to contribute their efforts primarily in the rural hospitals and their outpatient clinics.

This is Mary’s story:

I would like to introduce Sunil Daha.

Sunil is a 21-year-old in his fifth year of medical school at Patan Academy of Health Sciences in Nepal. He entered medical school at 17 years of age, having completed his education to that point all on scholarships. He is from Dhanusha District and is of the Dhanuk (Mandal) caste. He is the only son in his family and has three sisters.

From the age of 6, Sunil aspired to be a doctor – he was the smartest kid in his class. But the only way he could complete his higher education was with a scholarship. And the only way he could attend medical school was with a full scholarship. All of this required scholastic achievement.

From a very young age Sunil did not worry about the boundaries of the caste system – he played with all the children even though it was frowned upon. Once he completed grade 10, his father wanted him to work as a labourer, but he refused and said he wanted to continue higher education. With a scholarship he was able to complete grades 11 and 12, but had to travel three hours each way to and from school on a bicycle, as his family could not afford housing for him close to the school. During part of the period when he went to study and write exams for entrance into medical school, he was homeless. With the help of two close friends he scrounged accommodation and minimal food to allow him to complete the required courses and write exams. It was his devotion to scholastic achievement and his earnest desire that propelled him into medical school at age 17.

I think it is this determination, and knowing he had to be his best all the time and every time, that he has acquired an amazing knowledge base in his studies, and his work ethic is second to none.

Sunil was in Gorkha three weeks before my arrival and already he knew the whole hospital – all the staff, all the departments – and spent extra hours each day in Emergency, the delivery room, and the O.R. because he wanted to see and learn, knowing that in two years he wanted to be the most competent doctor he could be wherever he might be placed. We had a lot of discussion of how he wanted to increase the living, health, and education standards of the people he would live and work with.

Each time Sunil has returned to his home in the past five years, he has spent time going to his old schools and talking with the students and, on his most recent trip, he spent time educating to his community about health issues. He checked the blood pressure of over half the people in the community and gave them information about heart health. Very impressive for a 21-year-old.

Sunil is always very aware and appreciative of his mentors and instructors. He is always thinking and always asks questions. When I was leaving, he was assisting the emergency medical officer to rewrite policy and procedures for Emergency. He volunteered for this as he knows it will prepare him for the future.

“I need to have as much experience as possible, so when I am an general practitioner physician I will be capable one, and a compassionate competent leader, “ says Sunil.

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About Mary

Born and raised In Rural Newfoundland, Dr. Mary Wall’s early education was in a one to two room school and her high school years started in a newly built school which congregated all the children from 16 communities in grades 7-11. She graduated with a district scholarship for university.

After a 2-year RN diploma program she worked in a small rural cottage hospital in Newfoundland and then returned to Memorial University to complete a Bachelor of Nursing with one term in England for Occupational Health. Mary worked for 10 years in all fields of Nursing: medical-surgical, pediatrics, ICU, CCU, Home Care Nursing and a lot of ambulance travel; plus instruction in basic nursing skills in Portage la Prairie, Manitoba.

Mary then went on to receive an MD from Memorial University and started practicing full service rural medicine. She moved to British Columbia where she worked full time in full service Rural Family Medicine for 16 years, running 2 practices 20 kilometres apart with full admitting privileges at a rural hospital 45 minutes from her home. She was involved with OR assisting, teaching Neonatal Resuscitation and CPR and acting as the point person for CME at the hospital, plus obstetrics, ambulance call with her jump kit in her trunk, general practice in oncology with chemo two days a week and palliative end-of-life home care.

Mary moved to Kelowna, BC, where the majority of her work was as a General Practitioner in Oncology in a hospital setting. She continued with obstetrics in Penticton Hospital until June 2013; she worked three rural locums in Nunavut and also in Boundary Area of BC. Mary is an associate professor at the University British Columbia with a family practice residence in Options for Sexual Health Clinics.

In December 2017, I travelled to Lviv, the largest city in western Ukraine, to work with the faculty of Lviv Polytechnic National University.

With ongoing conflict in the eastern part of the Ukraine, and the influx of internally displaced people into more central and western regions of the country, the Lviv Polytechnic National University requested the assistance of AWB to develop a program in participatory action research (PAR). In PAR, researchers and community members work together to understand challenges facing the community and find solutions to address them. In the process of co-developing a culturally appropriate PAR research course for Lviv Polytechnic, I facilitated a five-day PAR workshop with academics, graduate students and local professionals. The ongoing work of faculty and community will support the development of strategies and programs to address the specific needs of internally displaced people and communities receiving them.

