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TABLE OF CONTENTS CONTENT PAGE

TABLE OF CONTENTS.................................................................................................................i DECLARATION.............................................................................................................................ii APPROVAL...................................................................................................................................iii DEDICATION................................................................................................................................iv ACKNOWLEDGEMENT...............................................................................................................v LIST OF ABREVIATIONS.........................................................................................................vi CHAPTER ONE: BACKGROUND OF INTERNSHIP TRAINING.........................................vii 1.0 Introduction.........................................................................................................................vii 1.1 Specific Objectives of the Internship.................................................................................viii 1.2 Scope of the Internship.......................................................................................................viii 1.3 Organizational Profile .......................................................................................................viii 1.3.1 Background of the hospital.........................................................................................viii 1.3.2 Geographical location...................................................................................................ix 1.3.3 MRRHs Mission statement, Vision, and goals...........................................................ix 1. 3.4 Objectives of Mbale Regional Referral Hospital..........................................................x 1.3.5 Activities of the organization......................................................................................x 1.3.6 Clientele..........................................................................................................................x 1.3.7 Mbale Regional Referral Hospital organogram...........................................................12 CHAPTER TWO: MANAGEMENT OF THE INTERNSHIP EXERCISE...............................13 2.0 Introduction..........................................................................................................................13 2.1 Reporting And Induction at the Organization.....................................................................13 2.2 The Department to Which I Was Assigned.........................................................................13 2.2.1 Category Of The Department.......................................................................................13 2.2.2 Services Offered At The Department...........................................................................13 2.3 The Activities And Tasks I Participated In.........................................................................17 2.4 The Officers I Worked With And What They Do.............................................................19 2.5 Relationship With Other Officers In Executing My Duties And Responsibilities...........20 2.6 Role Of The Work Supervisor.............................................................................................20 CHAPTER THREE: METHODOLOGY......................................................................................21 3.0 The Social Work Functions That MRRH Adheres To.......................................................21 3.1 Approaches To Health Care Delivery Used By The Agency.............................................22 3.2 Methods Of Social Work Used By The Student And Agency...........................................22 3.3 Different Skills Employed By The Internee During Fieldwork.........................................24 3.4 Various Techniques Used When Handling Cases..............................................................25 3.5 Application Of Theories Of Social Work Used..................................................................26 3.6 The Different Principles And Values Adhered To During The Internship........................28 3.7 Application Of Social Work Roles During The Placement................................................30 CHAPTER FOUR: FINDINGS AND OBSERVATIONS...........................................................32 4.0 Knowledge And Skills Gained During The Placement......................................................32 4.1 How I Intend To Utilize What I Have Learnt For My Professional Development..........32 4.2 Personal Contribution To The Organization (My Innovations).........................................33 4.3 Challenges Noticed During The Internship (Work Related) That Are Affecting..............33 4.3.1 The Organization..........................................................................................................33 4.3.2 The Workers.................................................................................................................34 4.3.3 The Internee..................................................................................................................34 CHAPTER FIVE: CONCLUSION AND RECOMMENDATION.............................................35 5.0 Assessment Of The Internship Exercise In The Organization............................................35 i

5.1 Recommendations For The Identified Problems................................................................35 5.2 Conclusion...........................................................................................................................36 APPENDIX 1: WORKPLAN........................................................................................................37

DECLARATION I MABALA FLAVIA do hereby declare that this report is solely my own initiative and has never been presented in any of the universities or institutions of learning for any award. Signed ............................................. MABALA FLAVIA Reg No: EJ11/BSW/BUW/012 Date .................................................

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APPROVAL I do approve that this work was carried out by MABALA FLAVIA under Infectious Disesases Clinic - Mbale Regional Referral Hospital. The fieldwork exercise was duly supervised by me and the report herein ready for submission.

Name:..................

Signature:............

Date:

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DEDICATION I dedicate this piece of work to my beloved mother miss Mugide Rose Mabala who has really struggled to ensure that i reach where i am. May God bless her abundantly. My only two brothers Mabala Robert and Mabala Ronald, my beloved niece Nguja Asadi and nephew Namulolo Sophie, you have all been important mostly my brother Mabala Robert who has opened up a way for my education. Lastly, I thank my maternal family members for guiding me morally, spiritually and academically. You have been role models for many of us. God bless you all.

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ACKNOWLEDGEMENT I acknowledge the valuable assistance especially of my mother Miss Mugide Rose Mabala who has been and still is more of a parent for the financial assistance and for being there for me at all times. Mummy, you are my hero. I also acknowledged with all respect all the staff of Infectious Diseases Clinic under the providence of Mbale Regional Referral Hospital for accepting me to carryout my internship training from their organization. I thank the ART clinic In-charge Sister Mutenyo Beatrice and the ART clinic Co-ordinator Doctor John Peter Masaba of Mbale Regional Referral Hospital for their dedication, patience, guidance and parental encouragement rendered towards me during my internship I would like to thank my Uncle, Aunties and Cousins for the care they showed me throughout my education. I also thank the friends i worked with in the organization; Kissa Jenifer, Fred Omiro, Sirikye Sowal and Dina Obra who shared with me what they knew since they were from different institutions Lastly, i thank my lecturers for ther efforts and guidance they provided to me. Speical thanks to the Director UCU Mr. Omoda and the entire staff of UCU v

LIST OF ABREVIATIONS AIC AIDS ART BSWSA CBC CDC CPD DR EID HIV IDC MOH Aids Information Centre Accquired Defficience Inmmuno Syndrom Anti Retroviral Therapy Bachelor of Social Work and Social Administration Complete BloodCell Count Centre for Disease Control Continuing Professional Development Doctor Early Infant Diagnosis Human Immunodeffitience Virus Infectious Disease Clinic Mnistry Of Health

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MRRH MRS OPD PHC PIDC PMTCT PNO STD SPNO SR. TASO VCT UCU

Mbale Regional Referral Hospital Medical Record System Out Patient Department Primary Health Care Paediatric Infectious Disease Clinic Prevention of Mother to Child Transmission of HIV Principal Nursing Officer Sexually Transmitted Disease Senior Principal Nursing Officer Sister The Aids Support Organization Voluntary Counselling and Testing Uganda Christian University CHAPTER ONE: BACKGROUND OF INTERNSHIP TRAINING

1.0 Introduction This chapter explains the importance of the internship exercise, background of the organization, mission statement, goals of the organization, what the organization does and the organizational structure. The Department of Social Sciences, Uganda Christian University usually plans for her students a period of institutional attachment where students are sent out to different organizations and placed to work under senior officers, who play the role of trainers and / or mentors in the field of specialization. Internship is a careerrelated, professionally supervised programme, designed to provide the students with an opportunity to receive a practical credit for a meaningful career related, realworld experience in a variety of organizational settings in preparation for the practical work they will be required to do upon completing the course.

