North of the Red Line

I have just come back 'home' after spending three weeks at various conferences, workshops and chasing car importation paperwork. One of those weeks was spent in Oshakati at a Ministry of Health workshop. Oshakati is Namibia's second city, an urban sprawl in the north of the country. The drive from Okakarara is around six hours and once you get past the Red Line, a veterinary quarantine boundary controlling livestock movement, the country changes significantly. Most of the north is communal farming land as opposed to commercial farming south of the Red Line. Many families live through subsistance farming, rearing goats and cows for their own consumption on shared farmland. There are many more villages and towns too - 60% of the population live in the far north. The landscape becomes more green and even some riverbeds remain wet in the dry season. However the biggest difference was the heat, which was easily in the mid 30s and a bit of a struggle. Oshakati is in Ovamboland rendering my developing yet basic Ojtiherero useless.

The purpose of the workshop was to review and further develop a Community Based Rehabilitation (CBR) volunteer training manual that had been piloted in some regions. It was attended by about 20 regional rehabilitation workers, occupational therapists and one physiotherapist in addition to me and another VSO volunteer. It soon became apparent that a group of the attendees were opposed to the CBR programme, which poses a greater barrier to the programme than transport or funding. Pilot regions have trained volunteers to identify and refer people with disabilities to rehabilitation workers but there has been little if any training on basic screening/assessment and clinical management skills. This would be fine if there weren't the human resources or transport challenges. In districts with no rehabilitation worker who are volunteers supposed to refer to?! There are about 80 rehabilitation professionals of varying competence servicing 2 million people in a country twice the size of France! There was a resistance to pass on skills and empower volunteers as the rehabilitation workers viewed this as a threat to their status. This is obviously ridiculous as they are needed to train and provide ongoing support to volunteers, there aren't enough of them and there are vacancies that can't be filled!

The week became a battle, although very good humoured, between this group and me and some like minded guys. We succeeded in keeping basic clinical skills core to the programme and it was actually a very enjoyable week. The programme covered chest infections and with me being the only person with respiratory experience I became the national advisor on community respiratory therapy - those 6 months on respiratory at QMC were not wasted!

At the end of the week I went to a Braai to celebrate South Africa heritage day hosted by a new Afrikaans friend I met on Coach Surfing - a social networking site for people traveling. Namibia is such a melting pot of culture due to colonial and tribal influences - languages spoke at the party included Afrikaans, German, Otjivambo, Portuguese, Norwegian and fortunately English! A late night added to the challenge of the 8 hour trip to Windhoek the following day.

Currently the car importation saga continues - I can't bear to recount the story so far. Fingers crossed it will be over soon.

Ant x