Reports from Swaziland

I am so happy, ecstatic and excited that both Z and I have made some great progress in terms of the projects we brought to Swaziland in our second week here. Earlier this week, on Monday, Z and I showed the bili-lights, the incubator and the diagnostic-lab-in-a-backpack to Dr.Stephanie Marton to elicit her opinions on how to jumpstart the projects. She was enthusiastic about everything; it was so amazing—and a great relief to us– that she offered up front, voluntarily, to help us collect the evaluation forms we brought for the projects and gather any feedbacks to send to us after we leave, since she will be staying here ideally until next summer. I have seen Dr.Marton’s work ethic, her generosity and her sense of responsibility, so it is really reassuring to know that we have a reliable contact in Swaziland, one who can check up on the projects after we leave. Moreover, Dr. Marton, or Stephanie as I will call her from now on, also helped us carve out a time at the weekly doctor’s meeting on Friday to formerly present our devices to all the doctors and the clinic’s management team. I am sure we will receive more help and advice after that.

Specifically for my area of the projects, the bili-lights and the incubator are not applicable to the clinic because it doesn’t have the capacity for in-patient overnight stays. So, Stephanie recommended that I tag along with her on her weekly trip to the Mbabane Government Hospital (MGH) so that I could see and assess the need for the devices there. I just finished my trip and this same day, Z went on her first outreach trip to see if the lab-in-a-backpack would be of use in that area.

Up front, I want to say that my visit to MGH was a great experience, an opening view of the current condition of the health care system in Swaziland. I will separate my trip into two parts: project related topics and my general impressions of the hospital. In the former, I received a promising jumpstart. Stephanie introduced me to the head pediatrician whose name I unfortunately cannot spell right now. When I gave him a brief description of the projects in the children’s ward, he immediately took us to see the Maternity Ward where they isolate the neonates. It was a refurbished section, so the area was in a much better condition than the rest of the hospital. It still smelt of paint. They tried to keep the ward as sterilized and as clean as possible; we were not asked to take off our clothes when we entered the dark and extremely warm room, but we could only observe ward at the nurses’ station. The mothers, who were in the room, breastfeeding the infants, were in nothing but towels.

 It was a very interesting ward, not yet fully furbished, kept at an almost stuffy, sweltering temperature of what I would guess 37 degrees Celsius. The room was very dark, with the heavy blinds shielding the windows in the middle of the day, so that the only major light actually came from a running phototherapy unit emitting white light. I was surprised to see white light being used because blue light phototherapy has been clinically proven to be the more efficient and effective treatment. I learned later that the hospital did not have access to the latter. In fact, most of the equipment we saw in the room—the two incubators, the one phototherapy light, the plastic baby bens—were donated. The hospital had no means of maintaining them and once they are broken, there will be no one to fix them. Moreover, the equipment was just not enough to adequately meet the demand of what I saw to be at least seven babies. In gist, though the ward was somewhat technologically advanced and equipped, its appearance belies the emptiness of promises: the technology doesn’t meet the current situation and once they are run down, what will happen?

Sad, but hopefully true, the simple, low-cost and easy-to-maintain bili-lights and incubator might be the answer. The head pediatrician was very receptive toward the projects, provided—he said jokingly or perhaps not so much—that they are free. That was the least of my worries right now because I was initially afraid of possible policies or initial hesitation or distrust of new technology that would prevent the two projects from even being used.  I am excited and a little intimidated that I will be formerly presenting the projects next Monday and Wednesday to the hospital’s management officials and doctors for the final verdict. If the initial implementation is successful and well-liked, I hope that Z and I can teach the Teen Club members (started and supported by Baylor clinic) to make the incubators and sell them to the hospitals because the club—which Z and I will be helping in the coming weeks—is in dire need of funds. Wish me luck!

Sidenote: Stephanie recommended me another site where she thinks the devices could be useful. I will probably have a chance to explore it next week!