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1.1 Specific Objectives of the Internship To give the internee an opportunity of balancing their appreciation of the Lecture room theories practical application. To prepare the internee for challenges likely to be encountered in the field of Social work and social sciences.

To fulfill the requirement for the award of the BSWSA degree.


To expose the student to the work environment which allows room for interaction with various offices and get acquainted with the requirements of executing his/her duties.

To acquire practical skills in social work. To develop interpersonal communication skills and ability to work as a team To create links for contacts for future job opportunities.

1.2 Scope of the Internship The internship exercise was carried out in IDC- MRRH which is located in Mbale Municipality and has a Catchment area of 11 districts namely; Mbale, Sironko, Bududa, Manafwa, Tororo, Busia, Butaleja, Bukedea, Kumi and Namutumba. 1.3 Organizational Profile 1.3.1 Background of the hospital Mbale regional referral hospital is a Governmental owned public hospital, funded by the Uganda Ministry of Health. It was started in 1924 as a small health centre and was later developed into a district hospital and has been expanding since 1950s till it gained the regional status. MBALE REGIONAL REFERRAL HOSPITAL serves districts of Mbale, Sironko, Budaka, Kumi, Pallisa, Tororo, Busia, Katakwi, Kapchorwa and sometimes moroto soroti and kotido. Mbale regional hospital has become the fourth largest in the country after Mulago,Butabika and Jinja hospitals. It was originally designed for a bed capacity of 370 but due to the increasing demand of services . The number of patients has increased rising the number of beds to 400. The hospital has grown through the decades by way of contribution of various stakeholders and freinds.

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The hospital was established with the basic aim of achieving the goals of primary health care (PHC) through the promotion of health, treatment and prevention of disease infections among the people. In the hospital, both inpatient and outpatient care services are provided and they include clinical, diagnostic and therapeutic services. The hospital is divided into the following departments: Obstetrics and Gynaecology, Surgery, Internal medicine, Paediatrics, Outpatient, Theatre, Masaba wing and Causality wing. It is run by a total of 330 staff. 168 are nursing staff who carry out curative, promotive, preventive and rehabilitative services among others. Masaba wing was constructed in the 1960s to cater for those who could pay. In Lions Aid Norway (LAN) in conjuction with Ministry of Health constructed and equipped the eye department. In the same year,Masaba wing and the clinic complex were renovated. Currently the Japan International Co-operation Agency(J.I.C.A) has constructed a new maternity ward.The other staffs include support staff, drivers and security personnel. 1.3.2 Geographical location Mbale Regional Referral Hospital is located within the Industrial division, Mbale municipality on Pallisa road in Mbale district in the eastern region of Uganda. It is located 42 km north of Tororo town, 56 km South East of Kumi town, 57 km East of Pallisa and 55 km South East of Kapchorwa town. Mbale district is 256 km east of Kampala city and 52 km from the Western Kenya boarder 1.3.3 MRRHs Mission statement, Vision, and goals. Mission Statement To provide general and specialized health services to the people in the catchment area for improved quality of life Vision To become the leading Regional Referral Hospital in the provision of quality specialized Health Services in the Region Goal Total satisfaction to patients across Uganda.

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1. 3.4 Objectives of Mbale Regional Referral Hospital Mbale Regional Referral Hospital objectives can be achieved through its functions that include: To ensure efficient and effective utilization of resource available in hospital. To contribute to regional and national human resource development for the health sector. To contribute to the development and implementation of the health policy and inspection work. To provide wide improvements in the quality of parent care as per ministry of health standards. To technically supervise district health services. To deliver an agreed range of additional specialist health care services like orthopaedic workshop, surgery, eye and radiology. To the highest health standard possible to the region. 1.3.5 Activities of the organization The activities are categorzed in cases of Curative, Preventative, Rehabilitation, Palliative, Family planning and Counseling services. The activities include; General health care and treatment including specialised care. Support services to lower health units. Health education in schools and communities. Immunization Water and sanitation.programmes. Technical and professional services through support supervision and guidance

1.3.6 Clientele Clientele comprise patients of both sexes and both Adults and children. The services Include;Medical Services, Surgical Services, Gynaecological and Obstetric conditions, Opthalmology, Ear, Nose and Throat,Dental services,Radiological services,Rehabilitative

services, mental health services. Laboratory services, counseling and support services such as those offered at IDC. The most common presented conditions are; Malaria,Diarrhoea,Anaemia,Pneumonia,Respiratory tract infections,HIV/AIDs with all related complications,Typhoid fever. Most of the Clients are general patients with simple treatable conditions seen and managed in OPD but others are referral cases- Complicated in nature, for specialized services that need admission and care as in patient. The Clients come from the catchment are already described above

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1.3.7 Mbale Regional Referral Hospital organogram. HOSPITAL BOARD MEDICAL SUPERINTENDENT

CLINICAL SERVICES OBS/GYNAECOLOGY GENERAL SURGERY ORTHOPAEDIC SURG E.N.T OPHTHALMOLOGY DENTAL MEDICINE COMMUNITY HEALTY PAEDIATRIC ANAESTHESIA PATHOLOGY

DIAGNOSTIC THERAPEUTIC SE SERVICE RADIOLOGY

NURSING SERVICES SPNO PNO AREA MANAGERS

FINANCE & ADMINISTRATION ADMINISTRATION PROCUREMENT HUMAN RESOURCE REGISTRY FINANCE

INTERNAL AUDIT

LABORATORY PHYSIOTHERAPY

OCCUPATIONAL THERAPY

SNO

PHARMACY

NURSING OFFICERS SUPPLIES E/N/M ENGINEERING MED. SOC. WORKER MEDICAL RECORDS DOMESTIC ASSISTANT SUPPORT STAFF SECURITY

NUTRITION

CHAPTER TWO: MANAGEMENT OF THE INTERNSHIP EXERCISE. 2.0 Introduction The previous chapter, mainly focused on the background of the internship exercise and its importance. This particular chapter will look into management of the internship exercise as a key aspect and the activities that the internee participated in, how different departments correspond with the work duties. This chapter also covers the activities which were carried out by the student. It includes how activities were conducted, the skills and methods of Social work put into practice, principles, roles and values. 2.1 Reporting And Induction at the Organization I reported to the Organization (MRRH) and to the Principal Hospital Administrators office in particular on the 2nd of September 2011. He allocated me to IDC unit and placed me under the supervision of the sister In-charge IDC Mrs. Mutenyo Beatrice The Sister In-charge briefed me about the Organization (MRRH)-background, mission, vision, strategic objectives, services offered its clientele and Organization structure. Orientation/induction was done during the course of the first week to expose the internee to various sub-departments under IDC like reception, Counseling, Laboratory, Data, and the Post test Club among others. This process gave the ad open mind to draw her work plan for the internship and also get familiar with the different departments directly working with IDC. She further briefed the internee about the duties and responsibilities of the Department and the operation of the entire Hospital-giving me first hand practical experience of the Organization.

