[Author Megan Jordan is a rising 2nd year medical student at UNC.]
Greetings from Malawi! My summer project in Malawi involves working with the Community Department at UNC Project, a group of employees who follow up with study participants and trace patients who are lost-to-follow-up. I’m working on a redesign of the tracing form and tracing database they use, in order to better capture information about reasons for non-compliance with study visits and procedures. The new form and database will hopefully more accurately collect geographic and demographic data about study participants. I’m also working on quantitative and qualitative analysis of patient demographics and study retention by occupation, location, and marital status.
The first part of last week I spent meeting with the Community Department at Tidziwe, finalizing the tracing form, and working on some very basic preliminary analysis about demographic trends among patients who are lost-to-follow-up in clinical trials at the UNC Project. On Thursday, the bwanas (bosses) returned from their conference in Mangochi, and I had a meeting with them to discuss my progress and plans for the next few weeks. On Friday I had a training with the tracing teams, teaching them how to collect information on the new form and trying my darnedest to persuade them that it will make their lives easier. They were clearly skeptical – but we’re piloting the form this week and I’m excited about getting their comments and ultimately having a system that actually works.
For the next three weeks, I’ll finish designing a new database that follows easily from the form, and probably my last week here I’ll pilot-test that with the people in data management. During this time and when I return to the U.S. I’m going to be working on a more qualitative analysis of reasons for non-compliance among female patients in particular. There are a whole lot of spousal issues that keep women from staying enrolled in studies, and I really think that’s something that needs investigating. If I have time, I’ll be working with the two students here from the geography department on a study of HIV prevalence rates by geographic area.
On Friday (Happy Birthday America!) after the training meeting, Irving Hoffman (UNC Associate Professor of Medicine and International Director of UNC Project) invited Emily and me to have lunch with a Malawian friend of his, Michael. We drove out to Kauma, a relatively young squatters’ village on the outskirts of town, and had a fantastic, authentic meal of nsima, rice, chicken, greens, and boiled pumpkin – courtesy of Michael’s wife Mary.
After lunch the guesthouse crew departed to celebrate the Fourth of July at Senga Bay, on the lake. We also hopefully gave Chris Sellers a good farewell party, as it’s his last weekend here before returning to the states to begin his MS4 year. Everyone who came camping with our group had instructions to dress as his or her favorite American. Unfortunately, while packing for Malawi, I made a point to leave at home: a) costume pieces, and b) any items of clothing that would unequivocally distinguish me as definitively American…so I didn’t have a lot to work with. As it turned out, everyone who dressed up as Americans (with the notable exception of Chris) wasn’t American.
We managed to do the Fourth in style…grilling out, drinking beer, and fireworks! It was a lovely time, but Emily and I went to sleep pretty early…so we could get up and take pictures of the sunrise!