Happy New Year to you all. My sincere best wishes, good health as we pursue our dreams and fulfillment.
Ubuntu is an idea from Southern Africa region which means “human-ness” and often translated as “humanity towards others”.
On arrival for my PULSE assignment, I was briefed about a major challenge JHPIEGO office, Zambia is facing on DBS (Dried Blood Spot) sample collection at the healthcare facilities where is has programmes on Mother-Child Health, dispatch to central locations at provincial head quarters country wide and receipt at the main laboratory at the capital-Lusaka. After analysis the results are then sent back through same channel. This whole process takes minimum 6 months for “lucky” subjects, on average it has been taking one year.
In a nationwide stakeholder meeting held in October, 2013 (Livingtone, Zambia) only 1396 samples with results had been documented by the Ministry of Health (MoH) a very low number for the many Mother Child Healthcare Programmes whose main pillar is to prevent Mother to Child (Infant) HIV infections. Evident there is a gap to be addressed. I had this as my objective to understand, analyse the problem and formulate solution/recommend solution.
This involved having meetings with other partners (NGO’s) learn their best practises, visiting the central laboratory doing the analysis to understand the process and face to face meetings with selected healthcare personnel in various parts of the country. In these meetings I was able to assess their challenges and also collected information useful for follow up with central laboratory as well how to address the problem. Allow me to take you through the process briefly.
Dried Blood Spot (DBS) testing is an easy inexpensive way of collecting, shipping and storing blood samples. They are less biohazard risk to handlers in comparison to liquid specimen. In the bio sampling blood samples are blotted and dried on filter paper. The dried samples can then be easily shipped to an analytical laboratory and analysed using methods such as DNA amplification (PCR) giving precise early diagnosis. DBS are collected during post-natal clinic visits at 6 weeks and 1 year
The specimens are collected by applying a few drops of blood drawn by lancet from finger onto an absorbent filter paper. It is then allowed to dry by thoroughly saturating the paper and air dried for a few hours. These specimens are then stored in desiccants (plastic bags) to reduce humidity and helps in keeping at ambient temperatures even in tropical climates.
Technicians at the laboratory then separate a small disc of the saturated paper either manually-hole punch or automation. The ‘blood’ is ‘washed’ with a solvent then taken to DNA amplication machines.
This technology is useful for diagnosis of HIV positive infants in resource poor settings. The samples have a long lifespan with reduced requirement for refrigeration. This has been useful in Mother Child Healthcare programmes whose main pillar is preventing Mother to Infant HIV infections.
With the results delaying to reach the facilities spread out across the country it becomes difficult to ascertain the HIV status of the infant early and make informed appropriate decision on when to initiate therapy when there is medical reason to.
Accompanied by two JHPIEGO staff and HIV/AIDs Prevention Manager who is also Major from Zambia Defence Force we visited the selected healthcare facilities in the Western, Lusaka, and Eastern Provinces. The healthcare facilities are under care of Zambia Defence Force but offer extended service to the neighbouring communities-JHPIEGO and Department of Defence have partnered to improve access to healthcare and Mother-Child Health.
I have taken the initiative to follow up the pending results with the central laboratory at the capital they were brought to my attention during my field visit. Long term, I have recommended a monthly postal courier service and also have advanced discussions with IT for innovative telephony solution-using SMS for tracking of the shipment and the results. This should help in Mother-Child Healthcare in Preventing Mother to Child Transmission.
Along the way from Western part of Zambia (Luena and Kaoma) we stopped by the road side to buy some mangoes. I was touched by the resilience of family selling mangoes to make ends meet. The girl on this photo had unripe mangoes and she was from a different family. As my colleagues bought ripe mangoes, she couldn’t sell. I saw face of desperation, she had courage to ask me in broken English to buy from her-I had taken notice on her efforts, my mind was greatly disturbed how I can help. I gave her 50 Kwacha asked her to buy school uniform when the term opens.
It bothers me how many of such girls face challenges to access education and have the positive impact to the communities we leave in. Philanthropy for me is love for humanity, it is ‘Ubuntu’, it is love for humanity, helping each other to bring a difference in people’s lives.
I will share more pictures and additional stories once I fix my phone that fell and screen cracked.