Hello everyone! It's Paul again, back in action after only two or three months of Rachel pleading me to write a post about my adventure in Africa. I'm a dutiful husband. This is a pretty long one, so make sure that you stand up and stretch in the middle.
First up: thesis! I submitted my final (approved) drafts of my thesis this week, so that was a great burden to get off of my shoulders. Here are some action shots of the final signing:
Such happiness!
All of the signatures
While my thesis was a great learning experience, I'm glad that it's out of the way. I do feel a sense of pride given that MIT-caliber professors have read and approved my work. Good feelings, but thank goodness it's done!
And now on to the reason that Rachel asked me to write this post. In March, I had the opportunity to spend two weeks in Zambia for an MIT class called Global Health Lab. MIT is big on "action learning" classes which pair student teams with clients that are then supplemented by guidance from professors who have years of experience in the field. The class consisted of ~11 teams paired with clients from across Sub-Saharan Africa and India, and including a wide variety of project topics. Here is a pic of me with my other three team members: we had a great team!
Our team: Me, Silvia, Saurabh, and Shriya
We were lucky in that our team had very diverse backgrounds, giving us a chance to approach the project in a variety of ways. Previous experience on the team ranged from companies like Amazon, Coca-Cola, Bain, Microsoft, Kimberly-Clark, McKinsey, and a variety of hospital systems in New York, Boston, and Atlanta. Most importantly, we were all excited to travel to Zambia!
Before we arrived on-site in Zambia, we were fortunate enough to have a few extra days to stop by in Cape Town, South Africa. What a wonderful place! Of course, I have lots of pictures - it's what I do.
We started by exploring Table Mountain, which is one of the new seven wonders of nature. It is quite a site, and provides a dramatic backdrop to Cape Town.
View from the top - the clouds poured over the mountain like a fluffy waterfall
Living in the clouds
It was pretty windy up top, but very beautiful
Our team with a quick selfie looking towards Cape Town
We had a little Titanic inspiration and decided to go with it
The sunset was very striking - quite a site
Moon overlooking the night lights of Cape Town
We hiked around Table Mountain for most of the afternoon and watched the sunset. All went smoothly until we realized that there weren't any cabs around to get back to the city! We finally found one, though he took advantage of his negotiating leverage and made us pay ~4x to get back. Oh well, still worth it.
On the next day, we booked an awesome tour guide named Rudy that showed us around the Cape Point peninsula. This included the Cape of Good Hope and several of the southern-most locales in Africa. The scenery reminded me of southern Australia, and included a beautiful combination of rocky cliffs and blue waters.
Oh, and seals! There was a guy at one of the docks who would put a piece of fish in his mouth, lean over the edge, and have the seal jump up from the water to take it from his mouth. Unsanitary yet entertaining.
Action shot - chest bump in progress. I'm not sure which is more beautiful - the chest bump or the scenery in the background. Probably the scenery.
There were a lot of baboons chilling in the area. They would sneak up on people and yank their Coca-Cola and sandwiches right out of their hands.
Some handsome guy I saw during the trip
This is one of the Capes - I can't remember which one, but it's definitely one of the pretty ones.
Happy to be getting some sunshine for the first time in six months
Ooooh
Aaahhh
Wowwww (running out of caption ideas)
Baby baboon hitching a ride on the back of a 4x4. What a baller.
Lots of sunshine = lots of pretty flowers
Penguins too! WHAT!? That's right, it was 80 degrees and there were penguins. Just a couple though.
Just kidding, there were approximately a million of those little buggers. They were fun to watch waddling around the beach chasing each other. They also did a lot of honking.
Fluffy baby penguin in the middle of Mama and Daddy
Braving the watery depths
After an exhausting but incredible day visiting the Cape, we watched another beautiful sunset on a beach back in the city. We were only there for two days, but we were lucky to see so much!