2.2 The Department to Which I Was Assigned 2.2.1 Category Of The Department I was assigned to carry out my Internship under counselling which falls under specialised care in IDC. IDC is a Unit that offers general and speciallised care for HIV/AIDS patients with a total of over 3500 active patients in HIV care. IDC falls under the Medical departmet of the hospital. 2.2.2 Services Offered At The Department. The department provides general and specialised care to HIV and AIDS patients. These services or activities can be categorised as below;

Orientation Reception Counselling services Nutritional support Health Education Laboratory services which include CD4 tests, etcetra PMTCT Palliative care Care and Treatment (for both ART and Pre-ART clients) Early Infant Diagnosis for HIV exposed infants including follow-up. Community support and follow-up. Community outreaches.

THE COUNSELLING DEPARTMENT The counselling department was the main department in IDC in which i carried out my internship exercise and is headed by Miss Nandala Constance with the assistance of other members like. The counselling department at IDC provides psycho-social support and care to clients living with HIV and AIDS. The Counselling department provides counseeling to all clients that pass through the clinic and these services can be discussed as below; a) Pre- test counselling. Pre-test counselling is offered to clients before testing to make client be firm or ready with the results he/she is going to receive. It is mainly about the reasons for testing, marital history, confidentiality, Information about IDC, previously tested for HIV, couple testing, behaviours of the client, among others. b) Post-test counselling. It is done after a counsellor has given out results to the client. Posttest counselling is offered to clients according to the results that the client has got, for example, clients found HIV positive are counselled on how to maintain a positive life and stay longer and healthy with the virus like doing light physical exercises, feeding on the balanced diet, seeking social support, spiritual care adherence to drugs among others.

Whereas negative clients are counselled on how to maintain that negative life by being faithful to one partner, ensure correct condom use or abstain from sex. c) Adherence Counselling/ART prepartion. Here clients are educated on the why complete adherence to drugs are needed. Information about what the client should expect or feel after starting ARVs is dissimeted. The clients is also furnished with information about how to take the pills, when, and what to do if one forgets a dose. They are also encouraged to get a treatment supporter. This sessions are mainly for preparing clients who are naive to ARVs for lifetime treatment taking ARVs. However, clients who are already on ARVs and are non-adherent are also counselled or reminded about the importance of taking ARVs. These sessions are very important for the clients. d) On going/supportive counselling. for clients already enrolled in care or taking ARVS. social problems may arise affecting their adherence and affecting their health. Hence the need for supportive or on going counselling. Here issues discussed include how to contact the clinic, symptom management/palliative care at home, prevention of opportunistic infections, shared confidentiallity. clients are advised to attend this sessions with their caregivers or encouraged to get one for those who dont have. e) Couple Counselling. Clients are advised on positive prevention especially the discordant, safe living, the never party is also encouraged to taste and support the positive one. f) Nutritional Counselling. This is aimed at equipping clients with information about good dietry, good feeding practices. The severely moulnourished clients are reffered for nutritional supplements as the counselling on good feeding habits goes on. LABORATORY DEPARTMENT. The laboratory department has a significant role in the centre as its where the tests that inform decision are done. It is headed by Mr. David Baliruno and boasts of a rich number of staff each performing different duties. The laboratory offers both free and paid tests. Most of HIV and AIDS clients enrolled at IDC are eligible for free laboratory services. However, some of the services are paid for. The tests done in the laboratory include;- CD4 tests, Viral Load, CBC, pregnancy tests, among other tests all vital for proper monitoring of HIV and AIDS cleints.

Phlebotomy/Bleeding of patients. This is where the sample of blood is drawn from clients by use of cotton wool with spirit, injection that sucks blood in the test tube and there after they attach the numbers to the clients sample and the form for tracking purposes. Laboratory room. After getting the sample from client, it is taken in the lab for testing. They first put the sample in centrifuge machine to separate the cells. In those cells formed, there are white blood cells, red blood cells and plasma where by they use plasma for testing. In testing the sample they have three testing procedures i.e. Determine, Dipstick for Confirmatory (start perk), Un- gold (tie-breaker). The sample is first put on a determine, if it reacts, you go to another procedure which is dipstick/ start park for confirmatory. If it also reacts, then the client is HIV positive you end there but when it does not react, you go to another step that is uni-gold, if it reacts the client is positive at least the procedures should show the same result,CD4 count and other tests are carried out. DATA DEPARTMENT This is the bank for all the patients records and information. The data department plays one of the biggest roles in IDC since data in used to measure the performance of the clinic in terms of services delivery to its clients. This department is Headed by Mr. Aleu Philip the Data Manager with two data assistants. The Data department at IDC represents the Monitoring and Evaluation system of the centre and uses both Paper based and electronic systems for monitoring patients. The Data department plays a supervisory roles as far as data capture into the MOH standard Data collection tools concerned. It also ensures that data is entered into the computers and saved securely for future references and research. It is this same department that compiles reports both periodically and adhoc. These progress reports are then subbmitted to different funding organization and MOH for planning purposes and decision making.

PHARMACY Here drugs are supplied to the clients. Both ARVs and Septrins. This department is headed by a pharmacy technician one Mr. Titus Watoya. Some drugs other than ARVs and Septrin for treating opportunistic infections are also present in the pharmacy and clients can access these drugs at no cost. RECEPTION This is the starting point for everybody including the clients. Its also the inquiries point. The reception is responsible for registering all clients which involves filling of background information and giving of file numbers to clients serially. Here information like, name, place of residence, and other demorgraphics about clients are recorded into the Pre-ART book. New files are then opened up for the new clients baring their client numbers. This sub-department is also under the counselling department and occupied by a counsellor at any one time. 2.3 The Activities And Tasks I Participated In Orientation. This was the first activity in the reporting week. There was listening, noting down and asking where neccessary. Answers were provided by the other counsellors and nurse in-charge, counsellor volunteers also where of great help. I learnt lessons about the centre, its principles, values, methods and activities. Reception and Recording. The reception signifies the starting point for clients. Directions including other relevant information is given to clients here. forexample those who need a transfer in and refered to the enrollment room in order to record and enter the clients records into the files with the guidance of the clinicians. HIV Counselling and Testing/Guidance The student/internee participated in the counselling of clients and guiding them with the help of the information on the ART card. This was done in the counselling room and it also helped the student know the preferences of the different clients. During the counselling sessions, the internee educated the clients following well laid out guidelines on how to take drugs/pills that is to say pre-ART counselling. A lot of information

