ASHP InterSections ASHP InterSections

June 1, 2010

Bringing Pharmacists’ Services to Rural Africa

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

%%sidebar%% 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. 

December 18, 2009

MUSC Residency Program Celebrates 50th Anniversary

 

Margaret Blair Bobo

MARGARET BLAIR BOBO was literally in a class by herself when she enrolled in the inaugural pharmacy residency program at the Medical University of South Carolina (MUSC) Medical Center in Charleston in 1958.Fresh out of the MUSC pharmacy school, where she was the only female in her graduating class, Bobo found being the program’s solo resident an exhilarating learning experience.

“My year there probably was the most monumental in my life,” Bobo said. “I had no pharmacy work experience, so I learned everything. I was a sponge.”

Bobo, who went on to join the MUSC staff as a pharmacist and assistant professor, is joining other alumni this year to celebrate the 50th anniversary of one of the country’s oldest residency programs. More than 450 pharmacists, have completed the ASHP-accredited program, a collaboration between the Medical Center and the South Carolina College of Pharmacy at the MUSC campus.

Over the years, the MUSC residency program has evolved into a multi-faceted program that is nationally known for the advanced practice experiences it offers. More than 40 clinical preceptors oversee the work of an average of 20 post-graduate year 1 (PGY1) and PGY2 pharmacy residents. About 200 pharmacy students apply for the available slots, of which only 60 are chosen for interviews.

 

MUSC's residency program is one of the most well-known in the country.

MUSC’s residency program is one of the most well-known in the country.

Changing with the Times

William H. Golod, M.S., Ph.D., the program’s pharmacy and residency program director from 1959 to 1965, is credited by many with helping to triple the number of MUSC residents by the 1980s.

That growth in residents has translated into more pharmacy care for more patients and improved patient outcomes, said Wayne Weart, Pharm.D., FASHP, professor of clinical pharmacy and outcome sciences at the South Carolina College of Pharmacy and professor of family medicine at MUSC College of Medicine. He completed a residency at MUSC in 1972.

The growth means that MUSC is “training more residents who go out and apply the high level of care they learn in our program,” said Weart. “We have over 400 alumni who are doing great things all over the country.”

“When I was there, I’m not sure I appreciated how far we had come” from the program’s initial founding in 1958, he noted.

By the time Ray became director, the program had already developed a “strong clinical flavor,” he said. At that time, residents joined daily hospital rounds with medical teams.

Today, the MUSC program boasts an array of disciplines, from psychiatric pharmacy to ambulatory care to adult internal medicine. That variety helps residents find their niches and sharpen the skills that today’s pharmacists need to work on healthcare teams, said Paul W. Bush, Pharm.D., M.B.A., FASHP, director of pharmacy and graduate pharmacy education at MUSC.

“With 23 residency positions, I think our program contributes in a large way to the enhanced role pharmacists enjoy in healthcare today,” Bush said. Today’s residents mentor pharmacy students, educate fellow clinicians and patients about medication therapy, and participate in drug-use review and drug policy development and management.

“It’s important to note that MUSC’s residency program has been ASHP-accredited since 1963. The fact that it has met such rigorous standards for so long speaks to the quality of the programs required of the residents,” said Janet Teeters, M.S., director of ASHP’s accreditation services division.

ASHP has been accrediting pharmacy residency programs to ensure consistent training and improve the level of practice since 1963. The Society will reach its own milestone—1,000 accredited programs—this year.

Current MUSC resident Michael DeCoske, Pharm.D., is thankful he has been able to experience so many facets of pharmacy before choosing his career path.

“It’s a great environment to start off a career in pharmacy,” he said. “You receive a lot of great career guidance. If I had never come here, I might have been off doing a specialty that wasn’t the best fit for me.”

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