By Alfred Sibanda T. and Gerome Brock
YAA Session Experiences (Alfred Sibanda)
One of my reasons for joining the Zimbabwe Medical Students Association (ZiMSA) was because it offers a platform for exploration of different environments. One gets the opportunity to meet and interact with new people in a variety of communities. Having taken part in quite a number of ZiMSA activities, we have gained quite some valuable knowledge and experience along the way, more so surpassing my expectations.
In the year 2020, one of our major accomplishments as the Youths Against AIDS (YAA) team at the National University Of Science and Technology (NUST) was completion of a series of sessions at various schools in the city of Bulawayo. This project began in early January but was however brought to an abrupt halt in March due to the introduction of national lockdown measures, to curb the spread of the deadly Covid-19 pandemic. However, even to our surprise, we managed to reach out to 4 schools, hosting 5 YAA sessions in that short space of time. Considering the amount of preparation that goes into hosting YAA sessions, this number was quite impressive. Looking back, I can only marvel at the level of organisation and team work that we exhibited. It goes on to highlight the massive effect team work has on task simplification. In this essay, we highlight a few of the experiences we have had during our work in IMUNZI (YAA sessions and IMUNZI Boot-Camp) and the lessons we’ve picked up along the way.
Youths Against AIDS sessions represent an important collaboration between the Ministry of Health and Child Care and the Ministry of Primary and Secondary education. That being said, we recognised the importance of officialising every session we had by obtaining a stamped and signed letter from the ministry of health and childcare, detailing approval and support of the initiative. This letter was crucial in the process of reaching agreements with school heads to host the sessions. Before each session, at least four steps were carried out, eventually culminating in the scintillating visits, all unique in their own way.
The first step in the planning of the visits was to decide the school to visit. This involved the local SCORA director, then Andile Ndlovu, calling a meeting where SCORA members would put forward suggestions for schools to visit, followed by justifications of the suggestions. A good fraction of our members came from high schools in and around Bulawayo, so each member shared experiences from their high school, concerns they had on the practices and behaviours in the school environment that necessitated the session.
After deciding on the school to visit, the next step was to then approach the school, present to them our verbal request to conduct a session, accompanied by a written request together with the letter of approval from the ministry of health and childcare. Most of the school heads we talked to were very much welcoming of the initiative. The first of our 5 visits was at Mzilikazi High School, near Mpilo Hospital. Medical students at Mpilo share a long history with the school, mostly in the form of regular career guidance visits. The deputy headmistress at the school was very warm and enthusiastic, making sure she understood our target groups, the numbers we were hoping to address, the equipment we required. After we agreed on the date and conditions for the sessions, she gave us a small tour of the immediate environment and the space we were going to use for our session. We had a similar experience at Founders High School, with the headmistress going on to introduce us to the head prefect at the school and having him alert the school of our visit. Sobukazi High School and Northlea visits were also met with nothing but overwhelming gratitude and enthusiasm.
Mzilikazi High YAA session.
After getting permission to conduct sessions from each school, the next step was presentation of the YAA sessions manual gracefully provided by IMUNZI. Volunteers among SCORA members would then pick areas they would like to teach on. Every member would also add on whom they think is best suited to present on a particular area, based on perceived competencies. Presentations were focused on reproductive anatomy, the origins of HIV and AIDS, contraception methods (including a demonstration on the correct use of male and female condoms), family planning, drug abuse, mental health, stigma and discrimination, myths associated with HIV and AIDS, and prevention and treatment of AIDS. Through all this, valuable lessons were learnt. We got to understand the importance of effective team building. It was made clear, as the sessions got better over time, that team analysis is an essential tool in achieving set goals. Each member got to learn various aspects of preparation and communication from another.
The last step before each YAA session was to have all volunteers hold a meeting in which we rehearsed our separate topics. Here, we would evaluate the information presented by each presenter, together with the mode of delivery. We developed a policy that each member was supposed to attend this rehearsal session in order to get to attend the actual session. This again, highlighted to us the importance of discipline and professionalism in effective team work. Each member learnt to respect the project, showing up on time or notifying the team of any delay or inconvenience in advance.
Following such an ostentatious preparatory process, the YAA sessions were bound to be, as it turned out, thrilling encounters with the school children. A key factor we made sure to respect was time. Showing up at the school at least 30 minutes before the session time in order to familiarise ourselves with the set up for that particular day was key. Additionally, we made sure to make a call to the school head, the day before each session, to remind them of our visit so that the necessary preparation is done.
It is always exciting to interact with a new group of students and this was the mood on the session days. Upon arrival at the school, and after setting up our venue, we would mingle with the children and talk to them about their work at school, their experiences and aspirations. This was an opportunity for us to familiarise ourselves with the groups. On one of the sessions, at Mzilikazi High, one sixth form student highlighted how he had always wanted to study science but was not sure of the exact path he wanted to pursue, adding that he was reading around areas in science in order to decide on his path. I was quite amazed at how this theme actually recurred especially among the science students. This actually triggered our collaboration with our then Preclinical Representative, Kelly Pettican, who would also join us, together with her colleagues and offer a few minutes of career guidance to the students.
