Back in February, the PC/Mongolia training team told all of us PCVs about an upcoming Project Design & Management (PDM) seminar for PCVs and one of their HCA or community counterparts to work on the design and planning of a specific project. In order to be invited to the seminar, we first had to conduct a needs assessment in our community to determine the most pressing issues and then come up with a project idea to address those issues.
So my supervisor and I (who really wanted an excuse to travel out of Zavkhan on Peace Corps’ dime) worked hard to complete a needs assessment before the deadline, which was right after Tsagaan Sar of all times. We reviewed statistics and health indicator reports from the Ministry of Health, along with hospital records and health department reports from here in Zavkhan. We also conducted key informant interviews with the director of the Public Development Division at the Zavkhan Governor’s Office, the treatment director at the Central Hospital, the head doctor and advisor of the Children’s Division at the Central Hospital, and the director of the Children’s Hospital. We conducted informal interviews and discussions with staff members and parents of patients at the Children’s Hospital, and we examined what medical equipment was available both in the Central Hospital and the Children’s Hospital.
Our needs assessment revealed that the infant and under-5 mortality rates are significantly higher in Zavkhan aimag than both the country average (all of Mongolia) and the aimag average (all the aimags minus UB). So basically, lots of babies and little kids die in this part of the country.
This is believed to be due to the fact that there are no emergency facilities for infants and children in Zavkhan. The Central Hospital has an emergency department, but it is not equipped to treat infants and children and is not staffed with pediatricians. So if a parent comes to the ER with a very sick child, they will either have to wait for a busy pediatrician to come there from another part of the hospital (and even then, there will likely not be the necessary medical equipment) or they will be sent to the Children’s Hospital, which is a few blocks away. But the Children’s Hospital does not have an emergency department at all, so even if the parent was able to finally get a pediatrician to look at their child, they wouldn’t have a monitor to see what was wrong with the child, or a respirator to hook the child up to, etc.
Our main project idea is to develop a children’s emergency department at the Children’s Hospital. We have identified 3 rooms on the first floor of the Children’s Hospital that could be converted into a 5-bed ER, and there are 6 doctors and 8 nurses from the Central Hospital that could be transferred to the new department so that it could be staffed 24 hours a day by at least 1 doctor and 1 nurse at all times. There is even a medical engineer at the Central Hospital that could train the staff on how to use the emergency medical equipment.
But what we need is—you know—the actual medical equipment. The Ministry of Health has a list of “hospital standards” that specify what equipment and supplies are deemed necessary for each ward/department of the hospitals. There are sections of that standard for infants and children and for emergency facilities, but of course our facilities don’t have most of that equipment, or the money to get it. I’ve looked into some of the numerous NGOs that collect used hospital equipment from developed nations and donate them to clinics and hospitals in developing nations, but those organizations generally send the medical equipment in those big 40-foot shipping containers to the nearest sea port, and the receiving organization is responsible for getting it the rest of the way. You may recall that Mongolia is a land-locked country, so going through one of those programs would require us to have the container shipped to a port in China, then put on a train on the railroad that comes up to UB, and finally put on a giant truck coming out here to Uliastai. So, just a bit of customs and legal paperwork and crossing our fingers that it wouldn’t just disappear somewhere along the way (as so many care packages do when they’re sent to Mongolia through China). Oh, and somehow paying for the shipping container’s long land-bound journey. So only slightly more complicated than finding a pot of gold to just pay for new medical equipment directly.
Anyway, there’s your background for our project. We and 20 other PCV/counterpart pairs were selected to attend the 3-day PDM seminar, which took place last week. It was held at a “resort” about 30km outside of UB, in a quaint little mountain area that had plenty of what looked like summer vacation homes nearby.
The seminar consisted of sessions on writing goals and objectives, creating a logic model and action plan, identifying resources, monitoring and evaluation, budgeting, and proposal writing. There was also a session on Peace Corps funding resources, which wasn’t as helpful for me and my supervisor because our (admittedly large-scale) project is not eligible for those smaller grants. So my one qualm with the seminar was that they didn’t cover other funding sources. If we do end up going the route of having an NGO ship us a bunch of medical supplies overseas, most of those programs do require a sponsorship fee of up to $25,000. Obviously our hospital does not have that money, so I’m looking into other entities that could help fund the project, but I have no experience with waltzing up to a company and asking them for money, and my counterparts didn’t even think about that as an option, so I’m assuming they don’t have much experience either. But outside of that, the seminar was extremely helpful. There was plenty of time for us to work in our pairs to apply what we learned in the sessions to our own projects. But now there is a lot of work to do to move forward.
According to the seminar schedule, we would be heading back into the city on Saturday morning. But since our flight back to Uliastai was at the ungodly time of 6:50am on Saturday, me, my sitemate, and our counterparts were supposed to be taken back on Friday evening after the last sessions. But then, during the closing session, we were informed that our flight had been delayed until Sunday morning (on account of a snowstorm that had gone through Zavkhan on Friday and was heading toward UB). So we hung around at the resort for another night and left with everyone else Saturday morning, with the snow already coming down.
But having our flight delayed meant an entire free day to spend in UB! It would have been nicer if that day hadn’t been marred by a snowstorm that I did not have the appropriate clothes for (It’s supposed to be spring! It was in the upper 40s when I left to come to UB!). Nevertheless, I managed to trek to several places, including a yummy café for brunch:
And several stores that sell stuff you can’t find out in Zavkhan, like cheddar cheese, popcorn, peanut butter, Vanilla Coke, etc., along with American goodies that can only be found in a select few places in UB, like cereal and Kraft mac & cheese. Yes, I managed to find what I’m pretty sure was the last box of mac & cheese in the entire country. I didn’t even know they sold it in UB, and I always get tons of it sent in care packages because I could probably live off the stuff. Then I saw one lone box on a shelf in one of the stores and asked a worker if there were any more. She informed me that there was a currently a shortage of the stuff.
Seriously, a shortage of Kraft mac & cheese in Mongolia.
I’m not sure if it had something to do with the recent recall by Kraft, though I can’t imagine Mongolia being a place that pays too much attention to things like recalls due to tiny pieces of metal possibly being in processed foods. But I also can’t think of any other reason for the shortage. When I tell Mongolians about macaroni & cheese, they seem to be unfamiliar with the stuff. And I know there are a fair share of expats who live in UB, but unless they’re all my clones, I can’t imagine them eating enough of it to cause a shortage. Anyway, while visiting a few other stores I looked for any more of the blue boxes, with no luck. I was either told about the shortage again or ensured they would be getting more in next week. Thus, I may have gotten the last box of Kraft mac & cheese in Mongolia, and definitely ate it for dinner the day I got back to Uliastai.
After shopping, I headed back to one of the city’s hostels that at any given time are likely to be filled with PCVs.
I paid for my bed (the equivalent of about $4) and took advantage of the free wifi until dinner. A group of us went out to a really nice bar & grill, where I got an actual Caesar salad (in a lot of restaurants, even if they have “Caesar salad” on the menu with a picture next to it looking all appetizing, you’ll get…something else…that should be illegal to call a Caesar salad), shared a pizza, and had a tequila sunrise and a B-52 that I didn’t know was really a Flaming B-52 until the waiter came with a lighter to set my shot on fire.
After dinner, we went back to the hostel. While others were being sociable, I went to bed to try to get at least a few hours of sleep before I had to wake up to catch my stupidly early flight. But I did spend most of the flight sleeping, and then proceeded to spend a large portion of the rest of the day napping, waking up to get groceries and to eat my mac & cheese dinner. Then it was straight back to a regular ol’ work week.