Here’s a story about my work recently published in the University of Manitoba’s ResearchLIFE magazine:

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About Maureen:

Maureen P. Flaherty is an Assistant Professor in Peace and Conflict Studies at the University of Manitoba. She has spent more than thirty years as a front-line social worker, then therapist, consultant and educator specializing in crisis and trauma recovery and intimate partner abuse. Her work in education and community development has taken her to areas of Canada, Ukraine, and Russia. Her research interests include gendered perspectives in interpersonal violence, narrative, visioning, community development and post-conflict community building focused on rebuilding agency through healing and inclusion. She is the author of Peacebuilding with women in Ukraine: Using narrative to envision a common future (2012), a co-editor of Peace on Earth: the role of religion in peace and conflict studies (2014), co-editor of Creating the third force: Indigenous ways of peacebuilding (2016), and lead editor of Gender and peacebuilding: All hands required (2015), all with Rowman and Littlefield.

I’m a person who loves numbers. So let me rattle off a few that will help tell the MicroResearch story: 30, 800, 25, and 3.

Thirty is the number of workshops MicroResearch has conducted since Noni MacDonald and I conceived the program in 2008. Eight hundred is the number of participants who have been trained. Twenty-five is the number of projects the program has helped launch in Africa. In this short essay, I will tell the story of three of the most recent trainees, from the recently completed workshop at Kabarak University.

Philip Towett’s Story

Philip caught my eye on the first day of the workshop. He’s every teacher’s dream, a student who relishes the opportunity to learn, and absorbs every lesson with abandonment. He told me he loved the way MicroResearch has helped him to approach research in a new way, “I like it when you ‘demystify’ the concepts of research.” But, being able to attend the workshop was not easy, requiring him to work double time before and after it, to make up for lost hours as a teacher. I was eager to hear his story, and add it to the many others. I’ve learned “In Africa, there are few ‘ordinary’ life stories”.

Philip was born in Bomet County, Western Kenya. The 6th of 10 children, 6 brothers and 3 sisters. His parents were subsistence farmers, for whom education was an unfulfilled dream but a cherished hope for their children.

As it turned out their oldest son, Stephen, was a particularly gifted learner. Though his parents could only afford to support him to grade 7 of school, he clearly was talented and could have gone on from there. But as good fortune would have it, Stephen was hired by Tenwek Hospital and was mentored by Dr. Ernest Steury, first missionary doctor, assisting him in his regular activities in the operating room. Here is where chance and good fortune can make the difference for several generations. Ernest recognized Stephen’s potential and inspired him and others. With the money Stephen saved as Dr. Steury’s assistant, he was able to support his brothers and sisters to seek even higher levels of education than his own. I’ve witnessed this model of family support again and again in Africa, brothers and sisters sharing the good fortune that God has given them with their family, a multiplier effect. While 2 of the 10 children died at a young age, Stephen was able to help the others gain an education. Because of his support, one of the siblings is now a police officer, and another a nurse. Philip’s own education beyond high school would likely not have occurred without his brother’s support as well.

With Stephen’s help, and his own hard work, Philip has achieved much, completing his Bachelor of Nursing degree with distinction at Great Lakes University of Kisumu and a master’s degree in Community Health and Development. He is now working on a Ph.D. at Jomo Kenyata University of Agriculture and Technology, while still employed full-time as a teacher at the School of Nursing at Tenweck. Philip follows his brother’s and the African tradition of helping family, supporting nephews and nieces through high school and beyond. As he said, “I have been given much, and I know much is expected of me.”

Sifora Fanta’s Story

Sifora is a Family Medicine Resident in her first year of training at Kabarak. Sifora appears to be in her late twenties but has a wealth of experience beyond her age. Blessed with a warm smile that comes easily, she brightened the room with her joy and excitement.

Though her residency program is in Kenya, Sifora is actually Ethiopian and has lived in other countries over her young life. Partly because of this, she is actually fluent in 5 completely different languages. Although Amharic, with its 250-letter alphabet is said to be the most difficult language on earth, this one came naturally as the child growing up in Ethiopia. Walaytegna, the local language of her region in Ethiopia, likely occurred before starting formal school. Next came English, which she learned at school, and now speaks with complete fluency. If you are keeping count, the fourth language will come as a surprise, Tagalog, the language spoken in the Philippines was learned while she lived there during high-school, university and while studying Medicine. Her final language (so far) is Kiswahili, the major language of Kenya. This one is still new, but I think will be conquered very soon.

Sifora’s told me she was inspired to study medicine by her own family doctor back home in Soddo, Ethiopia. When she is finished her training, she plans to return to Soddo to practice Family Medicine, just like her mentor. But first she must complete a research project. The MicroResearch workshop is tailored to help her achieve that goal. She also understands the role that research will play in her future, “Unless we have the ability to do research, we can not change and we will not solve the problems we have. I believe that MicroResearch will help me get there.”