was shared here between the internee and clients with the help of a counsellor in some instances. The internee also prepared clients who were to be tested for HIV and also those already tested for HIV. Hence the internee participated in both Pre-Test and Post-Test Counselling. Clients who tested HIV positive would be sent to the internee to prepare them for lifetime treatment of HIV and AIDS. This sessions demanded high levels of communication skills and sometimes clients would become emotional and break down. This demanded emotional strength on the side of the internee. Ongoing Counselling. This involves the continuation of counselling following poor adherence, client initiated or as instructed by the clinicians. This called for high levels of communication skills and sharing of information between clients and the internee showing confidentiality. This internnee participated in this sessions daily some of which where group sessions. Health Education The internee educated the clients on how to live positively for example on dietry, prevention of other infections or diseases, sharing confidentiality. Stigma and its disadvantages. These health education sessions were usually carried out in the morining in the clients waiting area before the clients receive any other services. The Health Education sessions provided both the clients and the internee with more knowledge since the communication was two way and the clients were actively participating. This sessions usually lasted 20 minutes and were interactive sometimes in all languages so that all clients would understand. Early Infant Diagnosis/PMTCT This involved counselling both pregnant mothers and those who have delivered about HIV. The internee participated in PMTCT counselling on how to prevent HIVfrom reaching the newly born or unborn baby, Safe Infant Feeding or Breast Feeding practices etc. Taking prescriptions under the doctors instructions, educating them on family planning methods among others. Pre-ART Counselling The Internee also participated in educating the clients to be started on ARVs on good practices about taking drugs. This often involved discussions with the clients about when to take drugs, in most cases the clients who decide and the internee would advise or inform basing on the decision of the clients.

These sessions where highly interactive. Sometimes the clients would inform the internee that they were not ready to start taking the drugs. Several Counselling sessions would be done before the final decision is made. This built strong relationships between the internee and clients based on mutual trust. Data Related tasks/Sorting and Retrieval of files The internee participated in sorting of clients files for the next day together with volunteers. The task involved picking files out from the file cabinets according to the appointment lists and arranging them to await the next day. The internee also helped in putting back clients results from the laboratory into their respective files so that by the time they are due for their next scheduled visit, their results would be in their respective files. These tasks were carried out in the data room or files room. Meetings The internee attended and participated in the monthly meetings of the units. Each department under the unit was to report on its progress, challeges and a wayforward would be developed. In one of meetings the internee was put to task to present a report on the challenges faced by the counsellors in the counselling department. This helped to build good communication skills the internee greatly benefited from. 2.4 The Officers I Worked With And What They Do The Nurses. The three Nursing officers i worked with headed by the sister in-charge where all helpful in guidance and in mentoring me during my internship exercise. The sister in-charge played the supervisory role for all nurses and counsellors in the unit. The other nurses helped in the day to day tasks like weigting of patients, traiging, etcetra. Counsellors. The counsellors provide couselling services to the clients thoughout the week. The internee spent most of her time with the counsellors sometimes counselling clients together or mentoring the internee.

Data Manager. Was very helpful when it came to informing the internee about the client load in the unit. The date manager provided the internee with details about the numbers of clients attending. This enabled the internee plan her activities basing on the workload. The internee also helped the data manager sort files to be entered into the electronic database. Phlembotomist. The phlebotomist was responsible for drawing blood for testing from the clients. Some of clients were sent directly to the phlembotomist from the internee after undergoing pre-test counselling. Clinicians. This included doctors and clinical offiers who sometimes sent clients to the internee for adherence and ongoing counselling/support. The clinicians treat the different clients, diagnise different infections and prescribe drugs for the clients. 2.5 Relationship With Other Officers In Executing My Duties And Responsibilities Generally the relationship with all officers,those identified above and many others was good. They were all very helpful to me executing my duties and responsibilities. They were co-operative and accorded me the necessary assistance.Most duties and responsibilities were carried out under instruction/supervision of the sister in-charge who was my work supervisor 2.6 Role Of The Work Supervisor She ensured that I was orientated into the Organization and in Particular the different subdepartments in the department to which i was assigned. She ensured that I arrived intime and involved me in the daily work in the unit as much as possible. She assigned me duties and responsibilities and aided me in execution of these duties. She endeavoured to explain the relevant policies and norms of the Organization to the internee. She played a motherly and supervisory role to me mentoring me and critising me where necessary.

CHAPTER THREE: METHODOLOGY 3.0 The Social Work Functions That MRRH Adheres To Mbale Regional Referral Hospital like any other health care agency has a setting for providing health care services to the society. It has become a social instrument which faces the community and, if functioning properly, should be able to reflect the communities wants and needs. Broadly, Mbale Regional Referral Hospitals activities or services focus on curative, preventive and/or educational, and rehabilitative functions of social work. Curative: Its primary function is curative and this is concerned with providing patient care and treatment with the goal of eliminating factors that have caused breakdown of functioning. This care can be categorised into short-term, intermediate term, and long-term care. The treatment of patients is done by way of inward, OPD and as clinic patients for example the its HIV clients at IDC are managed as clinic patients. This is generally the care given to the patients by the staff e.g. physicians diagnising diabetes, surgical operations, treatment of malaria, ART care. etcetra. Preventive and/or Educational functions: Mbale Regional Referral Hospital recognizes the importance of the preventive, promotive and/or educational components of health care, and provides all the required services through its infrastructure to the fullest extent possible. Through its community health department and by use of its periodic reports, the hospital has been able to track and monitor the incidence and prevalance of all communicable diseases consequently taking the neccessary preventive action. Various programmes have been designed to inform and educate the people so that they share a responsibility in preserving good health by adopting healthy life-styles. These programmes are focused mainly on the high risk groups such as pregnant mothers and children. One of such programmes is the HCT programme in the hospital. HIV counselling and Testing is done in all units with the aim of reducing its spread among people, especially the vulnerable groups. All mothers attending Antenatal are tested for HIV in its PMTCT programme. Health Education on HIV prevention is done every morning in most of the units, emphasis is made abstainence, condoms are distributed freely and all clients encouraged to test for HIV. This programmes also extends out to the community through the community outreach campaigns. Like the Immunization and VCT campaigns.

