Ouagadougou and back again

With the slow progress and the fact things seem are more mundane, there doesn't seem to be as much to write about lately. We spent last week at the First Annual Mother-Infant Congress in Ouagadougou - basically, a joint meeting of the Burkinabe Pediatrics & Gynecological societies. It was good to be there, and make some more connections. I've never seen so many retrospective chart reviews in my life (without understanding of their limitations)! There were some useful studies though.

We visited the main hospital in Ouaga and were impressed by their malnutrition service; they have dedicated nurses, WHO-based protocols and the hospital provides the ingredients for the therapeutic milk. Each meeting and site visit gives us more of an understanding of how things work (or not) here. I think we are slowly convincing people that we are interested in integrating into the existing system. All 4 of us are anxious to start doing more HIV related clinical work. The 3 pediatricians will continue to look after the Over 3 Ward in 2 week blocks. After Christmas in addition to taking my turn on the ward, I will spend a couple weeks at the TB clinic that currently sees the few identified HIV/TB infected kids - will work on developing those partnerships.

Our major focus over the next while will be to work on getting kids tested for HIV. There are around 1500 "Orphans and Vulnerable Children" (that is, children of parents with HIV)registered with the various agencies and only about 20% have been tested. Plus, few of the kids in hospital are tested even though in our hospital about 10% of the inpatients are HIV+. And we are also working on linking with programs that work to prevent mother to child transmission of HIV - those kids are nearly all lost to follow up.

For a variety of complex reasons, I have decided to go home for Christmas - will be swinging through Baltimore, Calgary and Victoria. I am worried about the cold, and the culture shock. So many things took some getting used to all seems quite normal to me...
... most consumer goods are sold from roadside stands, from the clothes from bales of used clothes sent from North America, to hardware (hammers & nails), to artisanat, to fruit from the roadside table that I pass each afternoon on my way home...
... everytime I am in town men wave cell phone recharge cards in my face (OK, I still don't like that)...
... people (away from the sellars of artisanat and the market vendors) are so polite, and kind even to strangers...
... most school age kids I pass stare and call "toubabou, toubabou" and smile their beautiful smiles...
... the roads are all unpaved, rutted red dirt roads that require one to pick their route carefully through on any kind of vehicle...
... kids in the hospital arrive far to late because their parents have no money, and even then sometimes can't buy the medicines they need....
... the taxis are dilapitated vehicles that you would wonder that they are still on the road, no mirrors, door handles usually broken off...
... in the mornings people are people are dressed in toques and heavy coats to ward off the cold - and its rarely colder than 18C (and worse yet, I need to wear a coat to ward off the cold)...

It should be interesting, at any rate. I am really looking forward to spending some time with my friends & family and putting some perspective on these last few months.
Take care!
Laura