Tuesday, July 12, 2016

Solved by a glass of wine


I will honestly tell all of you I have been partially selfish for not starting to work on a very important program here at the hospital. You see, I am a lost case – I mean, in most cases I get lost; anywhere, but here it’s worse. In most towns the infrastructure is lacking. There are no resources that goes into planning, therefore streets are not named, neighborhoods have grey areas, and homes are not numbered.  There is a nomadic theme, people reside in distant huts and the locations are not in an organized fashion.  You can imagine the stress I’ve had walking to new locations. People are always willing to assist, but the directions are like, “It’s near where they kill the cows”, or “It’s before the new house that Jobja Kossa built for his new wife.” I usually feel desolate.  I am pinched with that feeling when it comes to this project; buscas; that is Portuguese for “in search of”.  Hospitals assign workers, “activists”, to go and locate individuals that have abandoned their HIV treatment.  These workers take just the names and the area the patient lives near, and then go looking for them.  It’s like being asked to look for Paula on that side of the river, with a wave of the hand. “Where?”
Aside for the logistics, this concept of service is a bit odd for a foreigner; why wouldn’t patients return for health services? We would think that they either moved or have died, why go to search for them and tell them to come back with you? I can’t rationalize the service, being a structured American. I don’t dare ask because they would shrug and wonder why I doubt that activity. I think it has to do with the community group culture – we will go get them, their ours. I respect that spirit, but this method has a 2% success rate.
I’ve avoided working with the buscas partially because of the lack of my familiarity outside of the center and because of the dismal outcomes. Until now, a great conversation at a party ended up to be the best suggestion. I was reminding how this other project dealing with Malaria in my village has what is similar to a census report on population done two years ago; the houses were numbered and the residents were listed.  They have a technical phone book/GPS on a tablet!
 THIS COULD BE LINK TO THE ABANDONED PATIENTS!! 


After a conversation with one hospital supervisor, we visited the administrator of the other organization and the idea was endorsed. The idea is just a small start but I’m selfishly happy because of the possibility to work in these areas and find my way back!  A possible solution over a glass of wine; not bad.