The Way Forward
Since we’ve been in Swaziland, we have been on a constant lookout for projects that we won’t have the time to pursue, but that might be viable for future interns. I noticed that, often times, bloody needles, gauze, syringes, and even body parts, are thrown out in the common trash can. Even when sharps boxes were available, they were often left unused. This dangerous waste was then thrown out with other common waste, to be rummaged through and handled without care. A low-cost incinerator, a waste treatment technology involving the combustion of organic materials and substances, would be very useful in these situations.
Again, I wish I had more time to spend with nurses and expert clients in the field, working on adherence monitoring skills, or even developing a simpler adherence monitoring system. Of course, it would be wonderful to be able to provide hospitals with a low-cost, easy-to-use DNA PCR machine. However, this is likely wishful thinking, and an endeavor more suitable for a graduate or Ph.D. student. I noticed that Swaziland, like Malawi, has a network of “Community Health Workers”, called “Lay Workers”, who work in their communities to provide health care in the most remote regions of the country. These workers are provided with only a few tools, and would benefit greatly from a Community Health Worker backpack. This possibility is, of course, dependent upon how the pilot of the CHW screening kit rolls out in Malawi, and what modifications are made accordingly.
During our time at the Baylor clinic, we saw more than one pleural effusion drained with just a syringe and a needle. It was a painful process to watch. The doctor would poke the patient several times, unable to determine where the pleural effusion was located, making their best guess. Without the aid of either a pleural effusion kit, with butterfly clips for when the patient moves unexpectedly, or an ultrasound machine to track the location of the pleural effusion, the process was very painful for both the patient and the doctor. Perhaps, this is a problem that could be solved by some of Rice’s finest engineers.
One of the PAC doctors, Michelle, works closely with Swaziland’s ONE OBGYN. We discussed some of their barriers to treatment and diagnostics. They are able to do pap smears, but often have trouble both funding the routine examinations, and working with the pathologist to confirm a diagnosis. So, they are shifting towards the VIA screening method. While this method only requires vinegar and dye, the biopsies that are being done on detected lesions are atrocious. There must be a better way.
Of course, a resource that could be utilized at every Baylor Clinic is a curriculum for the Teen Clubs. Botswana has set the precedent with a well-organized, well-attended, well-funded teen club. But, even the director of the Botswana Teen Club is searching for a year-long curriculum. I wish we had more time to focus on these projects. Although, I’m sure we would have discovered more projects to be done along the way. One thing is for sure, there’s always work to be done in Africa.