Again, sorry its been a bit since I’ve posted. I think that this year, blogs will be a but more sporadic due to my workload and such. I appreciate all of you sticking with me though, and promise to try to keep it as interesting as possible.
So I am officially settled here in Quelimane. I have started hanging things on the wall in my apartment, hung up my hammock on the veranda, done the first load of laundry etc. Moving into a new house takes time. You have to go through each room and make it your own, introducing yourself slowly as time goes, and making modifications to small things. And on a Peace Corps budget, it is just that – slow goings haha.
Work has been going well, just like the house it takes some time. Pouco a pouco as they say, little by little… however I feel overall that i am making good steady progress. I just need to remember to be patient with myself, the process itself, and those that I am working with. It still amazes me just how quickly time slips away here in Mozambique. . . how did it suddenly become mid-September?
Quelimane has been a tricky place to get used to… while it has a very fun social scene, one can become a bit dependent on specific people, and when those people travel for work and other reasons you can kinda get left behind. I am trying to branch out and make friends, my work colleagues do not really seem interested in getting to know me outside of the office, which is fine (a bit disappointing) but I suppose that’s the way it’s going to be. I cant help but compare this experience to the one I had in Quissico- there all of my coworkers were very involved in my life, actually providing my social circle aside from a few families in the community. Here in Quelimane, I have my work circle between ICAP the DPS and the CDC, and then some friends I have happened to make in town. Most of my evenings are spent at home, cooking, reading my books and laying in my hammock.
a fellow pcv and i enjoying a beer on a friday night
My computer charger has decided, after years of dedicated service, to die. So most of my work is now being done here at the ICAP office at the computer… Most of my work, or at least thus far has me in the office at the computer, or in various reception areas at various health centers in the city. Those are interesting days, full of many different emotions – even after being in this country for over two years, I can be appalled and disheartened by the conditions of some of the health facilities here.
work at the office...
Imagine, you walk through an old rusty chain link fence into an overgrown sandy yard where many stray dogs that are covered in mange are laying. Chickens run amok in the yard, barefoot babies, some without clothing cry in their mothers laps – a majority of the people are huddled under the shade of a solitary mango tree, waiting, sometimes for hours for a consult. During this consult, the exhausted doctor or technician will only speak to the patient in Portuguese, not caring that the patients’ language ability starts and stops with a basic greeting. During these consults the technician will often shame the patient for not knowing better than to get sick, hand off a prescription for a potentially improper medication, and send them on their way.
And that’s just the consult rooms. In the reception area and HIV testing centers, where I do most of my work, paperwork and patient files are organized in such a clusterfuck, its amazing that any work actually gets done. The facility I went to on Monday has many patients who are consistently getting their medication from the pharmacy, but are not going to their consults. This is a problem for many reasons… one – the patients CD4 count may have changed, meaning that their dosage of medication should also be changed, two- the patients should not be able to get medication without a receipt from their clinical consult, which means that the pharmacy is handing out medication to potentially incorrect people. Etc. .
So what we did on Monday was go through all of the ‘abandono’ files and separate the ones who are actually active in the pharmacy, but not in the clinical consults. It was a lot of paperwork, number dictation, and not mentally stimulating at all. But necessary, and it will help us streamline the ‘busca’ process for that specific health center.
Yesterday I participated in a meeting with the DPS, CDC, Ministry of Health, and various implementing partners that discussed the current situation of HIV and the accelerated plan to get more people on treatment, and retention of these patients. Very interesting facts and statistics, again some more disturbing than I was expecting. Out of 4,682,435 people in Mozambique, 294,993 have HIV. Out of those, 117,997 are considered eligible to start ARV medication (meaning they have a CD4 count fewer than 300) however, only 83,767 are actually on the medication. And who knows how many of those who are on treatment will continue to stay on it, or have already abandoned it.
My day today has been spent writing up project proposals –
Community Mapping Project for Abandonos and Target Groups
Proposal: Using a terrain-view map of each district or area surrounding a health facility, outline the neighborhood demographics of abandonment rates. These statistics can also be broken down into target groups such as, pregnant women, people who have abandoned treatment within the past 6 months, children at risk, etc. This Community Map could not only be used as a resource for the local community, but in conjunction with the Montly Busca project proposal.
and the second is
Monthly Buscas for Abandonos
Proposal: Once a month, using the resources from ICAP (car/team) go into the field to help with the buscas activas that are further than Peer Educators can achieve alone. Choose a centralized location according to the Community Mapping project, travel there in the car and from a decided stopping point, walk in small groups to locate patients. This project could be completed once a month with an assigned team.
I look forward to seeing where these proposals can go, and am preparing for a proposal meeting tomorrow with a representative from the Ministry of Health about the GAAC toolkit. Lots going on. Lots of work is deskwork, and project management…. So I’m not loving it, missing the hands on lifestyle of my small community, but feel that its good I have that basis of understanding and can use those experiences to further my work here in a practical manner.
I have 80 days until I am stateside for my leave, and while I am in no real rush to go home, obviously, I am looking forward to it. Until then, I'll have a cold one at my downstairs bar, and send you all some love...
~ t
No comments:
Post a Comment