[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.