October 02

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Three months in Abuja

Greetings from Abuja, Nigeria,

My assignment is coming to its third month, I am about to have my annual leave and have a break from the African “winter”. For the local people it is winter indeed and you can clearly see it in them wearing long sleeve jackets and pullovers when it gets down to 20 degrees Celsius. To be honest, even being an active outdoor person my body clock wasn’t prepared to switch from the dry heat to that sticky, wet and extremely humid air during July, August and September. In fact I saw the sun about ten times until end of September. It is changing now and right at this moment the weather resembles more the European late spring – bright days with relatively good temperature gradient. The thunderstorms became more predictable – starting with distinct squall line, followed by strong winds and heavy rain. Before that, during last months, there was only overcast with heavy rains. It was funny the way it started raining – without any sign, someone just unzips the bag and tons of water pour down.

I really enjoy watching the African supercells from the balcony of the house where we live. These monsters may last for 5-6 hours cracking out the sky with lightnings while the roof is near to come off under the heavy winds and rain. This is something so spectacular that must be seen and even I am not sure if any video will render entirely what happens outside.

The things around the work developed in an unexpected way. Originally I had to work on the malaria program but shortly after I started they assigned me to a program called “Labs”. I did some stuff on the malaria tasks but now I am working entirely on the Labs and I would say my knowledge and skills found good use there.

The program aims to strengthen the efficiency of the laboratory network, increase the lab personnel capabilities, reduce the turnaround time (TAT) between the facilities and labs and many more. All these high level goals are embedded in projects. I caught some of them in the middle, in others they involved me from the beginning. But having being focused on the labs gave me decent understanding on the situation in the country which is not pink by the way. First of all, the blood samples TAT is really high – about 90 days currently for Viral Load and it’s been even higher before CHAI to involve Riders to transport the samples between facility and lab in Kaduna state. 90 days TAT means – I go to the facility, give blood for testing to see if I have HIV and receive my results after 3 months. I worked on data from surveys in the facilities and saw cases where it previously took about 9 months until the facility can get back the blood sample result. Not to mention the countless cases where blood samples have been lost or damaged during transportation. Next step is to reduce further TAT by mapping the routes between labs and facilities. Shout out to Riders and we hope to make Kaduna state great again! 🙂

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Another interesting project where we still work is the USSD for result delivery project. USSD is quite old technology which I honestly didn’t remember when I got involved. Shortly, it is a way to communicate with the network carrier through phones that don’t need to be “smart” and even the old Nokia 3300 could perfectly do the job. These is when you call those “secret” codes – *#7780#, *#06# and so on. As I mentioned above the TAT is the time until the patient gets back the blood sample result on a hard paper copy delivered by Riders. CHAI devised faster way to receive the results through the USSD technology. Every lab is equipped with a big, complicated machine which processes the blood samples. Once the results are ready, the lab scientist uploads them into newly build web-site (National Dashboard database). From there they can be accessed by the doctors in facilities via specially designed USSD code and there’s no need to wait until the hard copy is returned to understand whether the patient result. I suppose first question coming to someone’s mind might be – “Can’t they use just internet to do all this?”. Yes, but internet is not always available in the rural areas whereas USSD use only the mobile network, transports much less data and is a way more cheaper and reliable solution in this case.

At the beginning of the project we had to first present and introduce the whole project to 10 selected facilities, then train the focal persons, do a follow up and collect their feedback through surveys. I enjoyed that part quite a lot as it entailed visits and direct meetings with doctors from facilities and work with government representatives.

On the pictures: left-bottom – my colleague Tyra delivers presentation on the USSD technology to HCWs, left-top – Tyra and me in front of Mpape PHC, right – with Mr. Nuhu Aliyu, government official working on the National AIDS and STIs Control Programme.

There are 4 main mobile operators in Nigeria and the solution is deployed only 9mobile at the moment. Unfortunately not all operators have good signal everywhere and sometimes the service cannot be reached. Next step is to roll the solution out on MTN to ensure wider coverage. I mentioned above the National Dashboard which is a web-site where one can see the current HIV picture in Nigeria on aggregate and state level. My work here is mainly focused on testing the site functionalities, provide suggestions and even writing SQL queries to verify the data. I am really happy with that opportunity even though the site is written in PHP and uses Flash. 🙂

IMG_20170915_123010484 And for the end let me present to you our new neighbor – Henry the Porter. He flew in from somewhere, shares the house with us and is Jurgen’s best friend. 🙂