Rehabilitative functions: This falls under specialised care in the hospital. The hospital has specialised staff that are resposible for the provision of these services. These include, Physiotherapists, counsellors, nutritionists, occupational therapists. etcetra. 3.1 Approaches To Health Care Delivery Used By The Agency MRRH uses a Primary Health Care (PHC) approach to health service delivery where by its services are universally accessible to individuals of all ages, income brackets, and families in its catchment area at a cost that the community and the country can afford. Most of the services in the hospital for example malaria drugs are free while a client might be asked to buy a special drug if not available in the hospital. PHC is an approach to health that focuses on health equity producing social policy. For example in IDC, ARVs and other HIV services such as counselling and test are accessible freely by anyone irrespective of age, social status (income level) or background. The principles of Primacy health care are relavant today not just for the organization of health care systems, but also for how health care systems should act as an engine for promoting health and development more generally, and as an instrument for promoting equity and empowering the poor. 3.2 Methods Of Social Work Used By The Student And Agency MRRH employs casework, groupwork and community work, social welfare administration and social research methods in the execution of its social work activities. Some of the methods are used more frequently than the others depending on resource availability like time, or space. The decision to use one of the methods in preferance of another depended on the type of case. Casework Method This was the method that was most commonly used by the organization and hence the internee in carrying out tasks. This method tries to help the client, find a solution of their problem of social adjustment which they are unable to handle in a satisfactory way by their own effort. At IDC this method was mainly used to prepare an HIV infected client to join the HIV support group for meaningful living with HIV. The internee was able to go deep into the pains of an HIV infected person and enable the client to face up to the problem. Interviewing and assesement were major tools of casework. The internee also used casework dealing with clients during pre-test HIV counselling. For example the internee encountered a 17-year old unmarried student who had sex with only one

partner fealt safe because she was not sleeping around. She reported that her and partner were not using condoms, as she is very sure that she and her partner are mutually monogamous. She was willing to take an HIV test and saw the need for her partner to get tested, but was reluctant to discuss it with her partner because she felt she didnt want to get into that kind of discussion with partner stating that it would have a negative reaction from him since it had happened in the past. The internee was able to assess that the client was conteplative about getting her partner tested for HIV because she saw the need to know her partners status, though she considered the action to be risky for her relationship. The strategy the internee used was to invite the client to compare the benefits of getting her partner tested (knowing that she was not at risk for acquiring HIV) versus the negative consequences (her partner getting angry at her because of questioning his sexual history). The internee then offered a substitute by suggesting that the client can tell her partner that the hospital is recommending HIV testing to all clients and their partners. The client can then suggest that the partner be tested as part of a routine medical recommendation, without the need to disclose or mention past sexual history. The client agreed to try the approach. Group work This was applied in conditions were resources were scarce yet information was to be reached to big number of clients. In otherwords, the HIV infected individuals are much in need of group help. The group work focused the HIV infected individual in the group. The group Itself was a platform where the HIV clients were able to freely express themselves and share their problems and help one another. This group work The internee was instrumental in organizing the group, guiding the group work process. Mutual acceptance was the basis for the group work. The internee found that it was easier to help an HIV infected person to change his/her attitude to the rest of ones life in a group setting than to change one through case work. Community organizaiton work. This was mainly steered by the community linkages coordiantor who is stationed at IDC. Here people of a particular community would be called for a meeting at IDC or even at the community and discuss necessary action to prevent and control the spread of HIV. However the internee did not participate much in these activities. Social Welfare Administration

In providing services to the HIV/AIDS patients the hospital uses a few professionally trained social workers to man the service delivery towards this pandemic. This is evidenced by the existance of a hospital health worker. Social Work Research. For the effective implementation of any HIV related programme in the hospital, the role of the social work research has not be neglected. The hospital has a centre for Epidermiology and research. The issues surrouding HIV/AIDS are very sensitive to individuals, groups and communities. The hospital social worker is the most ideal person and therefore works hand in hand with the epidermiologist to assess these social issues and the type of gender dimensions of HIV/AIDS. 3.3 Different Skills Employed By The Internee During Fieldwork Since counseling is a conversation or dialogue between the counselor and client, the counselor needs certain communication skills in order to facilitate change. The internee used the following communication skills in executing the tasks. 1. Attending Attending refers to the ways in which counselors can be with their clients, both physically and psychologically. The Internee used effective attending to inform clients that she was with them and that they can share their world with the internee. Effective attending also put the internee in a position to listen carefully to what the clients were saying. Effective attending demanded eye contact with the client, being natural to the client, leaning forward toward the client (when applicable), maintaining an open posture, and being relaxed as much as possible. Effective attending puts counselors in a position to listen carefully to what their clients are saying or not saying. 2. Listening Listening refers to the ability of counselors to capture and understand the messages clients communicate as they tell their stories, whether those messages are transmitted verbally or nonverbally. When a client tells you his or her story, it usually comprises a mixture of experiences (what happened to him or her), behaviours (what the client did or failed to do), and affect (the feelings or emotions associated with the experiences and behaviour). The internee has to listen to the mix of experiences, behaviour and feelings the clients used to describe their problem situations. It was also important to hear what the client is not saying. so as to make correct judgements.

3. Basic empathy The Internee employed basic empathy when couselling clients. This involved listening to clients, understanding them and their concerns as best as she could, and communicating this understanding to them in such a way that they might understand themselves more fully and act on their understanding. To listen with empathy meant that the counsellor must temporarily forget about his or her own frame of reference and try to see the client's world and the way the client sees him or herself as though he or she were seeing it through the eyes of the client. The internee was then able to share this understanding of the client's world with the client in either a verbal or non-verbal way. 4. Probing or questioning Probing involves statements and questions from the counselor that enable clients to explore more fully any relevant issue of their lives. Probes can take the form of statements, questions, requests, single word or phrases and non-verbal prompts. The internee used probing mainly to encourage non-assertive or reluctant clients to tell their stories, to help clients to remain focussed on relevant and important issues, to help clients to identify experiences, behaviours and feelings that give a fuller picture to their story, in other words, to fill in missing pieces of the picture, to help clients to move forward in the helping process and to help clients understand themselves and their problem situations more fully 5. Summarizing The internee found it sometimes useful to summaries what was said in a session so as to provide a focus to what was previously discussed, and so as to challenge the client to move forward. Summaries were particularly helpful at the beginning of a new session. A summary of this point can give direction to clients who do not know where to start; it can prevent clients from merely repeating what they have already said, and it can pressure a client to move forwards. 6. Observation It was necessary to observe the client wholly. This required a lot of attention especially when the client is telling their story. Observation is especially important to be able to listen to the nonverbal communication from the client. 3.4 Various Techniques Used When Handling Cases. Social Skills Training Social skills training is a type of psychotherapy that works to help people improve their social skills so they can become socially competent. It is predominantly a behavioral therapy and can be done one-on-one or in a group situation. For example the internee in one or two cases dealt