Founders High Session: Kelly Pettican giving some career guidance to sixth form students.
From our first YAA sessions, assessing the questions that were being asked by the students after the sessions, we identified a loophole in our program. We tended to overlook a few things in our teachings. That led us to introducing a new activity to our sessions, the pre-session evaluation. Here, we would, instead of focusing too much on the students’ aspirations during the pre-session mingling with the students, ask the students a few questions on HIV and AIDS, just to gauge their level of understanding on matters related to HIV. This idea we took further by printing out questionnaires, facilitated by one of our team members, Anele Ngwenya. These had questions on areas most commonly associated with myths and misunderstandings.
At the Northlea High School session, we had quite a few students who did not know the difference between HIV and AIDS. We had some who knew that one was supposed to be the disease and the other was the cause, and a few who genuinely had no idea of what the difference is. A number of students did not understand the meaning of AIDS as a disease.
Nothlea High YAA session [Standing: Alfred (right) & Ngonidzashe (left)]
The experience taught us a valuable lesson. There is knowledge we often consider general knowledge as medical students and as students of Biology. From Advanced level Biology, we have learnt about health and disease and we continue to do so in medical school. We often then tend to overlook certain aspects when teaching students, with the perception that they obviously understand these. We quickly adapted, and would start from the basics, making sure to touch on all the sensitive areas before we explain each concept.
Students would privately call facilitators and ask them questions from time to time. However, some of the questions required more than a few sentences of answers and would thus disrupt the flow of the interaction. Also, we felt that some of the questions needed to be addressed to everyone as a whole. We thus adopted a system where we handed out small papers to the students, where they would take down all the questions they think of during the presentation, and then pass to us for answering at the end. We had lots of questions sent to us, and this made us realise that some students may have been too shy to ask questions out loud, but with the element of anonymity introduced, we got a better idea of their curiosities. A few of the memorable questions we got from students with this method were: “Why can’t scientists make a drug that also changes conformation in order to attach the HIV as it mutates?”, “since you said viruses can also have vaccines made against them, why does HIV not have a vaccine?”, “is it possible to sleep with an HIV positive person and not get HIV?”, “since you guys are studying medicine, can you actually tell, by looking at a person, if they have HIV?”, “I have heard of HIV positive mothers who give birth to HIV negative babies, how is it done?”. All very important questions that may otherwise have gone unasked had we not introduced the method. This particular experience highlighted for us the importance of continuous assessment in this endeavour. We need to constantly re-evaluate our pedagogical practices.
The most anticipated portion of the presentations, the condom use demonstration, was also probably the most misunderstood. In each session, we would have volunteers come up to the stage and demonstrate on models of the penis and vagina, how they thought a condom was supposed to be worn. Mistakes were observed right from the opening of the condom packet right up to removal of the condom from the penis or vagina. We had some students open the condom packs with their teeth, some put the condom inside out, and by far the most common mistake was failure to pinch the tip of the condom while wearing it on the penis model in order to prevent it from being turgid, increasing chances of bursting during sexual intercourse. After each condom demonstration, we had a burst of noise, with the students enthusiastically discussing the newly acquired knowledge, much to our amusement.
Sobukazi High YAA session: [Alfred demonstrating condom use]
In all our sessions, we made sure to involve the students as much as possible, keeping them engaged. This maintained high levels of attention throughout the sessions. This was perhaps triggered by the experience at Founders High School, where towards the end of the session, a few students began leaving the session. In addition to us asking for volunteers for the condom demonstration, one of our members, Anele introduced a fun activity on Stigma and discrimination against HIV, where, before his presentation, he took out one student and left her outside the hall before proceeding to engage the rest of the students with some jokes and fun questions. After this, he would then get the girl back and ask her what she felt when she heard the others laughing at what appeared to be jokes. The girl answered, and said “well, I couldn’t help but wonder what everyone was enjoying”. “You felt left out didn’t you?” Anele asked, as she nodded, yes. We observed a great deal of improvement in participation and enthusiasm after introducing extra fun demonstrations. We had a session where Gerome Brock also engaged the students in a charged game centred on following spoken as compared to acted out instructions. In the last sessions, we had began also adding analogies and stories to further captivate the students. One fun one that I recall being done, was Alfred’s (myself) description, before his family planning presentation, of how Isaac Asimov wrote that: “At the rate at which the world population was increasing (doubling every 35 years), by the year 2570, the mass of humanity will comprise all of life and we would all be reduced to cannibalism, and by the year 2600, the 630 billion world population would have each individual allocated only 2 and a half square feet of standing room, and by A.D. 3550, the total mass of human tissue would equal the mass of earth, and by A.D. 7000, the mass of humanity would equal the mass of the known universe!”.
