Reports from Swaziland

What a full week it has been so far! Our first few days at the clinic have been filled with observing DBS (dried blood spot) tests, blood draws, pill counting and patient adherence calculations, and all the other goings-on of the clinic. This includes conversations in SiSwati, some of which we have been trying to pick up on. Sawubona, for example, is the usual greeting when you see someone- it’s very exciting to learn! In response, you say yabo (yeah-bo). How are you is unjani, and then you say ngiyaphila (nee-ya-peel-a). I’m having some difficulty with some of the names of the staff at the clinic, as I’m having to learn entirely new sounds and syllables… let’s hope I can start picking it up soon! It’s especially helpful because some of the volunteers here have been giving us lessons when we’ve had free time.

Ben and I are watching these procedures to understand not only how the procedures are done, but the details of what is necessary to carry out such procedures, which is the information that will help us most with maximizing the benefit of the technologies we brought with us. To give a brief explanation of the technologies and observations so far (I believe Ben is giving more description about them in his blog), I will let you know that we brought 7 different designs from students:

1) Pediatric transilluminator that allows visualization of hard-to-detect veins- should be very helpful, and we will start letting the staff use them to see if they like them

2) Dosing syringe clips that control the amount of liquid medicine that is drawn and dispensed- pharmacy and doctors are very excited about these, as liquid medications for children are often inaccurately given

3) Transport system for laboratory samples that need a durable and controlled environment- though it won’t be used for just DBS tests like we had envisioned, we are discussing making different inserts for different types of tests and outreach clinics, which could be very helpeful

4) Salad spinner centrifuge that can determine hematocrit without electricity- unsure whether or not this would be useful in the rural areas, so we need to investigate different sites, but it wouldn’t be necessary in any clinic that has a lab, like this one

5) Automated hemoglobin assessment that analyzes a picture of a blood sample using a cell phone- waiting to hear from more doctors to hear where this might be best used

6) Adherence charts that simplify the calculation of patient adherence- could be beneficial if we adapt the design to suit the most commonly prescribed regimens

7) Pill counting device that maximizes efficiency in dispensing and counting tablets- have found problems already, mostly because medicines used for treatments are much larger, so counting on the scale is not very time-effective

We have been beginning to introduce the technologies to the doctors and staff here, and it seems that they will be very receptive to hearing our ideas, which is great news. We spent three hours explaining all the details of the devices, or “gadgets” as they’ve been calling them, to Michelle and Stephanie the other night, and we’re beginning to plan our rural community clinic trips, meetings with NGOs and other local organizations, and our dissemination of the technologies in the Mbabane BIPAI clinic itself. On Friday, we’ll be giving a short presentation about each of the technologies at the doctors’ meeting, and then meeting with Dr. Hailu, the director of the clinic, to determine that work that we’ll carry out over the next two months in Swaziland. I’m very anxious to figure out where we’ll actually be located during our stay, which will hopefully include trips to various rural communities with different constraints.

Beyond our work at the clinic, we’ve been able to experience a little bit of the doctors’ and expats’ lives here, which included my first attempt at Ultimate Frisbee last night. They’ve created a group, which includes some locals, too, called the Mbabane Mbananas, which makes me laugh every time I think about it. While I gave the game my all for the first while, I decided to stretch my legs in a more tried-and-true way to me by running laps around the field that we were playing. It felt so great to feel the cool night breeze, especially compared to the hot and humid Texas summer weather! After that, I joined in the last small game, and really enjoyed it the second time around- I have the catching part down, now I just need to get the throwing! We went to dinner afterwards with Michelle, as well as two of the medical students here at the clinic, Amy and Brigid (they’re actually both former peace corps members that were stationed in Swaziland that decided they really wanted to come back!), and thoroughly enjoyed the night. This weekend, with the beginning of the World Cup, we’ve been invited to two different viewing parties! On Friday, we’ll be going to Dr. Hailu’s house with the rest of the doctors and visiting scholars (which is what we and the medical students are called), and on Saturday, we’re going to a restaurant with the larger expat and Mbabane community- I think it will really be a great time, and I’m sure we’ll be able to meet very interesting people.

I’ve been wanting to upload pictures to the blog (Ben has successfully gotten a couple up), but the internet has been so unstable that it hasn’t been able to load any of my pictures yet. I’m going to work on it more and hope for the best, because I’d really like to share the sights of the city and our adventures. I’ll update again after what sounds like a productive meeting and exciting World Cup shenanigans!