Amy Akim’s Story

Amy was born in Nakuru, Kenya, but grew up in Mombasa. She now lives in Nakuru, the major city near Kabarak. Her parents are both public health officers in Mombasa, Kenya. Likely inspired by her parents, Amy and her two sisters are all pursuing careers helping others; one sister is a social worker and another an interior designer. All of them feel a responsibility to reach out to help the poor in Kenya. Amy said it on behalf of herself and her sisters, “The way to go is to work in underprivileged communities.”

Amy is a quiet, thoughtful person, but speaks clearly and eloquently when she wants to express her ideas. I’d add, that she is a natural leader and teacher based on the qualities she showed during the MicroResearch workshop this October. She became my teacher, as she explained the fundamentals of the educational program in Kenya, a system that, I believe, has much merit.

High school graduates who get selected to pursue a course in the university are partly sponsored by the government, thus their tuition is subsidized. But to be eligible for state support, high school graduates must spend two years in the community, learning some of life’s lessons from their family and elders. Following this, the most successful students may be accepted into a 5-year medical program and earn Bachelor of Medicine and Bachelor of Surgery (MBChB) degree. After receiving their MBChB, students are assigned to practice medicine in a state hospital. Amy did her 2-year work assignment at hospitals in Kangundo and Machakos in Kenya, regions with increased needs. Her ambition now is to earn a master’s degree in Family Medicine, a requirement for becoming a Family Medicine Specialist in Kenya. Completing a research project and publishing the results is an expectation for the Master of Medicine in Family Medicine at Kabarak. The university’s goal is also that the research done will be translated into action, and not collect dust on a shelf. Our academic hosts at Kabarak expect the MicroResearch Program will ensure that the research AND the knowledge translation aspects will be achieved. As Amy said during our conversation, “I’m looking forward to using what I have learned.”

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About Bob:

Dr. Robert (Bob) Bortolussi is a professor of pediatrics and of microbiology and immunology at Dalhousie Medical School with a clinical appointment in pediatric infectious diseases at the IWK Health Centre in Halifax, Canada. He’s a former vice president of research of the IWK and curriculum director of the Canadian Child Health Clinician Training Program (CCHCSP). Bob is currently a member of the Canadian Centre for Vaccinology. One of his projects includes co-leading a micro-research initiative with Dr. Noni MacDonald in East Africa. Bob went to Rwanda, Tanzania, and Kenya in 2016 and 2017 on MicroResearch projects with AWB (Nepal is next at the end of 2017).

I have recently returned from Banda Aceh, Indonesia, where as part of my sabbatical I volunteered with the faculty of the medical school of Syiah Kuala University to develop a project to reduce maternal deaths in rural Aceh.

About Keyna:

Dr. Kenya Bracken is an Associate Professor in the Department of Family Medicine at McMaster University in Hamilton, Ontario. In addition to a busy clinical schedule including full care obstetrics, she is actively involved in teaching and is Undergraduate Director Family Medicine and Enhanced Skills Program Director in her Department. She has worked internationally with the Society of Obstetricians and Gynecologists of Canada teaching emergency obstetrical skills in Tanzania and in other developing countries in various capacity building projects. Keyna is currently involved in medical education research looking at the uses of social power in clinical learning environments. She has been recognized for excellence in clinical practice by the College of Physicians and Surgeons of Ontario and has received numerous teaching awards. Keyna is a fellow of the Djavad Mowafaghian Foundation.

Earllene Roberts

I spent four months at State Islamic University Yogyakarta, working with the team at the Centre for Disability Studies and Services (CDSS). In fact, the Centre is so much more than its name conveys. The most impressive aspect of the Centre is the people who are its heart and soul: the 50+ disabled students, 110 student volunteers, 2 regular staff members, 6 researchers/ professors, and the Centre’s Director.

These individuals together make up a small but vibrant community that is committed to the equity and inclusion of disabled students, not only at their university but also within the broader society. These wonderful people welcomed me wholeheartedly and quickly made me a part of their group. And although I was there to give direction and to support their continuing work in services to disabled students, I can truthfully say that I received in return at least as much as I gave. Experiencing firsthand another cultural and social perspective on what it means to be disabled was an invaluable experience that contributed to my personal growth and knowledge of disability. The friends I made and the people I met enriched my life profoundly.

I have worked for decades in the field of disability services in a variety of sectors, including private for-profit organizations, government agencies, and post-secondary educational institutions. My professional background is in social work with a focus on disability. I believe disabled people, as a group, to be among the most marginalized and discriminated-against members of society in the world today. In many contexts it is still generally acceptable to refuse service, employment, or funding to disabled people solely on the basis of their disabled status. They are erroneously perceived as less capable, less deserving, or non-contributing citizens, and many people use this wrongful perception as justification for oppression. It is this injustice that drives me to continue working, studying and researching disability from a critical social perspective. My goal is to help move toward a society in which there is full equity, and in which all people truly include and embrace a diverse human spectrum that includes disabled people.

