So, are you there to work, or what?...

A number of people have asked me about work, and when we are starting.  Inshallah, we will start after our meetings with the Ministry of Health on Sept 7-8 and the official groundbreaking for the COE building on Sept 9^th… that’s the plan, any how.  We can’t start to work until our Memorandum of Agreement is modified to include what exactly us 4 physicians are doing (and to specify in part that we’re not just here to increase the numbers of pediatricians doing general peds care, but that we’re here specifically to look after kids with HIV and TB.

 

As far as BIPAI is concerned, after Sept 9^th, the plan is for us to start working in the general pediatric clinic, identify the first HIV infected kids and get to know the hospital.  While we do that, we’ll hopefully find a space in the hospital that we can use (+/- renovations) for our “transitional clinic”.  Once the transitional clinic is up and running, we will restrict ourselves to looking after HIV patients, +/- pediatric TB patients, as this is supposed to be a Center of Excellence for Pediatric HIV, TB and malaria… how we’re supposed to work the latter into an outpatient clinic I’m not totally sure.

 

Part of our role at first will be in building relationships with the local physicians, clinic staff, NGOs etc.  One of the important premises of BIPAI is that we are not there to steal staff away from government jobs (contributing in a way to brain drain). So each country has a policy that people already working for the government are ineligible to work for us.  And the staff get paid about the same that they would be making working for a government hospital. (in the spirit of full disclosure, that rule doesn’t apply to us… we will be getting paid much more than the local physicians although at a rate much lower than we would expect to make at home).

 

Another important part of our job is to provide continuing education for local health care workers, to improve their skills in managing kids with HIV.

 

Of course, this is all pretty theoretical… it will be interesting to see how we can make this come to life.  It’s a huge responsibility to be starting this from scratch, without even a local country director or anything. Just us. Its exciting but… what a challenge it will be.  And that’s without taking into account that we’re working in one of the most resource poor settings, in a health care system that is seriously underfunded with nowhere near the numbers of health care workers that are needed.  And not even mentioning the clinical challenges of being a brand new attending!

 

So, now that the housing is more or less settled, I’ll be spending part of every day learning Djoula so I can talk with some of the patients (and go to the market!), and part of the day reading and studying to prepare.  And then continue the emailing, and other settling in things we need to do.

 

Once we start working, I will talk more about it… but for now, it’s a matter of getting to know the place, and getting settled.