Botswana Handbook - University Of Pennsylvania

Sharing the expertise of a world-class university with our partners in Botswana tobuild capacity and excellence in clinical care, education, and research.Botswana HandbookUpdated 6-17-14

Code of Conduct . 6Things to Remember . 7Who Should Not Go to Botswana . 7Who Thrives in Botswana . 7About Botswana . 8Background . 8Botswana: Country Statistics . 8Location. 8Climate . 9Helpful Tips When Visiting Another Country . 10Demographics . 10Nationality . 10Tribes in Botswana . 10Religion . 11Language . 11Economy . 11Customs & Culture . 11Greetings & Respect . 11Cattle . 12Kgotla . 12Birth Dates . 12Body Language . 13Botswana Time. 13LGBT . 13Top Tips for Not Being an “Ugly American” in Botswana . 13Holidays . 14Additional Resources on Culture . 14Notes on Language. 15Essential Setswana . 16Language Lessons . 17Getting Ready. 17Preliminary . 17Making Your Travel Arrangements . 18Purchasing a Ticket through a University Account . 18Notify Boipelo Dibotelo of Your Arrival . 19Ground Transport in the US . 19Airport Pick-up . 20Passports and Visas . 20Immigration . 20Students traveling for Internships or Study Abroad . 20Medical Students, Residents, Staff & Faculty . 20Immunizations . 21Malaria Prophylaxis . 21Don’t Swim Except in Manmade Pools . 22International SOS Medical Care and Evacuation Insurance . 222

Penn’s Global Activities Registry . 23. 24How to Dress and What to Pack . 24Checked Luggage . 25Books to Read . 25Communication . 26Calling Home . 26Calling to Botswana . 27Calling around Botswana. 27Internet Access . 27Electricity . 28Mail. 28Money . 28Accessing and Converting Money . 28Credit Cards . 29Cost of Living in Botswana . 29Tipping . 29Transportation . 29Taxis . 30Combis . 30Buses . 30Plane. 30Travel Agents/Tour Guides . 30Safety. 31Crime . 31Wild Animals . 31Vehicle Accidents . 32Sexually Transmitted Disease . 32Steps to Follow in the Event of a Needle Stick Accident . 32Top Tips for Keeping You and Your Stuff Safe Traveling to and in Africa . 32Housing . 33Flats and Communal Living . 34Bon Sela . 34Rules:. 34UB Dorms and Other Housing . 35Restaurants . 35Having Fun . 36Malls . 36Movies . 36Theatre . 37Quizzo . 37Sports . 37Night Life . 37Bars . 37Sightseeing . 38Art . 383

Crafts . 38Day Trips in Gaborone . 38 Gaborone Dam. 38 Gaborone Game Park . 38 Kgale Hill . 38 Mokolodi Game Preserve. 38 National Museum. 39Daytrips Outside of Gaborone . 39 Gabane . 39 Kolobeng. 39 Mochudi . 39 Molepolole. 39 Oodi . 39 Otsi . 39 Thamaga . 39Vacations . 39HIV/AIDS in Botswana . 40Botswana’s Response to HIV/AIDS . 40Who is targeted for the ART program? . 41The Partnership’s Role and Work in Botswana . 41History of Penn’s Involvement . 41Partnership Governance . 41Current Programs & Initiatives: Clinical. 42Current Programs & Initiatives: Educational . 43Current Programs & Initiatives: Research . 43Measuring the Impact . 43Working in the Hospitals . 44About Princess Marina Hospital (PMH) . 44Harvard and Baylor Also Work at PMH . 45Credentialing for Residents and Faculty Working in the Clinical Setting . 46Hospital Staffing Terms . 46PMH Phone System . 46Set-up of PMH Medical Wards . 46The Firms . 47You and the Firms . 47Adjusting . 48Daily PMH Hospital Experience and Schedule . 48Daily Intake . 48Rounds . 49Patient Files . 49Laboratory Orders and Procedures . 50Call and Admissions . 50Needle Stick Exposure and PEP . 51Common PMH Abbreviations . 51Weekly Conference Schedule (Princess Marina) . 51Access to Educational Material . 524

A “Word” on HIV Testing in Botswana . 52A “Word” on Radiology at PMH . 52Laboratory Tests: Ordering Tests . 53Keys to Obtaining Rapid Results for Laboratory Testing at PMH . 53Lumbar Puncture . 53TB Sputum . 54Thoracentesis . 54Bone Marrow Aspirate . 54Hematologic Blood Tests . 54Chemistry Blood Tests . 54Serological Blood Tests . 54Coagulation Profile . 54HIV Testing . 54CD4 Test . 54Selected Normal Laboratory Values (SI Units) . 55Discharge and Follow-up . 55Discharging Patients from the Pink Firm . 56Top Ten Causes of Death in Botswana . 56TB Registry . 57Referral to South Africa . 57Transferring Patients List of Specialists Commonly Use . 57Common Medications . 57Appendix . 59Important Phone Numbers. 59Key Botswana-UPenn Partnership Staff . 59Common Acronyms . 60Pocket Reference. 62Individualistic and Collective Cultures . 62A Brief History of Botswana . 66Map of Gaborone . 68Princess Marina Hospital Map . 69Botswana Travel Agents . 70Risk & Release . 71Emergency Contact Information . 72Code of Conduct . 73Planning and Packing Checklist. 74Book List . 80Basic Setswana . 84Setswana Names . 93Additional Information & Resources . 955