While I was at SIU Yogyakarta, my job was to work closely with the Director to expand awareness of the Centre within the University and to enhance its profile. My main task was to work with the Centre’s staff in developing a training package to increase understanding of the Centre’s role within the University. I also helped form the Disability Faculty Liaison Committee, whose members, representing the university’s eight faculties, work with the Centre to develop methodologies for accommodating disabled students academically. I also developed procedures for communicating these students’ needs to the University’s faculty.

Irmalia (Irma) Nurjanah

Typical of the students with disabilities with whom I worked and who benefit from the CDSS programs is Irmalia (Irma) Nurjanah. Irma is studying Community Development and Communications in preparation for a career as a radio announcer. Born with low vision, Irma experienced an embolism at age 15 and became completely blind.

After losing her sight, Irma had to reorganize her whole life, adapting to a new way of experiencing the world and new ways of learning and engaging with her friends. However, her natural drive and intelligence soon reasserted themselves. Counselled by the blind director of a local NGO that advocates for students with disabilities, Irma attended an inclusive high school, where she excelled in her studies and graduated at the top of her class.

Irma is a leader and an advocate in the CDSS community at SIU Yogyakarta. She believes that the services it provides, together with the sense of community and belonging that it offers, have been crucial to the academic success of the students in the programme.

One of AWB’s donors had this to say about Earllene and the Centre:

“In December 2015 I was lucky enough to visit the Centre for Disability Studies and Services at the State Islamic University Yogyakarta. I was amazed to learn that this program is the only one of its kind in Indonesia, and that it survives and supports students with very little funding. The first thing that struck me was the energy of the students, who seemed to have the joy of learning in their eyes. I also got to meet the AWB volunteer from UBC [Earllene Roberts], who was engaged in helping the program be more effective and useful. It was a great experience for me and I wouldn’t hesitate to donate to other AWB worthy causes.”

– Colin Paranchych

About Earllene:

Earllene Roberts is the Manager of the Disability Resource Centre at the Okanagan Campus of the University of British Columbia in Kelowna, British Columbia. Earllene became an AWB volunteer in 2015 to work with the Centre for Disability Studies and Services at the State Islamic University Yogyakarta (SIU), located in Yogyakarta, Indonesia. The mission of the Centre is to integrate disabled students into SIU and to provide them with a variety of services. It is the only Centre of its kind in Indonesia. The Centre contacted AWB to help it make a transition from a volunteer-based system to a fully professional disability office.

I am passionate about nursing. I began my career by training for a nursing diploma and went on to earn a B.Sc. and then a Ph.D. I wanted to put my skills to work in the part of the world that most needed them so I went to work in East Africa. While working there in 2011 I became a volunteer with Academics Without Borders, under whose auspices I worked with the Aga Khan University School of Nursing and Midwifery. Our goal was to improve the school’s program so that it could offer a B.Sc. in Nursing to nurses who already had a diploma in the profession. I worked with the AKU faculty and administration at their Kenyan, Ugandan, and Tanzanian campuses.

In Tanzania the number of nurses and midwifes per 10,000 population is 2.4. Improvement to the nursing faculty translates into improved medical services to the population of Tanzania. In the time I’ve been a volunteer with AWB, we have trained a faculty of 6 people who in turn graduate 18 nurses per year with a B.Sc. in Nursing.

The nurses who study at AKU are highly motivated. All the students are front-line nurses who take courses after working a full shift. These nurses work in very challenging situations. For instance, patients may have been carried by loved ones for two days to reach a nursing station. Mothers who want care for their children must often walk for several hours and cannot travel after dark for fear of being attacked by lions, hyenas, or other wild animals. Sometimes a patient arrives for care in a wheelbarrow. With very little in the way of supplies or medication, Tanzanian nurses must manage to help burn victims, people with anemia and other preventable diseases, and people with HIV/AIDS, along with all the other health issues that people face. In one clinic I am familiar with in Arusha, Tanzania, it is not unusual for the nurses to see 400 to 500 women a day for prenatal care.

On average, a Tanzanian nurse cares for over 10,000 patients per year. So the 18 recent graduates of the AKU nursing faculty are bringing improved health care to 180,000 patients a year. In ten years, the number of highly trained nurses will have climbed to the point where they are providing improved health care for 1,800,000 Tanzanians a year.

Of course, if AKU is able to expand its nursing faculty, progress will take place much faster, and far more people will be reached and helped.

About Pammla:

Pammla Petrucka, who is an Associate Professor in the College of Nursing at the University of Saskatchewan in Saskatoon, Saskatchewan, has been an AWB volunteer at the Aga Khan University’s campuses in East Africa since 2011. Pammla has been working with AKU’s School of Nursing and Midwifery on its campuses in Kenya, Tanzania, and Uganda.