Days Go By

Yesterday, I traveled to Black Lion to meet with the graduating residents we trained in August. They had agreed to take a break from studying for their OB/GYN boards to talk with me about how they felt the training went and their hopes for utilizing VIA/Cryotherapy in the future. I was nervous that they would not feel comfortable being honest with me present in the room given the fact that I had organized and run the training, but they were delightfully candid. Originally, all of these focus groups were supposed to be organized and run by Melesse, an Ethiopian man with a Ph.D. in behavioral sciences that we had been paying a stipend to help us with surveys and data analysis. He had proven himself to be less than helpful despite the large salary we were paying him and eventually it came out that he had been suspended due to some disciplinary issues and now was no longer allowed to be associated with the department. So it was up to Dr. Dawit and I to run the show!

The residents had many positive things to say about the clinic, which was good, but did lament that the hands on experience was too short. We had anticipated that this would be a problem since the training was only 5 days and we had lots of material to get through, but it was difficult enough to get them such time off from their clinical duties. Due to reasons explained in my last post, very few had done additional VIA screening and only 3 out of the 9 present had done cyrotherapy, with the majority of these done by the two nurses we trained as their sole job was to run the clinic. Yet despite their lack of experience, all felt confident in their ability to screen and treat women in the future, which I think demonstrates how simple and easily implementable the method is. Our plan is to hopefully give one of the graduating residents a cryotherapy machine so that they can continue to screen for and treat precancerous lesions when they become practicing physicians in their hometowns. In other plans for the future, Dr. Dawit is hoping to integrate teaching VIA/cryotherapy into the OB/GYN curriculum and have all residents rotate through the clinic. This way, we don’t need to hold formal trainings and all of the OB/GYN residents will be exposed year after year. Of course the main problem is that we don’t have the funds to provide every resident with cryotherapy machines for when they graduate, but I’m hoping my search for a grant to cover the costs will be fruitful. After the discussion, I had each participant fill out a modified KAP survey so we could see if their knowledge and views of cervical cancer had changed after the training and also to assess their comfort with VIA/cryotherapy. While I haven’t formally analyzed the data yet, it looks like there was great knowledge retention between our training and now and that most people feel comfortable with VIA and cryotherapy. Hopefully I find the same thing at St. Paul’s next week!

As for the rest of my time, I have spent the majority of it at the hotel inputting data onto our online database. Unfortunately, all of my work requires internet and the only place where the WIFI reliably works is at the hotel. I didn’t buy my own network USB stick because I didn’t find the cost worth it as I'm only here for two weeks, so I’m at the mercy of Ethiopian WIFI, which is frequently down or too weak to support the website I use. This means that I am either in my hotel room watching FOX movies as I type away on my bed, or am in the hotel lobby, sipping Chai tea or a macchiato.  It doesn’t help that today after a whopping 15 hours of sleep, I have awoken to a burning chest and a cough reminiscent of an elephant seal. But I am proud to say that I made myself walk to a coffee shop and enjoy the gorgeous weather we’ve had here. Not a lick of rain. I curled up on a tattered chair at La Pariesienne and read my book while treating myself to a croissant sandwich and Ambo. Overall a lovely afternoon. Tonight I have decided to venture out to dinner on my own. I generally don’t like the idea of walking by myself at night, but think that the extra expense of a taxi is worth getting a change of pace. I must say I miss the days of gathering up all of my roommates and heading to a fun dinner out! I guess our stateside reunions will just have to do for now.