Vani and I are now halfway through the third week of our internship, and I finally feel like I’m getting used to life in Lesotho. Well, sort of. It’s still quite an experience waking up every day in a refrigerator of a bedroom (~50 deg F!) to the tolling of bells, walking (or rather hiking) our way to work amidst an endless sea of curious eyes and honk-friendly vehicles, and huddling together around the fireplace after dinner. And before this summer, I had never cooked my own meals, handwashed my own clothes, or felt so much like an outsider (there are next to no foreigners in Leribe). But I find myself… adjusting. It’s been challenging, but also very fun. And educational.
In my last post, I promised to describe the technologies that Vani and I have brought with us. Just to recap, Vani and I are working at Motebang Hospital in the Leribe district of Lesotho. We are here to demonstrate student-designed technologies that were developed to address global health needs, obtain feedback on these devices, and help out the hospital and surrounding community to the best of our abilities. The devices are:
1. Pediatric Transilluminator: uses LEDs to provide better contrast between veins and surrounding tissue to improve the accuracy and ease of venipuncture (such as for IV insertion). Especially helpful in obese and very young patients, whose veins are generally more difficult to find.
2. Bilirubin phototherapy lights: shines light at 470 nm to treat neonatal jaundice.
3. Warming Incubator: warms infants.
4. Oxygen Concentration Sensor: indicates the percent oxygen and flow rate being delivered to a patient. Especially useful in situations where a single oxygen source is split among multiple patients (don’t know how much oxygen each patient is getting).
5. Pulse Oximeter: indicates percent oxygen saturation in the blood and pulse rate.
6. Dosing Syringe Kit: An easily attachable set of clips that control how far up you can pull an oral syringe. Ensures that an accurate dose of medicine is delivered each time.
7. Pill Counter: A very accurate scale that allows the user to quickly count an unknown amount of pills. Can also be used to quickly count specific sets of pills, say 40, for drug packaging.
8. Adherence Charts: charts meant to simplify the process of checking whether a patient has been taking his/her medication. Especially important for ARVs (anti-retrovirals) for HIV+ patients, which require high adherence to be effective.
The reception to these technologies have been largely positive so far, and many of the doctors and nurses we’ve talked to were kind enough to offer helpful suggestions as noted by Vani’s previous post. A nurse in the intensive care unit found the pulse oximeter to be very effective and in high demand. She also made an interesting observation: she found that the device had a positive “psychological” effect on the patients. Apparently, it made the patients feel important to have the curious contraption attached to their fingertips. Also, a nurse in the maternity ward was able to the use the transilluminator to locate a vein on an obese patient (after failing to do so without the device). We plan to get more detailed feedback on the transilluminator in the coming weeks as we deploy the pediatric models in the pediatric ward.
On our way back home yesterday, we ran into a friendly pharmacy student, who we met last week during a demonstration of the pill counter. We had the adherence charts with us, so we showed them to her. She then shared an interesting tidbit about the practice of checking drug adherence at Motebang. She said that some patients are “clever” and know that they should have finished all of their medication by the time of their next checkup. So if they haven’t quite been keeping up with their regimen and have a couple pills left over, they will dump them out to avoid potential scolding during the checkup. The clinician, also “clever,” knows of this practice. Thus, it is common to give a patient a few more pills than necessary. The clinician knows how many extra pills he gave, so if the patient returns with no pills, he knows the patient hasn’t been adhering to the drug regimen. Interesting.
Over the next couple of days, we will continue to demonstrate technologies. On Friday, we will visit Mapoteng Hospital and Maloti Hospital with our program mentors. Thanks for reading!
-Eric