with situations where an HIV client had to be given skills on how to stop excessive consumption of alcohol yet the client lives in an area where there is excessive consumption of alcohol. Assertive Training Assertiveness training is a form of behavior therapy designed to help people stand up for themselvesto empower themselves, in more contemporary terms. It is a response that seeks to maintain an appropriate balance between passivity and aggression. Assertive responses promote fairness and equality in human interactions, based on a positive sense of respect for self and others. The internee used this technique when dealing with HIV positive adolescents who had lost a lot of self esteem because of stigmatization. Group sessions where organized with roleplays. Rational emotive therapy The internee used this technique to encourage the HIV clients to focus on their emotional problems in order to understand, challenges and change the irrational beliefs that underpin these problems. For example some clients believed that they would not live for more than 10 years. These irrational beliefs greatly caused a lot of emotional problems. The internee here had to explain the truth and help to eliminate those beliefs. 3.5 Application Of Theories Of Social Work Used Every social worker wants to do good and make the world around him a better place to live. How exactly one goes about solving a particular social problem depends on its nature as each one is unique in itself. Sound social work theory provides the path to analyze the root cause of the problem and identifies the way to choose the best course of action. Of course there are more than one better solutions to any problem and many levels at which a problem can be dealt with. It draws on sociology, psychological theory, economics and even political science to analyze the various aspects of a social problem. It provides ways in which people can be helped on a personal and social level, to overcome their hardships. Social Cognitive Theory Social cognitive theory attempts to understand social problems through the lens of individual psychology. An individual and his behavior affects and is affected by society. Antisocial behavior, which is the cause of many social problems occurs due to psychological problems and imbalances on an individual level. Social cognitive theory aims at solving social problems through counseling of people at an individual level. It relies on the individual efficacy to power the change that one wants to see in a society.

The social cognitive theory explains how people acquire and maintain certain behavioral patterns, while also providing the basis for intervention strategies (Bandura, 1997). Evaluating behavioral change depends on the factors environment, people and behavior. It views the adoption of behaviors as a social process influenced by interactions with a person and others in their environment. Two primary components of this theory are: 1) modeling of behaviors we see others performing, and 2) self-efficacy, a persons belief that s/he is capable of performing the new behavior in the proposed situation. If people lack awareness of how their lifestyle habits affect their health, they have little reason to put themselves through the misery of changing the bad habits they enjoy. They are lectured more than they want to hear about their unhealthy practices. Applications of theories of health behavior have tended to assume adequate knowledge of health risks. It is usually high. Knowledge creates the precondition for change. But additional self-influences are needed to overcome the impediments to adopting new lifestyle habits and maintaining them. Beliefs of personal efficacy occupy a pivotal regulative role in the causal structure of social cognitive theory (Bandura, 1997). Perceived self-efficacy refers to beliefs in one's capabilities to organize and execute the courses of action required to produce given levels of attainments. Although a sense of personal efficacy is concerned with perceived capabilities to produce effects, the events over which personal influence is exercised varies widely. It may entail regulating of one's own motivation, thought processes, affective states and behavior patterns, or changing environmental conditions, depending on which aspects of life one seeks to manage. Efficacy belief is a major basis of action. Unless people believe they can produce desired effects by their actions, they have little incentive to act or to persevere in the face of difficulties and setbacks. Whatever else may serve as motivators, they must be founded on the belief that one has the power to produce desired changes by ones actions. Exercise of control requires not only skills, but a strong sense of efficacy to use them effectively and consistently under difficult circumstances. Efficacy beliefs not only operate in their own right. They act on other determinants in the regulation of behavior (Bandura, 1997). Beliefs in one's learning efficacy and efficient deployment of effort enhance acquisition of knowledge and skills for managing the demands of everyday life. Efficacy beliefs also regulate motivation by determining the goals people set for themselves, the strength of commitment to them and the outcomes they expect for their efforts. Belief in the power to produce effects determines how long people will persevere in the face of obstacles and failure experiences, their resilience to adversity, whether their thought patterns are self-hindering or self-aiding, and how

much stress and depression they experience in coping with taxing environmental demands. The beliefs that people hold about their capabilities, therefore, affect whether they make good or poor use of the skills they possess. This theory is greatly employed in Behavioral interventions to reduce the transmission of HIV infection among sex workers and their clients through the promotion of condom use among the sex workers. 3.6 The Different Principles And Values Adhered To During The Internship The principles and values adhered to by the internee during the internship exercise are based on social works core values of service, social justice, dignity and worth of the person, importance of human relationships, integrity, and competence. These principles set forth ideals to which the internee aspired to. Value: Service Ethical Principle: Social workers primary goal is to help people in need and to address social problems. The internee elevated service to others above self-interest. The internee drew on her knowledge and skills to help people in need and to address social problems with no expectation of significant financial return (pro bono service). Value: Social Justice Ethical Principle: Social workers challenge social injustice. The internee pursued social change, particularly with and on behalf of vulnerable and HIV oppressed individuals and groups of people. The internees social change efforts were focused primarily on issues of poverty, unemployment, discrimination, and other forms of social injustice. These activities sought to promote sensitivity to and knowledge about oppression and cultural and ethnic diversity. The internee strived to ensure access to needed information, services, and resources; equality of opportunity; and meaningful participation in decision making for all people. Value: Dignity and Worth of the Person Ethical Principle: Social workers respect the inherent dignity and worth of the person. The internee treated each client in a caring and respectful fashion, mindful of individual differences and cultural and ethnic diversity. The internee promoted clients socially responsible self-determination. The internee sought to resolve conflicts between clients interests and the

broader societys interests in a socially responsible manner consistent with the values, ethical principles, and ethical standards of the profession. Value: Importance of Human Relationships Ethical Principle: Social workers recognize the central importance of human relationships. The internee as a social worker understood that relationships between and among people are an important vehicle for change. She engaged people as partners in the helping process to strengthen relationships among people in a purposeful effort to promote, restore, maintain, and enhance the wellbeing of individuals, families, social groups, organizations, and communities. Value: Integrity Ethical Principle: Social workers behave in a trustworthy manner. The internee acted honestly and responsibly and promoted ethical practices on the part of the organizations with which they were working. The internee was continually aware of professions mission, values, ethical principles, and ethical standards and practiced in a manner that was consistent with them Value: Competence Ethical Principle: Social workers practice within their areas of competence and develop and enhance their professional expertise. The internee only provided services and represented herself as competent only within the boundaries of their education, training, license and supervised experience. She continually strived to increase her professional knowledge and skills and to apply them in practice. Social workers should aspire to contribute to the knowledge base of the profession. Value: Privacy and Confidentiality Ethical Principle: Social workers should respect clients right to privacy. The internee respected the clients right to privacy and did not solicit private information from clients uncless it was essential to providing services or conducting social work evaluation. And once private information was shared, standards of confidentiality applied.

