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Bringing Pharmacists’ Services to Rural Africa

Jun 01, 2010

Getting Started

Imbi Ichile, Pharm.D.

When I first got to South Africa, I was very excited, but I also had to establish myself and my credentials. There was some skepticism about a pharmacist coming from the U.S. and coming through a pharmaceutical company residency program. I had to let them know I was there as a professional, and that I wasn’t going to push anything on them.

Cultural barriers were also a consideration. I had heard that I’d be in competition with traditional healers, but actually, I found there was a lot of camaraderie between traditional and mainstream healers. They do training back and forth. There’s a high level of cultural sensitivity involved. You can’t go in and say, “That’s wrong; this is right.” It’s more about how you work your pharmacy expertise into what their beliefs are. You get better results that way.

Finding New Opportunities

The residency required me to be quite creative, as I had to tailor the work to each site. In South Africa, I focused on patient education. You have to be licensed to dispense there, and I was not licensed, so that allowed me to focus on areas that pharmacists didn’t usually focus on. For example, in a 4,000-bed hospital, there were only nine pharmacists, so they had to get patients in and out. Educating patients and creating things like drug information centers were not a priority, so that was where I saw an opportunity.

In Lesotho, I trained pharmacy assistants and technicians. The Senkatana Center, which is a health clinic that only treats HIV patients, had a team of pharmacy assistants led by a pharmacy technician. I did a whole set of training modules, from basic drug delivery to adverse reactions to information on HIV disease states and how the virus affects CD4 cells. They all got certificates at the end. It was fulfilling for them and for me.

Reaching Out via Health Fair

One event stands out for me: We put together a full-service health fair during the South African Pharmacy Council’s National Pharmacy Week. Practitioners would usually just go around to the different wards in the hospitals and provide information based on the year’s theme. This time, the services came to the people in a rural area. Government, local hospitals, community-based organizations, and private entities all partnered together. We were able to offer more than 500 rural-area residents all kinds of services, including mental health, social services, pediatric care, and blood pressure and blood glucose monitoring. There was a fully stocked pharmacy, and there were five medical rooms for doctors to see patients. There were a number of diagnoses that the patients would not have otherwise gotten because they didn’t have access to care where they lived.

A New Way of Thinking

I found during my time in South Africa and Lesotho that the residents have a communal way of addressing issues. The community-based organizations that exist there offer all kinds of services, from health care to food and income-generating activities that help build independence and financial freedom. Their whole approach seems to be to embrace the HIV/AIDS community. For example, I saw a campaign with the tagline “I love you, positive or negative.” That was profound to me. We could learn from these health care providers how to structure our programs and policies to be more embracing, and how we can bring more people into care.

The most rewarding thing about the residency experience was the feedback I received. People there show a great amount of appreciation for things that we might consider small. The experience has also changed my perspective on what people can do, and have a desire to do, in that part of the world. A little bit of thought goes a long way there, and there’s a lot of encouragement to keep the program going. 

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