[July 27, 2010]

Two weeks ago, we had finished with the first round of our microenterprise training – teaching six different concepts selected by Angela from the Barefoot MBA repertoire. With this foundation of business principles, we felt that the program could move forward to teach the implementation of those concepts.

As such, today marked the completion of our second round of training. Again, we followed a similar format, with the HIV Support Groups and Village AIDS Committees separated into four different morning or afternoon sessions. This time, the program consisted of:

• Oral review of Session 1
• Lesson: Developing an Action Plan
• Lesson: Using 6 Steps to Create a Budget
• Lesson: Learning How to Keep a Cash Flow Ledger

For the new lessons, we taught the group leaders the steps to making an action plan and budget. We concluded those lessons by asking each group to use the process (as well as provided examples on a take-home review sheet) to draft both an action plan and budget for themselves. We also distributed accounting books that they could use to keep track of their finances. For this lesson on using a cash flow ledger, we showed them an example ledger, and had them set up their books according to our organization, with separate columns for Date, Description, Money In, Money Out, and Balance.

Although I felt a similar sense of detachment from the group training (due to my continued deficiency in Chichewa), I was actually able to offer some help this time! When the time came to distribute the Accounting Books and walk through the organization of the cash flow ledger, I walked around the room checking to see if the participants were writing down the correct headings. When I noticed confused faces and blank stares from individuals, I did my best to verbalize the process. Sometimes, (I think) I was successful in communicating my message. Other times, I was able to call on the help of participants with greater English proficiency and explain the process to them. It must have been an entertaining site to see… *Ask me for a video to see my teaching in action! (Thanks to videographer Casey Nesbit!)

On her next visits to each of the groups, Angela will follow-up on the drafting of the action plans, budgets, and ensure that they are updating their accounting books. Since application of these business skills will take time to monitor, we plan to keep in touch with Angela for reports on the HIV Support Groups’ and VACs’ progress.

Even so, the question certainly arises: What next?

We have planned to leave all of the materials in a handy binder for Angela to keep. These materials include: all of the individualized lesson plans from Barefoot MBA (such that Angela can pick and choose which concepts she would like to review and teach in subsequent meetings/trainings), the lesson plans for creating an Action Plan, Budget, and Cash Flow Ledger along with a print-out of the PowerPoint slides that highlighted main points and was displayed on a projector during the training sessions, a copy of the review sheet that covered all concepts taught in the first and second parts of training and was sent home with each group, and extra accounting books.

We have discussed with Angela the immediate future of the program, and we agreed for her to conduct follow-up with each group, reporting back to us via e-mail about business progress. We’re certainly eager to see how the Support Groups and VACs will apply their acquisition of new business knowledge, and hope that we have broken ground for this new program for microenterprise training at St. Gabriel’s Hospital.

 [July 20, 2010]

We’ve taken a break with our microenterprise training to bring Sally centrifuge (the hand-powered centrifuge testing for hematocrit as a measure of anemia) and the NoHands portable handwashing device to St. Gabriel’s mobile clinic.

As a handy reference:

• Mobile clinic – this service provided by St. Gabriel’s nurses and hospital personnel specifically brings Antenatal and Pediatric care to patients in surrounding villages. A car loaded up with staff and supplies heads out to a village one or two times a month, where eager patients wait for check-ups, testing, immunizations, and nurse consultations. Although there are no visits from clinical officers and patients must make a trip to the hospital for serious problems or further lab testing, this outreach program brings healthcare to the frontline convenience of the patients.
• Sally centrifuge – a BTB technology for a hand-powered centrifuge used to test hematocrit levels and serve as a diagnostic test for anemia. This technology was developed by Lila and Lauren, and is the same one that I mentioned in a previous post.
• NoHands portable handwashing device – another BTB technology for providing running water in the field. A plastic water carrier is capped with a spigot attached to a string that connects to a levered foot pedal. As the foot pedal is pressed, the string pulls on the spigot and water descends from the opening. The water carrier sits atop a sturdy construction tripod and can be adjusted to a desired height. This technology was developed by a Rice senior design team during the 2009-2010 school year.

Given the limited car space and eagerness of other volunteers to witness the mobile clinic in action, we were lucky enough to accompany St. Gabriel’s on two different outings – both of which were quite the experience!

Despite having gone out into the field to visit the HIV Support Groups, this mobile clinic outing was a chance to see healthcare being concretely delivered to patients. The first location was more bare: there was only one covered room that housed the nurse’s consultation. For taking vitals as well as testing, the hospital staff was situated outside, working from the bed of the pickup truck as well as off a few feet away, from the ground. This set-up was a serious concern, as our hematocrit testing was one of the diagnostics being conducted for pregnant mothers. With the supplies simply spread out (albeit within carrying containers and in sterile packages) on the dirt, Gift sat on a crate as patients lined up and kneeled down to greet him at ground-level. He recorded their information and then proceeded to take a finger-prick for blood samples. When we had enough samples for a complete run of the centrifuge, we spun down 30 capillary tubes within ten minutes of hand pumping and were able to read the results from an accompanying reader card.

We were relieved to have brought the handwashing device, as we were able to send patients to the water stand to wash up with soap prior to the finger prick. Watching the mothers use the handwashing device, we noticed how intuitive the device was. Of course, immediately after setting up, we all had a go with the handwashing device – under the curious stares of the Malawian mothers. While our demonstration probably helped them understand more of what the mysterious technology was, there still seemed to be no difficulties with usage of the device by locals.

The second site had many more antenatal mothers arrive at the clinic. There was even a long line ready and waiting as we pulled up in the hospital car. Fortunately, this clinic was housed at a community center, and we were able to set up both testing and nurse consultation stations indoors. The process followed suit – with workers first gathering the patients’ body weight and vitals, sending them for testing with me, Jasper, and Gift, and then directing them to a visit with a nurse.

Both outings were incredibly busy, time-consuming, and left me completely worn out on the drive back to the hospital. Stationed with Sally centrifuge, we saw and tested patient after patient, with the only break between mothers being the ten minutes for hand pumping of the centrifuge. Nevertheless, I was extremely pleased to see both technologies that we brought being used to their potential. St. Gabriel’s mobile clinic is such an inspiring program, and I’m glad we were able to contribute our BTB technologies.