Work in the New Year

[Unrelated update: things in the country have settled - obviously tensions still exist and there is demand for safety and security policies, but immediate ' threats' are less]

With the new year, comes new things to do at work! I am no longer working on manuals for the system, but with a meeting to review them, I officially handed them over to MISU and washed my hands of them. Had some difficulties completing parts of them because I do not know the procedures within the unit and was not getting the answers I needed so I felt I needed something new to work on. We completed the pilot project of the paper forms before Christmas as well which was an experience. Part of me wishes that I had been hands on at the clinic, but I enjoyed the discussions that my 'assistants' started after their experiences and am happy with the completed product. I have my doubts that they will ever be used because there are so many paper forms that exist already, but they were promised and we delivered them.

January started out a bit slow - it takes a little while I guess for people to get back to work after the holidays which I found a little frustrating because of my limited time here.

I am now working with Roland on module development within the system. The reasons behind this development and getting my head around the theory of the system was an adventure unto itself, but essentially they would like to have modules for different services offered because not all clinics offer all services and they would like to minimize staff training and information captured. For example, some clinics just do VCT (voluntary counseling and testing) so they do require all the features of the system like a clinic that does ART (anti-retroviral therapy). This project was started after a meeting with someone working at the National AIDS Program. Valid points are made, but part of me feels like the system is finally getting the input needed four years ago when it was in the development stages. I am pretty heavily involved in the planning and proud that the documents I have produced first for general module planning and now specifically for the first module, VCT, are the proposal documents being distributed for review and comments. This also concerns me because I wonder about the sustainability of the planning for these modules and what will happen to the drive behind the project when I leave. I'll do as much as I can before I go and share as much as my brain as possible, but there is only so much that can be done in six months and I have to come to terms with that. This part of the project has and will continue to introduce me to directors of clinics and individuals responsible for various aspects of the health care system. I have appreciated this opportunity to hear their different opinions and perspectives.

I am also working mornings at the TB Chest Clinic in Georgetown. The director feels passionate about the GHIS and frustrated with his staff for the lack of use of the system. There are data entry clerks that enter most of the data, but it is not in real time which essentially the system is designed for. I am enjoying my experience in a clinic setting and not just a snapshot, but seeing the routine and getting to see patients go through the whole process. All the staff has been trained in the system and most are familiar with it. There are some computer skills lacking, but they can be improved with practice. Mainly the problem with training is that they are trained and told to use it, but not shown how to incorporate into usage. I'm not saying I'm the best person for the job, but I am trying my best so I hope that counts. I have seen increased usage after spending every day for a week sitting with the triage nurse. Just helping her fit the system into her routine and doing something as simple as moving the computer desk so that it is less awkward for her to access while with a patient. The pharmacy is a bit of problem because they need doctors to input the prescriptions in real time for them to be able to use the system well. My next step is to work with the doctors. There are also more nurses at the clinic and DOTS workers (Direct Observed Treatment Short course - approved treatment strategy for TB patients) which are next on my list! I much prefer being in the clinic than at the computer by myself so half days in the clinic and half days at the office make for a good balance. The goal is to have the clinic in realtime before I leave. I remain optimistic because I think I have to - somebody else can be the realist.

Working at the Chest Clinic has also gotten me involved in their World TB day plans which should be quite the event. I designed some pamphlets based on material I was given - they were really pleased with them but apparently they will print better from Corel instead of Microsoft Publisher so they are going to use my contents and someone else's designs.