Category: Summer 2008
Binny Chokshi’s TB Bolo Update
Protocol:
We submitted the protocol to Dr. Flabou last wednesday. He emailed back with comments early this week, the most important being that we needed a signature from the Chef de Vilage of Sikoro and the Mayor. Once we fixed it up and got the signatures, Dr. Flabou told us to bring the protocol directly to the Faculty of Medicine (at Point G) which we did today. We met with the guy who seemed to be in charge of the Commite de Etique submissions, and he told us many things that we had not heard before. The two most important being 1.) We need to submit the protocol by Tuesday, in order for it to be seen that Saturday. This means that we will not go to the Committee until next Saturday July 26th. 2.) The cost of submission to the committee (as i think karamoko has written) is $500+. (S#e^%*Fge&^bK)!!!!!
Peer Educators:
We met with them last week, as I had emailed. It was a great productive discussion, that resulted in the decision to have a salary increase for the two month pilot period. We are meeting with them again tomorrow with a few goals in mind: 1.) To let them know that the budget was a go, and salary increase approved. 2.) To go over the curriculum with all 11 educators in French/Bambara, 3.) To go over the logistics of the TB BOLO project (specifically those that make it different from here Bolo, i.e cough questionaire, active screening for at risk patient) 4.) Introduce them to Salimata, from the clinic, who handles all the TB cases in Sikoro. We have asked Salimata to explain to the peer educators the process of a Tb patient in Sikoro, where to get tested, where to get meds, who administers meds, etc.
Binny Chokshi’s Week Two Report
Hello—
Last Monday I went to Point G and “shadowed” Dr. Diallo (so handsome! Haha.) I sat with him in his office as he saw patients for the morning. He’s definitely got a mix of visits. The next day I went back and rounded on the TB floor with the medical students and Dr. Patrice. He’s wonderful, does research (Ousmane is his ultimate boss) on HIV and TB and is looking at cytokine levels at different time points. His English is great, and he was very nice to make sure to explain the important points of each patient to me. In fact, if I was ever out of sight all of a sudden I would hear “Where’s Bin-Tu?” He heads the TB rounds to keep up with clinical medicine. I think he’s a great person to have be connected with GAIA, because he’s a little less busy than the big wigs, he’s much more accessible and willing to help. He spent over two hours with me a few days later looking over the TB curriculum suggesting small but helpful changes (i.e people in Mali don’t know what stress is, therefore they won’t really understand that its connected to active TB, haha.)
Binny Chokshi’s Week One Report
Most of the past few days was spent shaping up the TB curriculum and with a lot of sophies help we translated it into French. We decided to lessen the emphasis on co-infection in light of stigmatizing hiv and/or tb patients.
Sophie did a great job of presenting the curriculum to the Peer Educators yesterday. We met with them for approximately an hour (they gather the last friday of every month at the gaia house to get their pay etc.) We had printed out copies for them to share. Sophie engaged one of the peer educators to read the curriculum aloud (& translate into bambara) which was very helpful. Some were more receptive than others, asking questions etc, but everybody seems to have an interest. Karamoko chimed in often to clarify some medical terms (such as resistance, bacteria, etc.) A major question that came up was how kissing individuals with Tb can be allowed. I’m going to do some more research so that we can present this information more clearly. Most took a copy home with them and are going to read it over and prepare any questions that they have, which we will discuss when we meet with them next Friday.
Today in Sikoro–or Any Place on Earth
For pictures
http://web.mac.com/dr.annie.degroot/iWeb/Site/Bamako%20June%2015.html
But start with the words – the simple words of a doctor speaking to a patient, a very thin woman in a yellow headscarf, who is 28 years old and who waited for over two hours to have her turn in his office today. A small child sits quietly in her lap. The doctor asks her some questions. She speaks softly, coughing as she is answering. A medical student looks at her lab results. She has 20 T cells. He asks her if she had ever been given medication before, and she says yes, but it was a long time ago, and the medicine had run out. The doctor pauses, considering what to do. Her life is in danger, but she has no money to pay for emergency treatment, and the hospital is far away.