Dumela! (Hello) Welcome to the Botswana-UPenn Partnership (BUP). This handbook is anintroduction to Botswana for faculty, staff and students traveling to Botswana to work on aBUP program. The original handbook was written by Dr. Steve Gluckman with contributionsfrom Botswana-UPenn Partnership students, residents, staff and faculty for students andresidents doing clinical rotations in Botswana. We have tried to adapt it to all Penn peoplegoing to Botswana but some portions may be more applicable than others to your time inBotswana.The Handbook is an ongoing project; please help us inform those who will follow you byproviding additional information and feedback for additions or changes to this Handbookto Heather Calvert (hcalvert@mail.med.upenn.edu).Note too that there are online video orientations available on the Global HealthMediasite.Administration of the Botswana-UPenn Partnership – Philadelphia OfficeHarvey Friedman, MD, Director - hfriedma@mail.med.upenn.eduHeather Calvert, Associate Director - hcalvert@mail.med.upenn.eduCordelia Biddle, Administrative Coordinator - biddlec@mail.med.upenn.eduCyra Copeland, Grants Manager - cyracope@mail.med.upenn.eduAdministration of the Botswana-UPenn Partnership – Gaborone OfficeDoreen Ramogola-Masire, MD, Country Director - doreen.masire@gmail.comAndrew Steenhoff, MD, Associate Country Director and Director of Research steenhoff@email.chop.eduAri Ho-Foster, Country Operations Director - Ho-FosterA@botswana-upenn.co.bwBoipelo Dibotelo, Student, Resident and Visitor Coordinator - dibotelob@botswanaupenn.co.bwMiriam Haverkamp, MD, Clinical Rotation Supervisor - haverkamp.bup@gmail.comCode of ConductWhile in Botswana you will be representing not only yourself but also the University ofPennsylvania. It is critical that you remember this at all times. Public errors in judgment orconduct in Botswana are likely to not only be a problem for you, but could result incompromising the entire program. It is up to you to thinkAll Penn program participants andcarefully about the potential negative implications ofclinical rotators are expected toquestionable behavior. Though you will be working in Botswanawork full work weeks, Mondaythis program is an official part of the University of Pennsylvaniathrough Friday. This schedule doesand as such we are all subject to the same Penn policies as innot permit elaborate excursions toregional tourist destinations.Philadelphia.Remember that we are guests in Botswana. While staying in BUPsubsidized housing, you are also guests of the BUP. It is impolitefor guests to demand things of their hosts.In addition to being aware of our public appearance,communal living may put some unusual stresses on theexpected level of conduct. One of the benefits of being in6(Vacation trips to Chobe, Maun,Victoria Falls, Cape Town, etc. ALLrequire Friday departures.) If youwish to couple vacation plans withyour time on the continent, youMUST do it either before or afteryour rotation starts. If you violatethis rule, you may lose yourprogram funding, housing, or beexpelled from the program

Botswana is an opportunity for faculty, fellows, residents, and students to interact in aninformal way. This can strain well-established lines of acceptable conduct betweenfaculty and trainees. It is important to be mindful of this concern.Anyone traveling to Botswana on a BUP program must sign the Risk and Release andEmergency Contact Form to BUP staff before departing for Botswana (see end ofHandbook). Note too, that any student or trainee who is in Botswana on a BUP program isforbidden from driving a vehicle while in country on rotation. All students and trainees arerequired to report to duty for all regularly scheduled work days and hours.Your program may have other prerequisite requirements for your time in Botswana; pleasecheck with your specific program for any other requirements for travel.So, have fun but please don’t do anything dangerous or dumb.Things to Remember1. You represent the University of Pennsylvania. Your actions, positive or negative,intentional or unintentional, have implications for the entire program2. Being nasty or pitching a fit in nearly any setting in Botswana is unlikely to further yourcause and may result in your being sent home early.3. You live communally. Be mindful of the “rules of the flats.”4. If you travel outside of Gaborone or Francistown, it is important that BUP staff (BoipeloDibotelo) knows your itinerary. This is so that we know where you are in case there is anemergency and you need assistance. (This HAS happened in the past.)Who Should Not Go to BotswanaAnyone with an underlying immune deficiency or chronic disease that would predisposethe individual to a higher risk of TB disease should talk toInvariably, Volunteers who have completedtheir physician before going to Botswana. Such conditionstheir service speak of the relationships thatinclude: HIV, history of a solid organ transplant, chronic they have established as the highlight of theirservice. Many speak of how they havekidney disease, and recipients of chronic steroids or otherlearned to value and respect a more familyimmunosuppressive medications. The risk of progressingand community-centered way of life and offrom latent TB infection to active disease in the normal hosthow they have grown in patience andwithout treatment is low (e.g. 5% in the 1st year and 5%understanding. Such positive reflectionsover the subsequent lifetime), however, this is not true inare the endpoint of a series of highs and lowsthat are part and parcel of the process ofimmunocompromised individuals: HIV infected hosts withleaving the United States, enteringlatent TB infection, for example, develop active TB at a rateBotswana, and adapting to the practices andof 10% per year.pace of life in a new culture.Anyone with a psychological illness (e.g. anxiety,depression, eating disorder) whose symptoms may beexacerbated by the stress and challenges of a foreignenvironment should consult with his or her therapist orphysician or CAPs (http://ww

introduction to Botswana for faculty, staff and students traveling to Botswana to work on a BUP program. The original handbook was written by Dr. Steve Gluckman with contributions from Botswana-UPenn Partnership students, residents, staff and faculty for students and residents doing clinical rotations in Botswana.