Tekemt 3, 2003 0900 Bole Apartment, Addis. Oh, did I forget to say that we are in the year 2003? As you can read ( http://members.shaw.ca/ethiocal/ ) the calendar used here makes great sense for equatorial lands...you've just been pushed into the year 2010 by some Popish guy named Julian...think how different it would be if you were in the year 2003, as I am.
I made my maybe last visit to the family who live along the wall near the cathedral. All female, three kids and mom. Each time I notice more things, now that the initial shock of a whole small family living along a wall is easing. The kids are more relaxed. They dont seem to have any of the diseases of neglect. The little ones cough is gone. And they werent allergic to peanuts, thank you for cautioning me, Ellie. Today I had some of Kevin's left over loudly colored sweetened breakfast cereal (Puff-Pops or something), which generated intense interest. I'm glad that movie stars, who can, occasionally just gather up people like this and take them home. It doesnt solve any problems on a national level, but is that any reason to not alleviate suffering? I try to emulate Aminta...just give away what you can afford to give away. I think it fits with what i continue to read in Suzuki Roshi...I am also trying to work in a way that consumes the personalized traces of the construction process...to burn yourself up, leaving no trace in the finished work. Another take on the creative process.
They're down to two huge green John Deere tractors at the OiLibya gas station temporary storage. Presumably they are part of a Saudi sponsored rice farming project. I sure hope that doesnt intercalate with the big dam project. When several corporate sponsored schemes fit into a single resource extracting money making little value added much environmental destroyed picture, NOT doing said project to produce said picture becomes very difficult.
The power went off during the night sometime...long enough to soften up the sausages some previous occupant left in the apartment freezer, and it was still off when I came back from the walk.So I used up all my battery working on the power point, which I would like to finish before leaving. Its so helpful for people to have some more accurate idea of the magic, the 'emergent properties' of the student centered small group process that I've become quite passionate about sharing with anyone who will listen. Being there is, of course, the best. But any experience with things like this can be helpful.
Well, I got a chance yesterday at St Pauls. St Pauls was, as I think I mentioned, initiated by Haile Selassie, and moved to its present site above Merkato in the late 70's. Missionaries also contributed to its construction. Its a multi story hospital that, except for the low level of lighting that is preferred here indoors, might fit into a comparable era of building anywhere in the USA. It has a well developed internet 'cloud', thanks in part to the Tulane University initiated project that brought me here. And it has a medical school, with a curriculum that is lecture and organ system module based, as are the majority of medical schools everywhere in the english speaking world I know. The curriculum is very progressive (and only a few years old) in having very early clinical experience, a robust portfolio keeping and reflective practice requirement, and an admission process that encourages women and students from, literally, Afar.
So why dont they just adopt such a curriculum for the nation? Well, that might happen. So I jumped at the chance to attend a lecture in Module 4..which features Neurosciences..rather like the Brain and Behavior component of the UCSF curriculum.
Lectures are given in the School of Nursing building. I arrived for class at 8:30, but was told that the lecture was actually scheduled for 10:30 because the hall was being used for something else. So Direr, the driver of the Toyota SUV that is used by the Tulane program, and I went off to look for a small piece of cheap cheap ikash luggage that I needed to transport back the touristical items I've managed to accumulate. Direr and I get along well, so I understood at once that I needed to keep my narrow white face in the suv while he found the item, otherwise the price would inexorably double...nothing he could do about that. And so now I own a locally made synthetic fiber gym bag that thinks its an Adidas but seems more likely to be an Addis, given what I have been told about trademark enforcement. Then we drove up the hill, through the local markets, past the women woodcutters carrying large loads of eucalyptus branches, past the stands of eucalyptus that are parklike cleared by such women, past the small herds of donkeys with their humans trotting behind, and eventually to the Road from Hell in Heaven...worst road, best air, best view (of smog, unfortunately, its unmistakable from on top) and a nice break from city streets. Then back down again, arriving in time for a machiata coffee before going to class. As with any hospital/medical school, there are plenty of small coffee places unofficially snuggled up close. Then I went along, asked for help in finding the lecture hall for module 4, and was guided by a tall beautiful really blue black skinned man with decorative scars on his face and gentle perfect english who must have been 20 if that. A student.
