The Fixer Upper

Today started at 8:15 with the first group Michael, Maggie, Peter, and Stephanie from BioE along with Katie W., Aaron, Anthony, and others.  The second group traveled to CYEC to pickup our 9 translators, bag lunches, and drinks.  These drinks were fruit juices from the Highland factory and extra drinks were bought that will go toward our safari at Aberdares tomorrow.  People in the first car were able to see top of Mt Kenya faintly and Aberdares was passed along the way to Mweiga.  The first team to arrive setup the Mashavu station to be run later that day.  The first group was greeted by two goats who were using the shed for shade.  Aaron and Anthony hired a truck for 300 Ksh to transport the three tables and 25 chairs for kiosk setup.  After unloading the car, the two goats disappeared but their many gifts remained behind to haunt all of Mashavu during the sunny day ahead.

The BioE members present and Aaron setup up the table layout and kiosk computers.  The power outlet was one plug hanging from a cord that stretched across the power lines traveling over the road next to the Mashavu testing from the Mweiga Mary Immaculate Hospital.  The BioE team created data cards from notecards cut in half in order to contain a patients name, height, weight, blood pressure, pulse rate, temperature.  During setup, many locals walked by the kiosk and crowded around the testing tables in order to get a good look at the computers and the devices but they greatly hindered the setup process.  Peter entertained them while Aaron tied white rope around the perimeter of the shed in order to facilitate setup and protect the devices from damage.  Because the roof of the shed was not the best, we used a green umbrella and eventually a big tarp to cover the roof to provide shade for the spirometer and stethoscope stations.  The first table setup consisted of blood pressure and temperature.  The second table contained pulse rate, adult weighing scale, baby weighing scale, and height.  The third table contained spirometer, stethoscope, and health history.  Peter collected data from the temperature sensor and used a commercial sensor to calculate the accuracy of the device.  Maggie used the commercial blood pressure cuff to provide blood pressure data to patients even though our blood pressure cuff design is not functional.  Mike ran the pulse rate monitor and used his hand to check the accuracy of the monitor.  Katie W. took height and weight measurements for patients and sent them to Stephanie who provided spirometer data.  Michael used the stethoscope to collect only heart sounds from patients because lung sounds are too difficult to obtain in the noisy kiosk testing environment.  After that patients were sent to health history and to Mary for additional medical information.

The education team facilitated the smooth running of the station.  James spent time interacting with locals present within and outside the rope setup by Aaron.  One interesting person he met was a business student at Jomo Kenyatta University and he was antagonistic at first about the kiosk explaining that giving people their numbers and leaving helps no one.  After James informed him of the project, both its educational aspect and future plans the student was less apprehensive towards the station.  Renee monitored the CYEC kids kind enough to translate for us a second day.  The majority of the CYEC kids seemed to enjoy working the devices and translating more than class work.  The use of the devices by the translators earlier greatly assisted in the translation and use of the devices.  Chonda and Katie ran focus groups with patients after they traveled through the station.  They asked a variety of questions including would they use these devices in their community, how frequently would these use them, how much would they pay, did data collection take too long, was their privacy threatened by the quantity of people at the kiosk, how did they get to the testing station, and what does it cost (transport and consultation) to see a doctor.  People were willing to pay between 50 shillings and and 500 shillings but the majority of people said they would pay 100 shillings.  People in Central Africa are better off than Western and Northern Africa so the scalability of the kiosk system maybe be limited in these areas, a point brought up by Khanjan at our night meeting.  Also after seeing the focus group, patients consulted Mary about their information collected and got general health tips as well. Chonda also discovered that operators must be endorsed by someone respected in the community(pastor, doctor/nurse, etc.).  Julia was the traffic controller of the kiosk controlling the flow of people into the kiosk.  The experience has given her the information needed to improve the line logistics.  When the kiosk was shutting down, people were no longer admitted but many individuals were insistant on entering the station.  Many made offers to Julia including inviting her to their homes for food and many tried to appeal to her sympathy by asking her to help their grandmother.

The web team was quite productive today as well.  They met with Rebecca, the head nurse of Mary Immaculate Hospital.  After Rebecca got to see all of our devices by walking around the kiosk, the web team took Rebecca through a step by step demonstration of what would occur if Jimmy arrived at the kiosk with a stomach ache.  Starting with entering the kiosk, going through the devices and ending with the health history and feedback from a physician.  Rebecca said she would have no problem receiving the information from the kiosk in order to provide a diagnosis for a patient.  Rebecca also provided the web team with forms that patients encounter when entering the hospital.  Rebecca said nurses only take weight, temperature, blood pressure, and pulse rate which is less than our kiosk can provide. Rebecca told them that the chief complaint a patient presents is the most important information and influences the rest of the questions asked in the clinical encounter.  The web team feels that this would be better used in a second iteration of the system but for now the questions should remain the same to ensure a properly functioning system. Rebecca brought up the point that people would not want to pay extra for individual things (extra pictures, etc.) but she was informed that our kiosk will charge one flat rate for all of our services at one time.

Asante Sana,
-Michael Fickes, Bioengineeering Team