Value: Informed Consent Ethical Principle: Social workers should provide services to clients only in the context of a professional relationship based, when appropriate, on valid informed consent.

The internee used clear and understanding language to inform clients of the purpose of the services, risks related to the service, relavant costs, reasonalble alternatives, clients right to refuse or withdraw consent, and the time frame covered by the consent. 3.7 Application Of Social Work Roles During The Placement Enabler: In the enabler role, the internee helped the clients become capable of coping with situations related to HIV or transitional stress. for example coping with the fact that they had to take ARVs for life The internee as a social worker conveyed hope, reducing resistance and ambivalence, recognizing and managing feelings, identifying and supporting personal strengths and social assets, breaking down problems into parts that can be solved more readily, and maintained a focus on goals and the means of achieving them. Advocate: Advocacy involved directly representing a course of action on behalf on one or more clients, groups, or communities, with the goal of securing or retaining social justice. The advocate role involved stepping forward and speaking on behalf of the clients. Sometimes clients felt shy to open up to doctors and felt secure with the internee. The internee would then be an advocate to the clients. The advocate role was one of the most important roles assumed by the internee despite its potential difficulties since it involved speaking for the the depressed HIV clients. Negotiator: As a negotiator the internee helped the different clients by effectively representing them and helping them get services from the organization. A majority of clients needed some basic or extra services for example mosquito nets and it was difficult for them to burgain and receive these services. Here the Internee came in as a negotiator helping the clients get what they needed. Mediator: The internee used the mediator role in resolving arguments or conflicts clients had with their communities or the organization. Such cases involved divorce due to HIV discordancy and child custody cases. The internnee observed that many children who lost their parents due to AIDS and were themselves infected had been neglected in communities they lived in. As the mediator the internee helped the different families and communities work out such differences while maintaining neutrality. Integrator/Coordinator:

Integration is the process of bringing together various parts to form a unified whole.Coordination involves bringing components together in some kind of organized manner. The internee as a social worker functioned as an integrator/coordinator in may ways, ranging from advocacy and identification of coordination opportunities, to provision of technical assistance, to direct involvement in the development and implementations of service linkages for example identifying and linking mulnourished HIV clients to nutritional services. Manager: Management in social work involves having some level of administrative responsibility for a social agency or other unit to determine organizational goals. As a manager the internee was involved in activities like acquisition of resources and allocating them to carry out programs; coordinating activities towards the achievement of selected goals; and monitoring the process and structure to improve , assess, and make necessary changes in processes and structure to improve effectiveness and efficiency. For example the internee was involved in the procurement of Airtime to call lost-to-follow up HIV clients. Educator: The educator role played by the internee involved giving information and teaching skills to clients and other systems within the organization. for example educating clients on male safe-circumssion, positive prevention, adherence to ARVs etc. Broker: As a broker the internee helped link clients with community and organizational resources and services. The internee as a broker also helped put fallen families together and differnt communities in touch with one another to enhance their mutual interests, this required that the internnee be familiar with community services, have general knowledge about eligibility requirements, and be sensitive to client needs. For example the internee helped clients obtain HIV starter kits and other needed resources. Facilitator: A facilitator is one who serves as a leader for some group experience . As a facilitator the internee served as a leader in family therapy groups, task groups, sensitivity groups, educational groups, a self-help groups, or a group with some other focus. This involved moderating discussion and setting topics for discussion.

CHAPTER FOUR: FINDINGS AND OBSERVATIONS 4.0 Knowledge And Skills Gained During The Placement The internee gained alot of knowledge on how to conduct oneself in a multi-disciplinary work environment. for example the dress code, protocol of reporting and supervision. etc The internee also learnt alot about time management, how to manage time and plan for activities. Beating deadlines etc. The internee learnt a great deal of communication skills. How to handle difficult situations, the role of communication and its importance. This was gained mainly through talking to different people in different languages in the organization.. The internee also gained skills in HIV pre-test and post-test counselling, ART preparation counselling and ongoing and supportive counselling. The internee was also equiped with skills and knowledge of conselling different categories of people including marriage couple, youth, adolescents and children. The Internship exercise also helped me acquire conflict resolution skills. I was exposed to alot of conflicts that need my input to have them resolved, this helped me gain knowledge and skills on how to resolve conflicts. 4.1 How I Intend To Utilize What I Have Learnt For My Professional Development The internee dealt basically with people (clients) both internal and external, concepts of human behavior, growth and development, social psychology, HIV/AIDS and communication skills came into play, I couldnt have managed without the knowledge of these subjects. For instance, social psychology helped me to deal with persons individually when it comes to situations where a client cannot express his/herself in public, I was able to understand when they use physical expressions that occurs as a result of emotions for example failure to utter a word, body language and change of the voice tone. During the internship, the internee realized that it takes many steps (even in a smaller organization)to achieve a vision. This was ascertained by a number of observations The Internee observes that teamwork played quite a huge role in attaining most of MRRH mandates. It was equally important as the ability to work independent.But the goal must be to find a way to combine it in the right way. The Internee also learnt how to operate in a multi-disciplinary environment were different cadres operate in a team for the achievement of a common goal or objective. Team spirit is

very important for the success of any organization and the internee plans to build on her team involvement skills
The internee also learnt that for any Organization to succeed there is need for a good

administrative body for proper planning, budgeting, directing, Co-coordinating and Monitoring and Evaluation thus intend to put my administrative knowledge and skills into use to succeed as a manager one of the roles of social work.
The internee also learnt that for the Organization to thrive there is need for Inter-

departmental Collaboration.
To always delegate some duties and responsibilities in order to ensure efficiency.

Delegation of duties is necessary in order to achieve efficiency and effectiveness since it reduces work load and occupies as well as motivating those delegated. There were cases were the internee had to delegate some of the work to other colleagues.
The internee also learnt how to Relate with both superiors (High ranking) Officers and

Subordinates (lower ranking/lower cadre officers) a necessary for any organization to succeed. 4.2 Personal Contribution To The Organization (My Innovations)
Accomplishing duties and responsibilities assigned to me relieved the Department of

workload to some extent. Health Education to patients and caretakers is likely to improve on the hygiene of Hospital Voluntary services provided by the internee that helped the organization achieve its objectives. 4.3 Challenges Noticed During The Internship (Work Related) That Are Affecting 4.3.1 The Organization Lack of enough counselling rooms. Sometimes clients had to be counselled under trees. Furniture was not enough. The Department i worked with lacked a child friendly environment or other social amenities like TV etc. Lack of adequate education material. The organization had only one social worker who was not sufficient to serve in the whole hospital.