The next day, we arrived in Lusaka. After spending about four hours in the Customs line at the airport, we exited to find that our ride was MIA. No problem though, we're all pretty savvy so were able to have a few people help us out in finding a cab to the hotel. While there are a number of local languages spoken in Zambia, we were pretty fortunate in that English is taught in schools and is known by most. This meant that we didn't typically have problems communicating, which makes travel in a foreign place so much more manageable.
Before I hit you with another round of pictures, I want to provide a little background on our project. The main goal of our project was to help reduce patient waiting times at an antiretroviral therapy (ART) clinic in Lusaka, Zambia. The ART clinic serves over 250 HIV patients per day, providing essential medications, clinical tests, and counseling to each patient. We were fortunate to be working with both a non-profit organization, CIDRZ, and the Zambian Ministry of Health. CIDRZ (www.cidrz.org), our sponsor organization, is a non-profit organization which supports the Ministry of Health through clinical support, training, and research efforts. In addition, we were working with the Lusaka Urban District Health Management Team and the Kanyama Clinic to gather field data and to serve as a testing ground for potential improvements.
While the crux of the project was operational improvements and analyses, we were also very interested in seeing how the clinic impacts the community and the livelihood of each of the 10,000 patients it actively serves. Our hope was, and still is, that by providing an operational lens to the processes and system, we can reduce non-essential administrative burden and improve patient flow throughout the system. As a result, we hope to enable the staff to focus on their true mission: delivering health care to each patient.
The on-site experience was intense, but very satisfying and educational. We would arrive at the clinic around 7AM each day, stay until 4PM, and then head back to the hotel to work until 11PM. There was so much to do, and only so much time to do it! Most of our time during the first week was spent on observations, interviews, and time studies so that we could develop a detailed understanding of how things worked. The second week involved us trialing some experimental changes and assessing whether they were successful and how they could be further improved. For example, we reworked the patient check-in process to center around the patient instead of each sub-task such as weighing, triage, etc. This not only helped to improve the patient flow, but also increased the amount of patient-nurse interaction time (so could improve the experience for the patient while also allowing the nurse to focus on the activities that originally attracted her to the role).
Enough words, more pictures!
We had a dinner with some fellow student researchers from the University of Zambia on the first night. It was incredible to hear their perspectives on everything from pop culture to the government.
The clinic where we worked: Kanyama. This is the sign at the clinic entrance.
A shot of the outside waiting room. Patients would spend between 5 and 8 hours waiting to get a simple refill, with more than 100 patients waiting outside at times. This is what we were trying to improve.
One of the file rooms. Steps like finding a patient folder would take several minutes each, leading to clogs in the system. I almost had a heart attack the first time I saw one of the registry guys climb to the top of the ladder, balance on one foot, and reach up to the very top of the stack. Definitely not OSHA approved. Part of our improvements were aimed at improving organizational aspects like this to allow for more streamlined activities.
Look at that level of concentration. Intensity!
Here I am helping one of the nurses (Jocelyn) to revamp the check-in process
A shot of us and the full clinic staff. This was taken on the last day when we reviewed our findings and worked with them to figure out what they could accomplish after we had left.
We also had the opportunity to spend an afternoon visiting the community. Speaking to long-time ART patients, such as the lady in this picture, allowed us to get a better grasp of the full impact of the clinic. Hearing how the clinic had helped these folks become healthy again, to get jobs, and to spend more time with their families helped us to see the incredible value that the clinic and staff bring to each patient.
One of the schools in the area. We high-fived one kid, and then a deluge of high-five-frenzied kids came running through. Lots of fun.
Our team, posing with the staff who had showed us around the community. Everyone is laughing because the big guy on the right saw us taking a picture, screamed "I WANT IN!" and proceeded to run over and bear-hug Shriya. We all thought it was funny. Except Shriya.
While the two weeks flew by, it was an incredible experience and I think that we were able to provide a lot of help to the clinic. We tried to spend a lot of our efforts helping them to generate and implement their own ideas, since that capability-building is what will sustain after we left. What we typically saw is that the staff had great ideas for how to improve the processes, but these were not executed either because of time constraints or because they felt a lack of power to make the changes. The staff were all hospitable, and it was clear that they wanted to deliver the best care possible to each and every patient.
