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Bringing home lessons from abroad

BMJ 2007; 334 doi: (Published 01 March 2007) Cite this as: BMJ 2007;334:0703118
  1. Ying Wu, second year medical student1
  1. 1Harvard Medical School, Boston, MA, USA

Establishing a strong personal rapport through peer education can make a difference to clinical practice, thinks Ying Wu

Immediately after a bridge, we pulled up a short dirt road to the Livingstone Memorial Hospital in Molepolole, a village an hour outside of Gaborone, the capital of Botswana. I had been in Botswana for almost a year as a research assistant for a clinical and public health project testing the efficacy of an antiretroviral protocol for preventing mother to child transmission of HIV. Part of the study included giving mothers infant formula after delivery of the baby so that HIV would not be transmitted through breast milk.

Peer education programmes: helping people help each other

I spent that day in a two room shed, shadowing a doctor who provided routine prenatal and postnatal care for the women enrolled in the trial, and part of her job was to counsel HIV positive patients about the importance of using formula instead of breast feeding. The waiting area emptied as 12 noon approached, and the doctor greeted her next patient enthusiastically. The strong rapport and level of comfort between them was evident from the start as they asked each other about family members, caught up on village news, and shared laughs.

As the patient stood up to leave, the doctor handed her a can of formula, remarking that she must be running low. The patient extended her hand and accepted the can rather reluctantly. Looking at the doctor sheepishly, she said hesitantly that she did not need another can of formula. The patient explained that although she appreciated the gesture, she had no need for the formula because she could not use …

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