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Sexual Health HounslowSexual health and contraception services across various clinics in the London Borough of Hounslow.
Sexual Health SuttonSexual health and contraception services across various clinics in the London Borough of Sutton.
These are services for selective groups of patients and are based in 10 Hammersmith Broadway,A 56 Dean Street or John Hunter Clinic. Greetings from Malawi!A  My summer project in Malawi involves working with the Community Department at UNC Project, a group of employees who follow up with study participants and trace patients who are lost-to-follow-up. The first part of last week I spent meeting with the Community Department at Tidziwe, finalizing the tracing form, and working on some very basic preliminary analysis about demographic trends among patients who are lost-to-follow-up in clinical trials at the UNC Project. For the next three weeks, I'll finish designing a new database that follows easily from the form, and probably my last week here I'll pilot-test that with the people in data management.
On Friday (Happy Birthday America!) after the training meeting, Irving Hoffman (UNC Associate Professor of Medicine and International Director of UNC Project) invited Emily and me to have lunch with a Malawian friend of his, Michael.
After lunch the guesthouse crew departed to celebrate the Fourth of July at Senga Bay, on the lake. In order to get this idea across, we gave each of the participants a piece of paper with a series of value-laden statements, had them indicate whether they agreed or disagreed, and then made them practice defending the opposite opinion. Once again, whatever personal opinions an outreach worker held, they all said they would keep their judgments to themselves in order to better serve the goal of HIV prevention. So I posed another question: Do you ever really know the lifestyle of the person youa€™re talking to? That served to end that particular training exercise (not to mention, I am reliably informed, the hopes of several of the young female trainees). For anyone looking for a good way to come out of the closet, in front of a room full of Chinese government officials is not a strategy I would recommend. It is Sunday and I am sitting in the breezy living room of the UNC guesthouse which is just a five minute walk from Kamuzu Central Hospital where I am working. On 2A, I was supposed to be working directly with Dan Namarika, a Malawian physician who is the administrative head of the medicine department. Some of my patients have malaria, some have meningitis, one came with bad asthma, and another with renal failure. On the non-work side of things here, I am enjoying getting to know the people sharing the guesthouse who are fun and interesting.
Cosmos is a Zimbabwean nurse who is the hardest working nurse I have met here or anywhere else for that matter. The first anecdote involves tracheostomies, a procedure where an incision is made on the anterior neck down to the trachea, which is then opened for insertion of a curved plastic tube. The first encounter I had with tracheostomies was late on a Sunday afternoon soon after arriving in Lilongwe, when I was checking on some patients in the Intensive Care Unit (ICU). The next day I heard that they asked a different surgeon (there were three surgeons at that time for the 800 bed hospital) who then performed the tracheostomy in the middle of the night. Ia€™ll try to write again soon, as we are initiating several research projects in January (meant to have started in August, but the IRB approval process here is quite slow). He was diagnosed with Hydrocephalus when I was just 26 weeks pregnant, at that moment we were told he would not survive the pregnancy.


