Great coffee! Tom, Ed and I left the guest house this morning at 7:30 AM for the Grande Cafe "downtown" Bangui. We took a break from the daily grind and enjoyed a cup of Cafe au Lait and a pastry. From there we scurried back to the guest house to pick up Rebecca, Christophe and Luther (Rebecca is the nurse in Bangui, Christophe is the one responsible for orphan program in Bangui and Luther is the one responsible for orphan program in Berberati). We had a 9:00 AM meeting with the leadership of the city's only hospital for children, National Pediatric Center.
The 6 of us met with 6 representatives in the Assistant Administrator's office until 10:45 AM. It was another great meeting where we built new relationships between the our staff and the hospitals officials. These relationships are very valuable because we send our orphaned children to this hospital for care ranging from broken bones to AIDS treatment. Having a relationship with the leadership reduces hassels in the admitting the orphans, making payment, and getting help in the communities with their social programs.
During the meeting we discovered that this one little hospital is "caring" for 1,342 HIV positive children, in addition to all of the other children they serve. The World Bank is providing ALL of the AIDS anti-retroviral drugs at the moment. For them, the challenge is not access to these drugs, but the limitation of the number of beds (patients they can accommodate) and the amount of follow up work in once the child returns to the community (to make sure that they continue to take the meds and take them properly). Interested fact: One of the reasons that hospitals in the developing world struggle so much that 90% of all the fees charged for service go to pay for contract staff. That leaves very little for operating income, improvement, etc. In this case, the government does pay for most of the basic operating costs on a monthly basis. (see inset photo of hospital).
One of the people in the meeting shared with us that issues do exist for people diagnosed with HIV in some communities. For example, if you are HIV positive, you qualify for the drugs and some food from the World Food Program. However, the family may decide to "kick out" the HIV positive person or child. So to survive, the person sells some of the food to survive thereby weakening themselves at a time when they need that nutrition urgently.
Off to another meeting at 11:00 AM with one of the 10 regional Ministry of Health centers. The one we met with is in the North side of town and is responsible for 2 states, Ombella Mpoko and Lo Baye, covering a combined population of 676,435 (11% of country). Most of our 8 centers in the city of Bangui are in these areas so this was a strategic meeting. The meeting was with a man named Fidel and it was extremely valuable - praise be to the Lord! We learned that this man would connect us to all of the programs happening in the region for vaccinations and health training. For example, we learned that just recently, every child can have all of the core vaccinations for free, like DPT, polio, yellow fever, BCG, etc. Rebecca was excited to say the least. We learned about how the regional office works so we can leverage this information in other regions of the country as well.
The 6 of us met with 6 representatives in the Assistant Administrator's office until 10:45 AM. It was another great meeting where we built new relationships between the our staff and the hospitals officials. These relationships are very valuable because we send our orphaned children to this hospital for care ranging from broken bones to AIDS treatment. Having a relationship with the leadership reduces hassels in the admitting the orphans, making payment, and getting help in the communities with their social programs.
During the meeting we discovered that this one little hospital is "caring" for 1,342 HIV positive children, in addition to all of the other children they serve. The World Bank is providing ALL of the AIDS anti-retroviral drugs at the moment. For them, the challenge is not access to these drugs, but the limitation of the number of beds (patients they can accommodate) and the amount of follow up work in once the child returns to the community (to make sure that they continue to take the meds and take them properly). Interested fact: One of the reasons that hospitals in the developing world struggle so much that 90% of all the fees charged for service go to pay for contract staff. That leaves very little for operating income, improvement, etc. In this case, the government does pay for most of the basic operating costs on a monthly basis. (see inset photo of hospital).
One of the people in the meeting shared with us that issues do exist for people diagnosed with HIV in some communities. For example, if you are HIV positive, you qualify for the drugs and some food from the World Food Program. However, the family may decide to "kick out" the HIV positive person or child. So to survive, the person sells some of the food to survive thereby weakening themselves at a time when they need that nutrition urgently.
Off to another meeting at 11:00 AM with one of the 10 regional Ministry of Health centers. The one we met with is in the North side of town and is responsible for 2 states, Ombella Mpoko and Lo Baye, covering a combined population of 676,435 (11% of country). Most of our 8 centers in the city of Bangui are in these areas so this was a strategic meeting. The meeting was with a man named Fidel and it was extremely valuable - praise be to the Lord! We learned that this man would connect us to all of the programs happening in the region for vaccinations and health training. For example, we learned that just recently, every child can have all of the core vaccinations for free, like DPT, polio, yellow fever, BCG, etc. Rebecca was excited to say the least. We learned about how the regional office works so we can leverage this information in other regions of the country as well.
This was also a great lead as this center is responsible for sanitation - including water works, latrines, sewer and garbage. We have an immediate issue with contaminated water in Kiamba. We hope this new connection can help us make progress on getting issues in that area resolved.
Around 1:00 PM we made it back to the guest house where we all had lunch and then took a break until 2:00 PM. Are new focus was to boil down all of our findings to 2 of the most important things we need to improve/fix and then work on solutions that don't include budget increases or major changes in staffing, etc.
After about one hour, we decided that we can best improve overall health by doing the following 4 things:
1. Implement a standard Grow Chart Record, tracking height and weight quarterly.
2. Implement a semi-annual Parasite Management plan, October and April.
3. Complete the vaccinations as needed for all children.
4. Begin to develop a Community Health Training program.
Tomorrow, we will be working on improving feeding through frequency, community training for small gardens micro-nutrients and identification of higher nutrition value foods. Since dinner, Tom and I spent some time working on budget issues and then I worked on these notes until 9:30 PM. Another 13 hour work day ;-0
While finishing this, the power went out - I am sitting in the dark typing on my laptop.
-Matt Storer
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