I traded a pint of blood for a coke at the hospital today....

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So it’s been a heck of a last few days so I’ll just try and fill you all in a little. Right now we have just come back to the hotel and are watching the news of the earthquake in Haiti. It’s just terrible. Of course as I’m in Malawi and I should probably tell you all about that.
So, yes, let’s see. Yesterday we went to the district hospital and looked into what the process there was for PMTCT, EID dried blood spot testing and how the patient tracing process is working right now. We interviewed the Senior HSA and followed the patients through the process. So, the DBS testing was the one with the most comprehensive follow up procedure. If the mothers don’t come back for the results, they have two people dedicated to go out and follow up with those mothers and tell them that they need to return for their results. So they go out with a motorcycle and trace every single one weekly. However, the PMTCT and exposed children follow-up isn’t happening at all. They don’t currently record the defaulters anywhere. However we interviewed the head of PMTCT (who had been travelling with us the entire time) and she said she would be the one in charge of compiling the lists and would be happy to start doing that. Luckily, the ministry has just distributed and the health facilities have started using them since the New Year, a new antenatal register which has 5 lines for each pregnant woman which makes it much much easier to see who has defaulted from the program. So this bodes very well for the follow up. The head PMTCT nurse said that if the communication system could be put into place, they would start trying to follow up on these patients as well.
After these meetings, we went for lunch at the place with the giant baobab again and then headed back to the hospital to conduct a focus group with the HSAs. We ended up with I think 10 people. 8 of which had mobile phones. The focus group went well and we gained a few when we send for sodas. Fanta = more people in your focus group. Okay, quick right now update… This CNN report is really really sad. I just can’t believe it. And… the TV keeps turning itself off. So, last night was good, very mellow. Just sort of took it easy.
This morning we headed out to Chiradzulu. We arrived at the beautiful new hospital and met with many of the administrators. They seemed to think the program we were doing research for sounded good, though they had a dedicated group of patient tracers funded by Médecines Sans Frontières who were stationed at both the hospital and each health center. But this is kind of a good thing, if it wasn’t something that someone was already doing, it’s either the most amazing new idea ever or a terrible idea that would never work. So, anyway, their program is working really well, which is a great sign for our program. So we went out to a health center, and as is our normal scheme, Annalies and Michal went to go follow the antenatal procedure and I went to go and interview HSAs. I interviewed the senior HSA and one other one as well. After that we went out to another health clinic where Annalies and Michal interviewed the head PMTCT nurse and I interview two HSAs. Sorry NYC team, we have a lot of transcription to upload. So, after that we headed back to the hospital to check out the lab and I had read last week that Malawi was completely out of blood in the hospitals. It was the daily headline and people in the hospitals were dying from lack of blood. So I told the matron that I would donate and they traded me a coke for a pint of my blood. I’ll post photos soon. I think that they were not so used to people just donating though, as they were a little confused at the lab as to what exactly I wanted to do and took my information down on a quarter sheet of blank paper. They also had trouble finding a vein, the arm that is totally tattooed wasn’t any help for them, but they decided to give my deep veins a shot on the other arm and got the needle in and blood out. After that we headed back to the hotel and now I’m here writing to you all. Tomorrow we have an appointment at 7am with the hospital that does the PCR testing to see how that is done and then we are off to somewhere else. I’m going to try and be up at 4:30 to catch the sunrise in the morning and I’ll post pics if I manage. Last time I was up at 5:20 but the sun had beaten me. Okay, goodnight everyone!
P.S. Going to watch Malawi play the Africa’s Cup game… they won a huge upset last time so this should be fun!