A Diesel-Fueled Response

Today, Alex and I headed into the field. The goal was to find seven patients - the hospital had been alerted of their declining health, by SMS, through seven different CHWs. The motorbike-enabled, text-message-guided journey through the catchment area completed a (once) theoretical cycle: The CHWs surveying communities, then communicating their most urgent needs; the hospital gathering resources (diesel, drugs, and medical advice), then traveling to the villages.

Often, we stopped by the CHW's home. Above, Pascalia directs Alex to the patient's location. After the picture, she ran home, put on her St. Gabriel's Hospital 'Positive Living' shirt, and joined us for the consult.

A brief overview of some of the cases:

- An HIV-positive man, on ARVs, with Karposi's Sarcoma and wet beriberi.

- A 13-year-old girl with stomach cancer and massive ascites. Pascalia is the closest CHW, but her bicycle 'ambulance' is not operable. So, we texted Moreen, who is just a few villages away. She'll bring her ambulance, and get the girl to the hospital.

- A 72-year-old man, who is sputum-positive for TB, and was complaining of severe joint pains.

- An man, suffering from epilepsy, fell into a fire two weeks ago. He has developed a massive ulcer on his left heel. Left, Alex is explaining how to wrap gauze. The man happily let us take a picture of the scene.

We met with the hospital staff when we returned - after traveling 100 km in 6 hours, and visiting 7 different villages. Everyone agreed that the day was a success.

The entire hospital staff is now fully aware of the project and its goals. We're all moving in the same direction. The consensus is that a second, simple cycle, once disseminated, will greatly aid follow-up and monitoring programs: The medical staff (looking to follow up on a TB patient, for example) consulting the CHW map, and contacting the nearest CHW; the CHW checking on the patient, and responding to the hospital re: their status.

Tomorrow, we train another 15 CHWs.