Today is Friday, which means several things:

1) It’s casual dress day in the IDCC office. People are wearing sweaters, jeans, and polos. However, I’m wearing a blouse with black dress pants because I only brought one pair of jeans to Botswana.

2) Everyone gets to leave the office an hour early, at 3:30PM instead of 4:30PM. That means that I will have time afterwards to go to Main Mall and buy groceries before it gets dark!

3) It is officially be the end of my first two weeks in the IDCC. Therefore, an obligatory progress report is due, as follows. I’ll start with the SAPHE Pad because it’s a month’s worth of progress farther ahead than the others, since Lila was working super hard on it during her internship!

SAPHE Pad

• Dr. Doreen Ramogola-Masire, Country Director of the Botswana-UPenn program: questioned the sterility and cleanliness of the handcrafted pad; she did not feel comfortable advocating for it to the other doctors in PMH due to this issue
• Observing in the Labor and Delivery Unit of PMH (see Lila’s blog for more details): birth attendants showed quite a bit of interest when Lila presented it to them and confirmed that the current method of measuring blood loss was by visual estimation; question of sterility vs. general cleanliness
• Salome, the midwife with 10+ years of experience: thought it would be highly useful; she said that it only needed to be as clean as the linens that they used for delivery; showed a lot of interest and wanted me to bring the pad the next time she was visiting the IDCC, but she never showed up 🙁

Summary: The SAPHE Pad definitely addresses a health challenge that is applicable globally. There will always be childbirths, but there is no accurate method of estimation of blood loss except by unguided visual estimation. The next step is to actually implement the device; however, this is at a blockage because the cleanliness of the handcrafted pad is a concern. I understand that concern, as I saw how the pads were made on the OEDK tables (not necessarily the cleanest environment) and how the fabric was scraped off the original Chux pads with scissors in order to obtain the blue sheet. However, I think that if professionally manufactured in a very clean environment, the pads could definitely be implemented, and are a very marketable product that would make a very positive impact on healthcare.

InvertaBottle (& Dosing Clips)

• Mma Monare suggested that I visit the Pediatrics ward, as that is most likely where I’ll find home-based care. I’m going to observe at the ward (and hopefully get to chat with some of the doctors and nurses there) the week after the next, since the paperwork to allow me to go observe there takes time to get approved.
• I haven’t had too much luck in meeting doctors that administer liquid medication or are directly involved in providing patients with liquid medication that requires exact dosages. Perhaps I need to talk to nurses more to get feedback for the InvertaBottle… I have also been attempting to find the outreach doctors, but no luck!

Summary: I recognize that the Invertabottle is a little more difficult to get implemented since there currently exists no apparent need here at PMH for a liquid medication dosing system for home-based care. The dosing clips by themselves might be more appealing, though, since they are suitable for a wider variety of situations.

Dremofuge

• The doctors here don’t actually do any lab work, so I need to talk to people who work in the labs.
• I’ve brought this up with Shruuti, a post-doc who performs long-term research in the Baylor office (I can’t remember the exact name of the program) at the edge of PMH. Otherwise, however, I haven’t found many lab technicians or researchers. Shruuti left for a 2-week trip, but is coming back towards the end of June, so I’ll ask her more about the lab environment here.

Summary: Although Gaborone is plagued with at least one power outage a week (they almost seem to be purposely scheduled during dinner time), places such as the Princess Marina Hospital have their own back-up generator. Heck, even our rich neighbors next to Pilane Court have their own back-up generator. I believe that the Dremofuge is definitely a very marketable product in settings where power outages exist but back-up generators don’t. Again, I need to find an outreach clinic.

Other Contributions

• The Cervical Cancer Screening database:
  The IDCC only has clinic days on Tuesdays and Thursdays. Mondays, Wednesdays, and Fridays are all about the paperwork, data management, and other behind-the-scenes office work. I’ve been helping out with identifying and fixing discrepancies between their different databases for their different cervical cancer screening sites, as well as helping them catch up on the data entries into the database. I think that if there were a computer science major here to help them fix some of the coding errors, he or she would make their lives so much easier and make such a big positive impact. It’s unfortunate that I can’t help out in the data management aspect, especially since it’s this that takes up the majority of their time. Also, although the nurse enters data by hand into the Registry book, we have to take that data and enter it into the computer afterwards. One of the biggest problems is needing to enter the data in multiple times for different files.
• Updating the SOPs
  Because the patient in-take forms as well as the evaluation, treatment, and results forms have been modified and updated, the SOPs regarding how to fill out those forms need to be updated as well. Lila and I updated the SOP for the IDCC, but I will be heading over to Bontleng clinic next Monday and Tuesday to observe and update the Bontleng patient SOPs.