The technologies Rice sent with me include a gynecology backpack and portable stirrups. Dr. Kortum’s collaboration with Dr. Doreen Ramogola-Masire at the University of Botswana provided me with the opportunity to implement these designs. Unfortunately, Doreen does not do outreach trips to rural Botswana. She focuses most of her energy on the government funded screening clinics in Gaborone and therefore already has most of what the backpack contains. She did, however, find use for the stirrups at the Bontleng clinic.

Doreen’s women’s health program is structured in such a way that primary screening is done by a single nurse, Meta, at the Bontleng clinic about 2 miles from Princess Marina. Women’s cervices are examined using Visible Inspection with Acetic Acid (VIA), which reveals any precancerous lesions (highly nucleated cells uptake the acetic acid and turn white), which Meta then photographs. These pictures are reexamined by the staff and Doreen every two weeks at the Quality Assurance Meeting. Any women with particularly disconcerting lesions are sent to the LEEP clinic at Marina.

Unlike the LEEP clinic, the Bontleng clinic that Meta runs does not have stirrups. Instead, most women simply place their feet at the end of the padded examining bed. After demonstrating how the stirrups work yesterday to Meta, I left them with her to use at the Bontleng clinic. The women seemed a bit nervous to try them out of fear of falling off the bed (luckily none of them did). The only drawback of the design is that they are meant for a hard surface (like a table) and therefore the hinges do not lock into place, creating a somewhat weak joint. Laying on a cushioned surface, the planks of the stirrups rested at a slight angle, but it was not enough to negate their use.

Because the Baylor clinic is so well staffed and well run, I feel like somewhat of a burden. This is common to most internships or volunteer positions at my level of education, but is nonetheless frustrating in each instance. I am waiting to hear from the Associate Director about whether or not I can contribute to the upcoming CDC project. I know very little about the project currently, but hopefully will be able to contribute my writing. In the meantime, I have shifted most of my focus to the UPenn women’s clinic. I redesigned their screening forms to make record keeping more efficient and am building up their database. The clinic already has a data clerk hired to do this, but he is overwhelmed with work and apparently “gets flustered easily.” I found one of his ID badges at the clinic and, in good humor, have started wearing it.

Meta, the nurse from the Bontleng clinic I previously mentioned, is one the most entertaining people I have ever met. She spends a good 75% of her life laughing and is always smiling. Monika and I have even picked up her “Ehhhhhh Ma” (equivalent to “Yes Ma’am” in English). This past Thursday she informed me that she would be picking up a goat and wanted me to slaughter. I immediately turned white at the request, but accepted the offer. Fervently interested, Monika joined me for the adventure. Meta took us on a number of detours to Bokamoro Private Hospital to visit a friend, to her Aunt’s Camel Inn Lodge for a tour of the suites, and finally to her Aunt’s house. By the time we arrived, the goat has been slaughtered and skinned, and I had missed my chance for initiation into Botswana manhood. Meta made us try the fresh goat innards, which prompted Monika into a series of subtle gags, but only slightly fazed me. We then loaded the goat into her car, stopped at a supermarket for cooking oil, and headed to her house, where met her husband, son, daughter, and housekeepers. Unfortunately the power went out, but her husbands connected a car battery to power the TV so we could watch the news. It was definitely a night toremember.

I’ve reached the half point of trip, which comes as a surprise to me. Once you get past the initial adjustment and slow pace of the first week of work, life here starts to fly by. Unfortunately, my back has begun to hurt again (I had spine surgery in April to remove a herniated disc), most likely due to running too early on in my recovery or traveling with a heavy backpack. I’ve stopped running and now focus all my energy on a proper rehabilitation. I can only hope for the best while I’m here.