We're starting at the begining...

Hello everybody,

so I have gained back most of my strength, my appetite is still not quite up to normal, and these long days exhaust me a bit, but I'm getting around and am able to work which is nice.

so, the first day in the field was yesterday, and I started with the biggest facility that will be part of our pilot, the Yala Sub-District Hospital. I started off the day with a Community Health Worker (CHW) focus group where I went over the proposed software with them and got their feedback, I was able to add some specific time things in the software outline, like to send the reminder for the appointment to the CHW 3 days before the appointment itself is due, as well as to wait two days after the appointment date to see if the mother has shown up before sending another request to the CHW and that after that they should be transferred onto a list for the Ministry of Health HIV tracers to go follow up five days (three days for the reminder to get to the mother and for to her to prepare to go to the clinic and two days of potential showing up time) after that. The other big thing that came out of this was something that I had as sort of an afterthought feature but the CHWs seemed like they were very interested in. That would be the part where they could receive a request from someone in a household to have an HIV counselor to come to the house and help them disclose their HIV status to their partner, and the CHW could text in the persons info and it would generate a weekly report for the HIV counselors at the MOH site of people to go and follow up with. They thought that this would be very helpful. The more that I go and talk to people, the more I realize that this module is less about a reminding schedule (though that is still the cornerstone) and more about helping the MOH and CHW coordinate their activities for the improving of services for patients.

So the head of the HIV unit and the head nurse in charge of Maternal and Child Health at Yala both were very interested and enthusiastic about the project and said they would be willing to take on the extra workload, and in fact they were emphatic that they be included in the original 3 clinics selected for the Alpha phase of this project. So, needless to say, the day went very well indeed.

I also met some other people from SIPA who were here at the MVP field office, I was a bit surprised because I didn't know of them before this, but they were nice to talk to as I had quite some time to wait between arriving in the morning and when we would be going to Yala. And again, after Yala and lunch, I went back to the field offices and had about 2 or 3 hours to kill before the transport back to Kisumu. And of course, I had decided not to bring my laptop to work with me that day to keep my bag light, but regretted it when I was sitting here with work I could be doing, but no means to do it.

I got home around 6:30 and Katie, Claire and I decided to head to Mega City to go to Mon Ami for dinner. It was nice and we ate and hung out for a while and then headed back home around 10. I was suprised by how tired I was, by the time we got ready for bed and I laid down with Katie and Claire, I fell asleep almost immediately. It was crazy, I normally have a bit of a hard time falling asleep, but not then.

Today, it was off the the field again, with the goal of going to Sauri and Marenyo health centers. So of course, like all other days, I got to the office way too early, which was fine as I just hung out and chatted with people and got to catch up with Dickson and James, who are the programmer and head of Health respectively.

We left for Sauri and when I arrived, I found a very helpful in-charge and they of course wanted in on the alpha run as well, which works out well because they share quite a few patients with the Yala sub-Dist. Hospital. When meeting with the Maternal and Child Health Nurse (MCH), I found out that they have all the HIV+ pregnant women come in the same day once a month. This was something that we hadn't taken into account and so I'm very glad for talking to people first, as it's an easy fix, but not one I would have seen on my own. I got the information from them on their PMTCT (prevention of mother to child transmission of HIV/AIDS) and antenatal procedures, as well as their organizational structure and their TB system and joined the car to Marenyo. When we arrived it seems as though the in-charge had a commitment and had left his MCH nurse in charge off all patients, I couldn't take up her time with questions and delay care for all the patients lined up so I decided it would be best to just come back there on Monday. Even with the Malaria delay and this one, i think that I will finish the initial field research portion well ahead of schedule, which is nice. So, I arrived back to the field HQ to find it pretty well deserted, and I've commandeered a desk and am writing up this and my notes for the day and waiting for the car to Kisumu which I think arrives at 4 on Fridays.

That's about it for today, tonight we are headed to Simba Club for their famous friday night buffet, Kaniko and Yoshi from the guest house and Francis from MVP are joining us and then tomorrow we have many competing offers from people wanting to hang out, and then it's off to the bar to watch Ghana vs US on a big screen for World Cup, I've been very conflicted, but i have to keep supporting my team, and besides, it's the first African World Cup so we need an African team in the finals, so Go Black Stars! But in a way this game is the best case for me as I'll be happy even if my team loses. Sunday i think that the plan is for us to go to the market to buy a charcoal grill and some cloth and then it's off to Kiboko Bay Resort to go swimming!!! Okay, that's it for now, time to get back to work!