From a personal level, I gained a much better appreciation for HIV treatment and how much progress has been made in recent years. While it was tough to internalize the fact that the hundreds of patients per day were all struggling with this terrible disease, it was uplifting that the ART regimen enables each patient to live to the fullest day to day.
After our whirlwind of work, we were lucky enough to have a couple more free days to spend visiting Zambia. Zambia is home to Victoria Falls, which is known for having the largest sheet of falling water. At twice the height of Niagara and twice the width of Horseshoe, only Iguazu gives it a run for the money in volume. The roaring falls and misty skies definitely reminded me of my adventures in Iguazu with Rachel a few months ago.
Maybe take a stretch break at this point? NOW ON TO MORE PICTURES!!!
On the boat near the top of the falls. Check out that color scheme.
Sitting near the top with the team
Swimming in the pools near the edge. The mistiness on the upper left is the drop-off of the falls. Don't worry, I'm still alive.
Us near the edge. I can only assume that the rope is there so that you can try to grab it as you're swept over the side.
Another one of us with more falls in the background. The ladies weren't having any of this, so they didn't join us. It was actually quite safe. Or that's what I tell myself.
Beautiful! This is only one small section of the falls, but it's still overwhelming.
There were some zebras walking around. They did not let me ride them.
More sunshine = more pretty flowers
Some baby baboons monkeying around with each other
Over the top edge. We later walked on the bridge in the background, but I wasn't able to get any pictures from that viewpoint. The water from the crashing water soaked us as if we were in a torrential downpour, so I had to leave my camera in the dry bag. Thank goodness for the dry bag!
From the other side of the same footbridge in the previous picture
So much mist. It was just an unbelievable amount of water.
From the bottom near the bungee jumping bridge. The bridge also connects Zambia (left) to Zimbabwe (right).
Saurabh decided to do the bungee. Here he is after a successful jump. I had experienced a lifetime of fear when I bungee jumped in New Zealand, so decided to pass on it this time.
Here's a peaceful monkey to help calm anyone having fits about the bungee jumping. Mellow monkey.
We also did a lion tour, where we got to spend some time with big versions of Buncombe
I don't know what that stick is supposed to do. It certainly wouldn't help me if that lion decided to have a little piece of Paul for dinner.
The team, preparing to be eaten. But don't worry, we have our sticks.
Chewing on some sticks. Just a big ol' kitty.
Lazy like kitties.
Sweet like kitties.
Stretchy like kitties. One of my favorite pics.
Playful like kitties. The guide had a bundle of leaves on the end of a big stick and string. Basically a giant-sized version of a cat toy. And boy did those lions love swatting at it!
Beautiful Zambia. Bet you didn't picture anything like this when I said Sub-Saharan Africa, did you?
Lots of beautiful flowers. Mom will have to tell me if these are all flowers that are also in the U.S.
Our final stop was at an elephant orphanage. This is a baby elephant chugging some milk formula. So cute.
Elephants are so loving.
But man, are they weird looking up close. Maybe not the best time for a zoom lens...
This baby had trouble standing and drinking, so decided to just screw it and plop down. Seems pretty comfortable to me too.
Also, we saw Albert Einstein.
Whew, I'm exhausted! Writing blog posts is hard, and Rachel is much better at it than me. Thanks for sticking around and giving me your attention, and I hope that you learned a lot about South Africa and Zambia. It's a beautiful region and was a very eye-opening experience for me.
Last, but certainly not least, Happy Mother's Day! We hope that everyone has a wonderful day and that it is filled with beautiful sunshine, much laughter, and maybe some ice cream. Rachel and I are both very lucky to have such caring, healthy mothers and we look forward to seeing them soon! Flower for Mother's Day!!!
We love you!
