Work Wrap-up

I spent my last Monday (March 21) in the field—my first trip out to Lwak since week one. I went with Godfrey (Deputy IEIP branch manager and my immediate boss) and we were tasked to meet with George (head of the field teams) and Peter (head clinical officer), the two gentlemen who will be tasked with implementing the strategies which we had developed over the past two months. The meetings went very well and we covered all of the details we needed—thankfully, everything that was planned was deemed possible and the few issues that arose were addressed on the spot and reworked to function better in the IEIP field and hospital systems. This was a successful day, and part one of my hand-off process. I needed to make sure the field teams agreed with the new algorithm and process and had all their concerns properly answered.

Tuesday, the woman whose job I had been doing while she was on maternity leave, came back to take her job over. Talk about good timing. She and I sat for about 6 hours as I went over and over all the thought and work which had been done in her absence. She grasped the scope of the changes we had made and was verbally appreciative for my work. We repeated a few of the key components and I handed her my to-do list—which was getting longer by the day. She had a few questions, I answered them and that was it. Half of my project was successfully out of my hands.

Wednesday was the big day. This was the day that we flew the woman out from Nairobi who was not on maternity leave, but whose job I had also been…assisting with for two months. Essentially, we had been making rapid changes to the protocols in Kisumu and she was isolated out in Nairobi without much of a clue (and didn’t seem to mind or have much interest in learning what was new—this is really what is worrisome).  And so she arrived.

I sat down with her and my other coordinator (who I had worked with yesterday) and I reviewed essentially all the same information. I explained the raw data, the projections and the budget—except with a focus on Nairobi (Kibera – name of the area). I got a lot of attitude from her most of the time, although attitude here is not what we think of in the US, it is way, way more passive aggressive. “If you say so,” “That’s acceptable, I guess,” “I wouldn’t have done it that way,” “But what about…” and other ways of just slowing down the process. Look, you just made about $3000 over the past two months and never showed any interest in developing changes. Eventually, after working through a lot, and helping her to vocalize her real problems with both me and my two bosses, I think we got on the same page, and I think she’s going to do a fine job here.

She stuck around on Thursday, an additional day, after learning how much work had been done and how far behind in comprehension she was currently. I worked with her for a few more hours and we got together a little more and started to understand one another. It was an exercise in patience.

And that was the end. I arrived in February and was given a concept and a working draft of an algorithm. I learned the IEIP system of interviews, clinic visits and data collection, I researched and learned about the principles of TB surveillance, I sorted through raw data, I worked on the computer (a lot), I churned out projections, I obliterated a budget, I reworked an algorithm (and a budget), I spent the budget, and I transferred my knowledge to the current and future coordinators. Overall, I had a pretty awesome experience.

There are special thanks and acknowledgements which should go to the CDC Foundation and the Hubert Family for providing me funding to travel and work on this project. Thank you to CDC / KEMRI in Kisumu, Kenya for allowing me access to their plentiful resources. Thank you to Deron and Godfrey for their mentorship, as well as George, Peter, Allan, Ratwar, Janet, Rachel, Kenneth, Fred, Rhoda and so many others who helped me succeed.