The class, about 80 of them, were gathered in moveable student deskchairs in a lecture hall that could have held twice that many, but with low ceiling and almost no lighting (the flourescent fixtures were burned out). The chalk blackboard running across the front loomed in the dimness, unreadable. There was plenty of light outside, but little coming through the small windows. The lecturer, in a white coat with stethescope on neck, was explaining dress codes and responsibilities...the module was just starting. When he asked for questions, and a general buzzing started, I made my way up to talk to him. Fitzumberhan Girma is an MD, recent graduate, and hopes to continue as a medical educator. What now, I asked. The lecturer is coming...in about an hour...but the first real lecture will be tomorrow. What will the students do now, I asked, looking at the animatedly conversing group. Oh,I will keep them here for some time.
Hmmm. Well, my personal deal with myself is not to try anything strange for the first week in a new place, but this is day 15...so...
'Would you like to try a communication experiment with them?' I ask my new colleague. ' It would only take about 20 minutes...I can explain to you, and if you think it would be good, we could do it?' He agrees, and so, as those of you who know the contents of my teaching trickbag can guess...I did a dyad!
It takes very little time to explain how the exercise of listening and talking works; make a group of 2, one person talks for a minute while the other listens, then on a signal, switch roles. At the end, I extemporized, I'll ask you to combine in a group of 4, and at the end, I will ask one person from the group to report. OK
Talk about what? Talk about 'what I know about the skull' (the topic of the first lecture). Then, in a group of 4, choose one word that conveys what you would most like to learn about the skull.
Well, it took a little longer to set up, of couse. To get them laughing, I tried some amharic, and it always gets a laugh to make an agreement about no hitting, before asking them to agree to really talk and really listen, not combine the two. And they laughed when I said if they knew nothing about the skull, they could spend a minute sitting in silence.
If its possible to fail in a dyad, assuming basic language competence, I have certainly never seen it happen.
But whats the experiment?
Well, I wanted to see if this group of young students would get into it. Of course they did, with the usual happy increase in noise level. I put in the group of four process to produce a product, the one word...and got a great selection..ethmoid bone, cavernous sinus, cranial vault, petrous bone, eustacian tube, sphenoid sinus, frontal bone...and so on...
But I wanted to go a little farther, to see if some storytelling by an expert would be appealing. Because an expert, me in this case, can of course take any of those words and spin out a clinically or science based story about their personal experience with sphenoid infections (one of the more difficult diagnoses I have made, along with cavernous sinus problems), or how eustacian tube dysfunction leads to the clinical dilemma as to whether to treat middle ear infections with antibiotics. Do the students remember it all? Of course not. But it gives an expert a chance to jumpstart their lecture, and just by keeping a list on the board, and occasionally ticking off one of the student requests, it creates some back and forth. The next step, as Kosta did for years, is to create groups within the lecture that meet each session for a period of time within the lecture period to discuss what they have just heard. And all of these, I believe, are stepping stones to student centered inquiry directed learning.
But suppose there arent enough experts in the country? Suppose lectures devolve into boring recitations of recently boned up material given by a GP who is adverse to lecturing in the first place? It may be 'traditional' curriculum in the first world, but in other worlds, perhaps in Ethiopia, the idea of creating the infrastrucure to support a 'traditional' curriculum in as many medical schools as they need is, perhaps, not the best plan. But I guess it sounds good.....
I got some nice applause at the end, which I'm not deluded enough to think means much, but the students who came up ask questions afterwards did seem to appreciate the exercise. And I dont need to tell you how amazing looking and how alive THEY all were!!!
Well, I've used up all the time for dispatches on medical education. But actually, aside from a few machiato breaks with Oluma and a wonderful lunch with Yodit and her big brother who are part time farmers as well as educators and businessmen, I didnt do anything else. It will be much the same today, and tonight...the 11:55 to Frankfurt, a 6 hour layover (but thank god for the business class lounge with its showers and its edibles and its plush although Germanic banquettes with internet access), and then back to Boston and on to Cape Cod.
Aloha
Alan
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