Important Lessons

I realized that I made my first significant mistake in my research this week. In my initial observations of the patient flow in the PMTCT clinic, I talked to the wrong people and was mislead to believe that all HIV + patients go through the antenatal clinic first for their initial visits. To make a long story short, they recently changed the patient flow and now all HIV+ patients have all of their antenatal clinic visits in the place I was originally supposed to implement a cough monitor! My implementation in the antenatal clinic would have worked great 6 months ago before the transition, however, now I am back to square one.

Luckily, it is only week 2 of our screening, and I'll be able to use the data collected to do a comparison study later sooo hakuna matata.

Anyway, my mentor wrote me a great email in response to my mistake:

Welcome to Kenya and OR (operations research) work in the developing world.

Lessons learned:

1.) Talk to everyone.

2.) Talk to everyone again.

3.) Talk to the heads and talk to the people in the trenches

4.) Walk the walk- meaning follow on the ground where you think the patients will be

5.) The most important lesson- ANYTHING THAT CAN GO WRONG WILL GO WRONG.

I am finding the challenges of conducting operations research in an entirely different culture and resource poor healthcare system to be the aspects I enjoy most about this work. There are moments that I feel like an undercover investigator attempting to unravel and understand the intricate nuances of what at times seems like an alternate universe. The environment causes me to slow down in my conversations and analyze phrases and facial expressions that I would never think twice about in the states. And, the moment I think that I have successfully figured out the system, it seems to transform right before my eyes as it did earlier this week!

The Kenyan response to my frustration? They smile and in unison respond "haraka haraka haina baraka, kwa hivyo polepole ndiyo mwendo" which means "hurrying has no blessing, going slowly is the way" I can feel my anxious American-programmed brain retaliating already! I can only hope that I get to a point this year when this approach feels more natural to me....