This morning, we started our day off with a trip to Makama Hospital. We had previously visited this facility to view antenatal care day, so because of our curiosity to learn more, we knew we had to come back for an opportunity to interview and talk with healthcare workers. That is exactly what we were able to do today. We got to talk to some nurses, staff, and healthcare workers. When we initially walked in, we saw that a health talk was being given so we watched for a short period of time before going to a back room to talk to 3 nurses, 2 of them being midwives. It was great to learn about how they do health talks on different topics, what they do to help sickle cell disease patients, and to see how deeply they are helping the community. We also discussed their path to becoming healthcare workers and what they learned about sickle cell disease in their schooling. This was helpful in us being able to identify any gaps that could be occurring in nursing school education systems, in order to work to supplement them with our materials and workshops we are continuously refining.
After Makama, we began our drive to Fullah 2, another PHU across town. As we drove closer and closer to the PHU, one of the giant mountains that surrounds Makeni grew on the horizon. Pulling our car up to Fullah-2 PHU, we realized that the health clinic sat right on the base of the mountain; it was beautiful!
We entered the PHU and were greeted by many nurses. It appeared that they were in the midst of an immunization day, but they still had time to speak with us. Three nurses gladly sat down with us and we were able to conduct our interview.
Using the new interview questions, we received the useful information we needed: protocols for patients presenting bone pain, recommended SCD management techniques, referral specifics, and community outreach data. However, we did hear one unusual thing: bone syrup. It is apparently given to patients during SCD crises.
After wrapping up our interview, our interviewees were curious to know more about the disease. Trying not to get into too many specifics, since we are not medical practitioners, we explained useful information about inheritance patterns, folic acid, and avoiding things like tying up limbs during SCD crises. Then, as we waited for Baima, our driver, to return, we ventured up the mountain to take some photos, and Hamsa joined in on the local soccer game!
Transitioning from Fullah 2, we proceeded to Fullah 1, situated a mere 15 km away. Upon our arrival at the Fullah 1 Community Health Post, we were warmly welcomed by their dedicated healthcare worker. However, there was a discernible undertone of caution in her approach. Jake, representing our team, elucidated our team’s mission and objectives. Clearly, the community health worker’s dedication to her community’s well-being was evident when she promptly contacted the District Medical Officer to verify our intentions.
In situations like these, language barriers can often pose significant challenges. Fortunately, our proficient translator, Joe Sesay, was on hand to ensure clear communication. Joe adeptly relayed our mission and intentions to the District Medical Officer in Krio, guaranteeing that every nuance was accurately conveyed. Thanks to his precise communication, we were able to bridge the initial trust deficit. With a nod of approval from the District Medical Officer, the community healthcare worker graciously consented to an interview.
Throughout this process, Norman took the lead in guiding the dialogue. The rest of our team played a supportive role, contributing by posing essential supplementary questions. It was these engagements that proved pivotal in garnering the insights for which we had embarked on this journey.
Finally, after returning from a long day of work, we had one final meeting at WHI. Prof. Joseph invited one of his former students, a CHO at a hospital an hour or so away. He provided some really helpful insight, and was one of the most knowledgable CHOs we had spoken to. We finished the day by transcribing and enjoying beans, rice, and peanut sauce!