Just Another Manic Monday

Blog 5/23

Interviews

health care 38,
fun 21

We headed back to CYEC today to work on the bio devices, kiosk operation, and to conduct
interviews. The boys headed down to the soccer field first thing in the morning to try out
the baseball bat they made with the kids. The group that was conducting community surveys had to postpone
their trip until after lunch because the CYEC and the students
that were donating their translation skills were occupied by a visiting film crew. The morning
flew by and we were all happy to have lunch at CYEC again after waiting two hours for dinner
last night at Ivory. After lunch some of ventured back down to the soccer field to teach
the kids baseball, although they had never played, some of them were hitting the ball better
than us. Meanwhile, Brianna, Tara Y, Rene, Gill, and Shengnan finally headed out to conduct their surveys.
The afternoon was quite successful and the youth they travelled with to help translate did
a great job connecting with the community. In all, 38 health care surveys and 21 surveys on
what Kenyans do for fun were recorded. A quick debrief at the end of the night revealed Mashavu
would be conducting two demos in Nyeri tomorrow afternoon. On a side note, some of the girls finally decided
to do some laundry and after hanging everything out to dry they received an additional rinse
cycle as the rain finally came pouring down for the first time this trip.

Carey and Roma had the opprotunity to spend the day with Khanjan and here is the account of their day:
We got a late start to the day because our taxi driver showed up at 9:30am instead of 8:15am as scheduled. Khanjan, Mary of the CYEC, and two members of the Mashavu core team had scheduled a number of meetings for the day, the first of which was with the Medical Superintendent of the Public General Hospital in Nyeri, Dr. Ngugi.
Although we arrived for the meeting an hour late, we still beat Dr. Ngugi to his office as he was running even later than we were. We first explained the Mashavu system and then discussed scheduling a focus group at the hospital with local doctors, nurses, and community health workers to demonstrate the system and discuss potential areas of improvement. Dr. Ngugi was very enthusiastic about the project and about the potential of telemedicine in general. Although the community health workers will be more difficult to track down, the focus group was set for 2:30pm tomorrow. We also asked Dr. Ngugi to recommend potential clinic sites and we will hear his advice in that area tomorrow.
Following that meeting and the arrangement of a new taxi driver to replace the tardy one, we drove to the Ministry of Public Health and Sanitation to meet with Dr. George Ngatiri, Provincial Director of Public Health and Sanitation, and Dr. Gichuyia Nthuraku M’Riara, Provincial Medical Director. Patrick, Deputy Director of the CYEC, and the two doctors who have been assisting the Mashavu project, Ross and Carol, joined us as well. After gathering chairs from an adjoining room in order to accommodate everyone, we introduced ourselves and discussed both Mashavu and Ross and Carol’s medical database project. Both doctors were extraordinarily supportive and expressed interest in attending either the demo at Public General Hospital or the clinic at Mary Immaculate in Mweiga next Monday. The doctors brought up the current trend in Kenyan public health away from communicable diseases towards more non-communicable diseases such as hypertension and diabetes and potential Mashavu applications in those areas. This was interesting as Dr. Ngugi had also brought up problems treating the increasing numbers of diabetics and hypertensive patients.
We switched drivers again following this meeting as our previous driver (the second of the day) had not yet returned to pick us up when we left. From there we continued to Mweiga to meet with Sister Veronica of Mary Immaculate. We were initially received by Sister Mary and we shared coffee while we waited for Sister Veronica. The coffee was cold which we all thought was great since it was very warm out but Sister Mary was mortified because apparently in Kenya it is an insult to serve a guest a cold drink. Once we had convinced Sister Mary that we were enjoying the cold coffee, Sister Veronica arrived and we began discussing logistics for the Mashavu clinic to be held at Mary Immaculate on Monday. After ironing out the details, we toured the facilities and outlined the organization of the coming clinic.
Once a tentative plan was in place, we said our thanks and goodbyes and continued on to Kimathi University to meet with the Dean of Students there. Prior to our meeting, Khanjan and members of the CYEC staff had discussed with the Dean the possibility of having some of the students there out to the CYEC this Saturday to provide feedback on the Mashavu project. The Dean was very supportive and logistics were put in place to be confirmed later on via email.
From the University, we returned to the CYEC to rejoin the rest of the team, zigzagging back and forth across the road the whole way to avoid the maze of potholes. All in all, the day was very successful. We put plans in place for a number of clinics and focus groups and were enthusiastically received by everyone.

Monday on the BioE front was filled with running tests and tinkering with our devices in an attempt
to produce some compelling results. The blood pressure cuff, our pride and joy, works like a charm and
produces accurate results consistently. The thermometer also seems to be adequate, despite Alice C. somehow
managing to shatter three commercial mercury thermometers in a day and a half, leaving us without known values for
comparison. We’ll let it slide this time because she is one of the few with a quazi-working device and they aren’t
too expensive to replace. The pulse oximeter team spent most of the day rewriting their labview program to be more
simplistic and mesh better with the other devices. The rest of the day was spent trouble shooting this new program
and continuing to decipher the problem behind the erratic oxygen saturation readings. Apparently Jeff, Pat, and
myself have around 219% oxygen in our blood? I think that’s more than Batman. But I digress. The pulse oximeter does
yield accurate heart rate readings and pulse waveforms. The spirometer is still struggling but we’ll get back to you
all about that,hopefully with some good news. Dr.Butler finally arrived yesterday after a cancelled flight due to
volcano ash, lots of waiting and layovers, and lost baggage. He did, however, bring with him a soldering iron and
peak flow meter, two extremely crucial instruments in our tinkering efforts. The peak flow meter allowed us to
digitally detect a patient’s force expiratory volume and peak flow rate and to calibrate our spirometer calibrator. Sorry
for the redundancy; we’re still quite confused ourselves. Jeff and myself stayed up late last night with the help of
Khanjan, Chanakya, and our newly aquired soldering iron to finish making the new circuit board that we will use for the
adult weighing scale. Upon completing, we handed it over to the electrical engineers for a more comprehensive analysis
and troubleshoot. Lastly is the stethescope, which had a pretty good day at CYEC. Dr. Butler worked for hours with
Tom on filtering the sound received from the device. Their solution was to encorporate a second microphone which
detects only background noise and use that to remove the noise from the actual, desired signal. All in all, it was a
successful day at the CYEC. Each day I see progress on the devices as new ideas are formed and minor breakthroughs
are made. About half of the devices work completely and accurately, and the rest are extremely close to completion.
We have one more day to finish them up and I have all confidence in my BioE team. Tune in later to see what tomorrow
will bring.