Frank’s Second Trip to Africa: Part 1

Last Updated on Thursday, 5 August 2004 08:49 Written by Steve Thursday, 5 August 2004 08:49

A friend of mine, Frank Ordway, has been working with the U of Washington and a few volunteers to help AIDS clinics in Africa migrate from paper-based systems to electronic ones. This series is made up of emails he sent back while on his second trip to Africa. His previous trip is documented here.

I arrived safely, soundly and largely pain free in Kampala two days ago. 3 flights, (Seattle-Amsterdam-Nairobi-Kampala) in a total of 30 hours from Bellingham with 21 hours of flight time, we live in a remarkable age. I got exit rows all the way, including sitting next to another gentleman with a herniated disc and we took turns lying on the ground and taking pain pills. To give you a sense of my state of mind at the time, on the flight from Amsterdam to Nairobi I cried like a baby watching the Last Samurai.

Upon arrival here at midnight I was met by half of the clinic staff with hugs, smiles and laughter at our good fortune to be seeing each other again. After a good night’s sleep we went to the clinic first thing Thursday morning.

In my 10 years of doing technology assistance and literally serving hundreds of groups, I can safely say that this organization is the most adept, empowered and undaunted organization I have ever had the pleasure of serving. When we were here last year we set up a network with largely pirated software, questionable hardware and intermittent power. The clinic provided a variety of services, but focused primarily on three areas of service for youth (WHO defined as 14-24)

• STD Treatment and counseling
• Volunteer Testing and Counseling for HIV
• General Sexual education and counseling

Due to a variety of factors, their ability to deliver consistent service in all these areas was challenging. Lack of inventory control, access to trained counselors, service delivery flow issues, overuse of paper, limited space etc. all impacted their capacity. These were the issues we were confronted with in our original 5 working days last year.

By the time we left last year they began using a DOS based flat file system to track their services in these areas. The program was limited at best but the staff here is remarkably inventive. They were able to establish data entry protocols and exports to Excel for analysis.

Upon arrival yesterday, on the front of the main admin building, was a glass case with 8 different reports detailing their service delivery for the previous month. They have weekly management meetings, and monthly whole staff meeting to analyze the data they are now tracking. The results are remarkable-

• More accurate counts have allowed them to manage their inventory of drugs, condoms and HIV testing kits so they do not run out. They are more proactive in acquiring the resources they need ahead of time and have the data to back up their requests to various powers that be. Graft and corruption are rampant, so having this data is critical in their ability to acquire the needed resources without having to resort to bribes.
• Better distribution of counseling and medical talent has allowed them to deliver all their major services every day, as opposed to having them available on certain days of the week. By skill sharing and rotating responsibilities, care giver burn out has been dramatically reduced.
• By tracking where their clients are coming from they have starting using there own buses to organize the visits by out of town clients to reduce fatigue and frustration.
• They do not turn people away any more! Because they have been able to deliver their services more often and more efficiently, they are able to deal with the daily demand. They serve over 120 clients a day in 6 hours and close to 2800 clients a month. Last year it was 65 a day, in 8 hours, offering fewer services and turning away people every day.
• They now have the capacity to have added daily pre-natal services as well.

I know have a penchant for going off the deep end, so here we go. After seeing the effects of our assistance I have never felt prouder in my life. Proud to have the opportunity, proud to work with such a remarkable staff here at the clinic, proud of the team from Seattle team that has been responsible for puling this off, and proud to have coworkers like all of you with your high standards and professionalism. I channel your energy to support me. I would give anything to bottle my sense of gratification and up and send it to you all. Our organization has had a lot of recent struggles that I know has sapped energy and diverted some our attention from the work we all really want to be doing. Rest assured our work matters, A lot.

To know that this work has actually saved lives is one of the most humbling, emotional and indescribable events in my life. To be hugged and thanked by patients…I am not worthy. I cried today not because of pain killers and exhaustion and Hollywood schmaltz, but because of simple sense of grace I feel has touched me. I wish I could attach that sense to this email for all of you to share.

Day 2

Over the next 24 hours, we hope to install the new database, convert all the viable data from the DOS system, upgrade RAM, Operating systems and office software. And spend next week training, troubleshooting and documenting. I have connected with a local IT miracle worker, Michael, who will help me take all the workstations to a location where we have access to a “high speed” (46k) line-of-sight wireless to be able to download all the various patches and service packs for their pc’s over the weekend (there is no Internet access here at the clinic). I asked Michael if there was a Ugandan word for Miracle Worker, Yesveni was his response. He asked me if I had such a word and I told at that where I work our miracle worker is called “Charlie” [our IT guy at NPower]. Now the staff here all calls him Charlie.

It the midst of all the technical work, our little project has got the attention of the Ugandan Ministry of Health and in turn every press outlet in the area. So this morning, as we deal with power outages, VBS import script debugging and what not, we are confronted with a muddy parking lot full of reporters from national papers, radio and TV stations. Frank Schott and I are about to be interviewed by this throng. I will gather the stories as I can and bring them home.

Emily D [NPower's communications guru], could you send me some quick talking points?

Our hopes last year where that by helping this clinic refine its services, that the model of their approach could be codified and used to establish best practices in clinics across Uganda and hopefully even further. The Ministry of Health here is asking the clinic to start putting together a start-up kit so part of the dream is coming to fruition. Next week when I am leading a summit in Addis Adaba that will be attended by other clinic directors and public service providers from around the world, we will use the case study of this project as the basis for our efforts (an endeavor which has filled me with more stress than I have felt in quite some time, if ever). Lindsay and Emily B, I am trying to bring your expertise and enthusiasm for making these kinds of gatherings truly empowering events to bear. I EVEN HAVE CREATED CHECKLISTS! That’s right. Frank Ordway has a created a checklist with duties, times and deliverables. Our original dream is actually happening. The support and fostering of this project by the folks at the Evans School must be mentioned, it would not be happening without their care and leadership. The decision by the NPower Board to donate time to these kinds of projects must also be mentioned and given thanks. Not that we work internationally!