Working/Operating on Meager budget Lack of transport for follow up of clients in the community.

4.3.2 The Workers Workload due to understaffing in most units Staff welfare is relatively poor given that most staffs are renting out and relatively far hence making time management. The workers salary payments are some times delayed which affects the performance of their tasks. Some staff not adequately trained yet handling difficult cases. In the organization some counselors are un experienced among them have limited knowledge and skills in what is expected from their performance. 4.3.3 The Internee At the Commencement of the exercise, I met a number of challenges because it was my first exposure to work given that I have never been involved in practical counselling before and Health work. Practical application of the Lecture theories was at first a bit difficult Language barrier was a major problem that the internee faced when in the field most especially when I was at the reception, other clients knew one language where by we were not able to understand each other there for a challenge. Limited time frame for the Internship exercise makes it difficult to get adequate exposure to all areas and activities of the Department and organization. The internee had to leave pre-maturely before the complete products of her effort were finalised. Some staff were not willing to cooperative with the internee. Such were not willing to reveal skills and knowledge to the internee. The internee was also financially handicaped during the exercise and this caused serious financial difficulties since she had to facilitate her transport to and fro the agency, lunch and breakfast.

CHAPTER FIVE: CONCLUSION AND RECOMMENDATION 5.0 Assessment Of The Internship Exercise In The Organization. My period of placement in Mbale Regional Referral Hospital good, productive and interesting because the whole staff of Mbale Regional Referral Hospital and particularly IDC were very friendly and expressed a high degree of professionalism, hospitality and customer care. Internship is a very important exercise in the Organization because The Internees boost the staffing level by accomplishing tasks The Internees bring in new inventions and innovations The Internees help the management to identify some problems unknown to them The internees help in suggesting solution/recommendation for the Organization to overcome challenges. 5.1 Recommendations For The Identified Problems. The following are some of the recommendations the internee was able to draw from her observation to the problems of both the organization, workers and other parties concerned and also to help in better service delivery. The organization should try to motivate their employees/staff in order to improve on their performance. Fore example paying of their salaries in time and allowances. This is because it was found out that the staffs salaries and allowances are some times delayed. The internee also recommends that once in a while the agency should organize a team building exercises outside MRRH Complex to its staff in order to bring them closer. This would give staff time to re-examine what they have achieved so far, share personal experiences and ideas, learn to be together and appreciate the importance of team work at work. There is need to train staff to enable them handle tasks more efficiently, especially those involved in counselling. There is need to provide more infrastructure in the form of more conselling rooms since it was observed that there are very few counselling rooms in the facility. The agency also need to recruit more staff, especially social workers/cousnellors to handle the ever increasing number of clients who have social problems and hence need

5.2 Conclusion From my experience I can wholeheartedly recommend Mbale Regional Referral Hospitals internship programme to any social worker who would like to experience an organization that has in my opinion realized their vision to find the balance between being progressive, able to balance human concerns and needs, technical considerations and nevertheless being highly successful in its service delivery and professionalism. What you have to bring with you is the willingness to improve knowledge about the environment,your work experience and you have to be able to work independently, self motivated and you must solve smaller problems on your own.

APPENDIX 1: WORKPLAN Date Schedule 1st 5th September 2011 8th 12th September 2011 Orientation & introduction to the clinic/Unit Agency Activity Orientation Venue Agency Objectives/goals - Visit and learn differnet department and thier locations learning how the activities are carried out and procedures in the agency To be guided by the agency supervisor on how to carryout activities. To draw out an internship plan with my work based supervisor 15th 19th September 2011 Reception Agency to learn how the agency works To learn how to welcome clients To learn how to use the ART books/registering clients into the ART books. To learn how to direct clients and deliver services to them 22nd 26th September 2011 Training in Counseling Counselling department To get familiar with counselling practices in the agency. To learn how to enroll new clients into HIV care Questioning Observation Casework Counsellor fred. Questioning Listening Recording Casework - Counsellor Fred questioning observation - Counsellor francis Skills - questioning listening Methods Person responsible - Sister Incharge

Date Schedule Activity

Venue

Objectives/goals

Skills

Methods

Person responsible

1st 5th October 2011 8th 12th October 2011

Training in Counselling & guidance Enrolling the new clients

Counselling department Enrolment department -

To know how the activity is done e.g enrolling new clients into HIV care To record the given information by the client onto the ART cards To know the environment in which the client live i.e asking the place and the people the clients stay with. To maintain the clientss confidentiallity and respect. To know how to respect the clients dignity and be trustworthy to the client Learn the counselling procedure To learn the observation of confidentiallity. to learn how to help the client make righ

Questioning Observation Questioning Assesement.

Casework

Counsellor Francis

Casework

Counsellor Francis

15th 19th October 2011

Counselling and guidance

Counselling department -

Interviewing communication, listening intensively

Casework

Cousnellor Constance

22nd 26th October 2011

On going counselling

Counselling department -

Advocacy

Casework

Counsellor Frances & Consellor Constance

29th 31st October 2011

Counselling

Counselling department

decisions & involve hime or her actively. To know to record and report on teh helping process

Assesement skills

Casework

Counsellor frances & counsellor fred.

Date Schedule 3rd 7th November 2011

Activity Health Education

Venue Agency

Objectives/goals To learn how to educate the clients on how to live a postive life

Skills Communication Intervention

Methods Groupwork method

Person responsible - Consellor Constance & Counsellor Fred

To learn the importance of health education to the clients To learn how to share information from different clients and their view about HIV/AIDS To learn how to transfer the clients information into the ART books. To access the recorded file numbers incase of the next appointment by the doctors

10th 14th November 2011

Data Recording

Data room in the agency

Recording Observation

- Philip

17th 21st November 2011 Prevention of Mother to Child Transmission of HIV EID point/room at the clinic -

To know the population of the clietns in the ART clinic To learn how to teach mothers on how to feed their babies safely To learn how to educate the mothers about the transmission of the virus Communication skills Groupwork method - Nakate Janet

Date Schedule 24th 28th November 2011

Activity HIV cousnelling and testing (HCT)

Venue room at the clinic

Objectives/goals To learn how to offer the HCT service To learn how to discuss the

Skills Questioning Intervention

Methods Casework method

Person responsible Counsellor Fred

Counselling -

importance of knowing ones HIV status. 1st 4th December 2011 Counselling Counselling room at the clinic To learn how to give postive and negative results to clients. To deal with a helping relationship between internee and the clients. To maintain the respect for the client Questioning Interviewing Assessing Casework Counsellor Constance