Sobukazi YAA session: Anele Ngwenya giving his presentation.
To cap that off, we always had snacks to give to the participating students. However we made sure that the focus was not diverted to the snacks instead of the presentations.
After each session, we made sure to thank the students and school heads who could not hide their excitement for the sessions. We got a number of requests to consider coming back to the schools. However, our work did not end there. After every session, during our lunch meal, we would take time to critically analyse each person’s presentation, pointing out the positives and negatives and recommending improvements for the next session.
Founders High School post session: [left to right- Denis Magondo, Andile Ndlovu (NUST local SCORA director), Ngonidzashe Mafuratidze, Kenneth Tshuma, Mrs D Moyo (Founders High Headmistress), Alfred Sibanda, Lindah Nkomo, Polite Mabhena, Anele Ngwenya, Natasha Chatikobo and Lindiwe Ndondo]
All the YAA experiences, unique in their ways, have been a well of knowledge. We have had the opportunity to give to the community what we can. We have, through these sessions, learnt what it feels like to be of assistance to the community. Valuable lessons in team work, team analysis, audience analysis, communication skills and continuous self-evaluation, have been learnt. These sessions, in addition to imparting valuable knowledge on the school children we managed to reach out to, have definitely improved the character of the doctors we will be in the coming couple of years.
IMUNZI Boot-Camp (Gerome Brock)
Every year so far in the IMUNZI project has seen the year end in its pinnacle with the annual boot-camp. Each year volunteers from the organisations that make up IMUNZI (IMCC, UNICA and ZIMSA), concern themselves with going into the community and conducting YAA (Youth against HIV/AIDS) sessions. At the end of the year, through a collaborative effort, a boot-camp is held in Victoria falls where community youth ambassadors are trained who will continue with the work of educating their communities about HIV/AIDS, with the intention of increasing awareness, reducing stigma and discrimination, fostering a culture of abstinence before marriage and faithfulness to one partner after marriage and inculcating the mantra of prevention is better than cure while sharing guidelines and strategies on prevention.
In December 2020, five members of SCORA from Zimbabwe’s three medical schools went to Victoria Falls to participate in the annual boot-camp. I was part of the team who travelled and suffice to say, we had an amazing time there. Our mission was to impart information to the wonderful youth ambassadors who were there, and to form meaningful relationships that will bear fruit in the work we are doing in the IMUNZI project and in the fight to eradicate HIV/AIDS from our world.
In light of the covid-19 pandemic and how this new “norm” is impacting the mental health of many, our boot-camp this year focused not only on HIV/AIDS, but also on mental health and family planning. From the day that we arrived, our friends from UNICA (United Children of Africa) were very welcoming, accommodating, gracious and supportive to us. Over the next 3 days, together with UNICA, we led the youth ambassadors through fun, engaging and informative sessions on HIV/AIDS, mental health, family planning and substance abuse. We shared, laughed, danced, played games, learnt new information and most importantly, we had meaningful conversations about these and other topics. The games and our early morning exercises with the beautiful African sun rising over us were not only fun and engaging, but particularly useful in illustrating the points taught in each session. Kudos to the UNICA team for the great activities and to the ZIMSA team for the informative sessions. Despite how much effort you put into preparing a meal, it’s up to the tasters to enjoy it and the youth ambassadors were very receptive to all that was in the program.
The culmination of the boot-camp is in the youth ambassadors then sharing what they learnt with their teenage campers who join the camp on the fourth day. We were not surprised to see that they excelled at sharing everything we had taught them with the campers, who now have the responsibility of putting what they learnt into practice. Our hope as always is to see an HIV free generation and we know this is possible through programs such as the IMUNZI project.
As awesome as the boot-camp was, nothing is without its shortcomings. The facilities where the boot-camp is currently held could do with a facelift and some improvements to make the camping experience even more satisfying. Hopefully as time goes by, we will see some good Samaritans making this a reality.
Our camping experience was a much needed end to the harsh realities 2020 brought to all of us. Our team ended our camping experience with a bonding trip to the mighty Victoria Falls, which at the time of the year was a breath taking scene. Apart from our trip to the rainforest we satisfied our thirst for adrenaline by doing the gorge swing over the Zambezi River at Wild horizons lookout cafe. We sat down to enjoy a sumptuous meal at the renowned 3 monkeys restaurant and afterwards, we bonded over a couple of drinks at the famous Victoria falls Safari lodge while watching elephants come to drink from the waterhole while being silhouetted by the setting of the beautiful African sun over the Zambezi. A trip well worth it!
None of this could have been possible without the partnership and support of our friends at IMCC (International Medical Cooperation Committee) in Denmark and DUF (The Danish youth council), who we sincerely give thanks to and for.
The ZIMSA team would also like to thanks our UNICA friends who hosted us with special mention of Kelvin (Giggs), Tariro, Ellen, Simba and Panashe. We would also like to thank Malvin from Wild Horizons for his gracious hospitality and friendship.