I'm working on a redesign of the tracing form and tracing database they use, in order to better capture information about reasons for non-compliance with study visits and procedures. On Thursday, the bwanas (bosses) returned from their conference in Mangochi, and I had a meeting with them to discuss my progress and plans for the next few weeks. We drove out to Kauma, a relatively young squattersa€™ village on the outskirts of town, and had a fantastic, authentic meal of nsima, rice, chicken, greens, and boiled pumpkin a€“ courtesy of Michaela€™s wife Mary.
We also hopefully gave Chris Sellers a good farewell party, as ita€™s his last weekend here before returning to the states to begin his MS4 year.
It was a lovely time, but Emily and I went to sleep pretty earlya€¦so we could get up and take pictures of the sunrise! The point was not to make anyone change their beliefs, but merely to help people recognize that their audience does not necessarily share those beliefs, and to try to gain some perspective on why that might be. Most of the participants were less interested in defending an opposing viewpoint, and more interested in hastily informing anyone listening that this wasna€™t really the way they felt, you see, but that they had to follow the rules of the game.
Then she would never seek care from us again, never participate in our activities or come to the Wellness Center. Not a single trainee looked at or spoke to me for the rest of the day, and that evening my co-workers found me sulking in a nearby bar, loudly bemoaning my failure to get through.
He was born August 24, 2011 at 9:50 AM with a malformation to the right hand and then they gave him a 2% chance of survival. The new form and database will hopefully more accurately collect geographic and demographic data about study participants. On Friday I had a training with the tracing teams, teaching them how to collect information on the new form and trying my darnedest to persuade them that it will make their lives easier. I'm going to be working on a more qualitative analysis of reasons for non-compliance among female patients in particular. Everyone who came camping with our group had instructions to dress as his or her favorite American. One middle-aged health department official protested the loudest and flatly refused to follow the instructions. The student may sell sex during the weekend for tuition money; the middle-aged business executive may secretly be taking antiretrovirals.
They reminded me that I cana€™t change everyonea€™s mind in one day, and some might not ever change their minds.
His diagnosis soon followed Epilepsy, Scoliosis, West Syndrome (type of seizures) and Morning Glory Syndrome (no optic nerves). I'm also working on quantitative and qualitative analysis of patient demographics and study retention by occupation, location, and marital status. They were clearly skeptical a€“ but wea€™re piloting the form this week and Ia€™m excited about getting their comments and ultimately having a system that actually works. There are a whole lot of spousal issues that keep women from staying enrolled in studies, and I really think thata€™s something that needs investigating.
Unfortunately, while packing for Malawi, I made a point to leave at home: a) costume pieces, and b) any items of clothing that would unequivocally distinguish me as definitively Americana€¦so I didna€™t have a lot to work with.
Or the young American trainer to whom you just proclaimed that homosexuality is a mental illness may in fact be gay.


If I have time, I'll be working with the two students here from the geography department on a study of HIV prevalence rates by geographic area. As it turned out, everyone who dressed up as Americans (with the notable exception of Chris) wasna€™t American. March 5, 2012 I uploaded a picture of TreA  like I frequently did to show off his acknowledgements, he was holding something, he rarely did. Just asking cause he looks a lot like my friends little boy"A A  I thought to myself, how could she possibly have known that? Roland, an efficient and also caring attending physician, the work environment suddenly becomes one in which you can think and learn and enjoy being a doctor, as opposed to feeling like you are constantly hung out to dry, having to search for feedback or assistance.
Sure enough I looked it up and it was simply a Tre Checklist.A  Everything I read was My Tre.
March 23, 2012A  I took Tre to Genetics, which they were still testing him for all kinds of stuff. Sweet that it all began to make sense, it all added up, I knew that I didnt have to wait anymore,A  Bitter knowning that I would never see him smile.
Since then I have doing everything to teach people about Moebius, even though Tre is not here. I know there is a mom out there who is waiting for a smile like i was and i want to find her, who ever she may be. Me, my sister and a Moebius Grandma send FREE Tutus and bows all around the world giving SMILES to little girls with disabilities all around the world. It was July 15, 2011 when we were given the crucial news that he had masses of water surrounding his brain and his head was expanding at an abnormal rate.
An amniotic exam was performed to assess his chromosomes for any other form of disabilities, to no avail. He was due on September 24, 2011 yet we were told he had a very very low percentage rate of surviving to full-term.
As the months passed and many doctor visits later; he was diagnosed with Moebius Syndrome, West Syndrome, Congenital Scoliosis, Morning Glory and Epilepsy. He endured many many hospital stays, but our Baby Tre, aka Treski, kept holding on and fought against all odds until the day of November 13, 2012, at 14 months, his tiny frail body could no longer hold on and he passed away. His journey was long and trying even though it was in a short time; however he did get the opportunity to celebrate his first birthday. And that is just a shortened version of Baby Trea€™s stretched life but he was loved every minute of it and we cherished every second of it. August 8 2015 Official 2015 Moebius Syndrome Awareness Day Page Our 2014-2015 Moebiuis Syndrome Family Holiday HeroesGallery 2 Moebius Syndrome Awareness Day 2015 Video Gallery Smiling with our Hearts upon the World!
Just asking cause he looks a lot like my friends little boy"A A  I thought to myself, how could she possibly have known that?



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