Archive for the ‘Data Collection Officer Trip Reports’ Category

Wildlife & Flooding Rains: Challenges of Riding to Health Centers

Sunday, January 20th, 2013

James Mwanza, author of this post, is Stanford’s longest serving Data Collection Officer. He provides another perspective to the challenges of working in and traveling to rural health centers. To learn more about Stanford’s groundbreaking research in Zambia, visit our website.

I am based in Livingstone district, the town well-known tourism due to the Victoria Falls, one of the Seven Wonders of the World.

A new river cuts a road in Kazungula. J. Mwanza.

I also cover Kazungula District, the second largest town in the Southern province of Zambia. Every month, I travel approximately 1,300 kilometers to access my health centers to collect data. The distance to the health centers differs from season to season due to meandering road networks. During the rainy season, which is now, most roads are closed due to poor conditions and new ones open up. Six out of 11 of my health centers in Kazungula are not accessible by vehicle due to lack of bridges.

EHT with patients at Nyawa health center. J. Mwanza

Kazungula has experienced rains starting the end of October until the present. The roads and vegetation have already changed. Some roads are impossible to use. I often pass through water to continue the journey to Kauwe, Nyawa, Katapazi, Simango and Mandiya health centers to collect the data. Kauwe is one of the most remote health posts in Kazungula district, 250 km from my base.

During the rainy season I am forced to use the National Park or Game Management Area, meeting elephants and lions. It is interesting to rub shoulders with wildlife. Human animal co-existence is really happening during our research. But I love wildlife and I enjoy riding in dusty roads. Collecting data from the health centers is the key business, no matter how hard it is, data collection is always close to my heart.

Ministry of Health mobile health unit. J. Mwanza

During my most recent multi-day trip to 6 centers,  I had the opportunity to find a Zambian mobile hospital at Nyawa health post 195 kilometers from Livingstone town. The EHT who is the main focus person in the study was busy facilitating the visit of the mobile health trucks. The visit of a mobile hospital is a benefits the community by providing people with chest, eye and ear exams. They also bring medical equipment not otherwise available in rural areas.

Like my colleague Samson who posted earlier, I met my goals of the trip by scanning the HIA1, HIA2 tally sheets including Child Health tally sheets. These forms help Stanford fully understand the activities of EHTs and the impact of Riders for Health’s intervention. I also managed interviewed the EHT Mr. Mukhombwe in-person to learn about his health outreach activities although it was quite difficult since he was busy with the mobile hospital.

Every trip is different from the other and challenges differ. During this trip the journey was much longer than usual – by 150 KM – due to the roads that have been affected by rains, but I managed to collect data from the health centers as planned.

Early Morning on the Motorcycle

Sunday, December 9th, 2012

Samson Muchumba is a Stanford data collection officer based in Choma District. He interviews 23 Envionmental Health Technologists (EHTs) every week at urban and rural health centers, asking them about their health outreach work and access to transport. Every month, he visits each health center in-person to collect data critical to the evaluation. To learn more about Stanford’s health supply chains evaluation in Zambia, visit our website.

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In Choma District where I work, there are four routes to reach the remote rural health centres. These routes are; Mapanza, Pemba, Sikalongo and Masuku.

It was 6 am when I peeped outside; it was cloudy and appeared as if it was going to rain. I became reluctant to wake up to prepare for the trip along Masuku route. When I was still debating within myself whether to go or not, my phone rang. It was one of the Environmental Health Technologists (EHTs) I was supposed to visit that day. He was trying to find out if I was still going to visit the health centre. I told him the visit remained as scheduled. I got out of bed and started my routine preparations.

Along Masuku route there is Simakutu, Simukanka, Masuku mission and Masuku terminal health centres, the furthest being Masuku terminal which is 82 km from the District Health Office.

Before starting off I did the routine motorcycle check up, i.e. I checked if there was enough fuel, the engine well lubricated, the lights and brakes were operating well, if tyres were well inflated, and nuts and bolts were tight enough.

I started off from my home around 7 am so that I could reach the first health centre at 8 am. It was too early for me to eat my breakfast, so I carried packed snacks for breakfast and some also for lunch.

Just a few kilometers from town, the road became sandy for some kilometres. I had tough time riding the motorcycle along this road, for the wheels were sinking. And at some places, the road became rough with pot-holes and ridges. The speed was literally reduced and I kept swerving to avoid pot-holes and ridges.

The first stop was at Simakutu health centre which is 35 km from the District Health Office, and it took almost an hour to reach there due to the bad nature of the road.

I was met by the EHT, Mr. Cliff Chiluka and I found him facilitating a meeting for the community health workers.  It was an emergent meeting. He explained to the meeting attendants so that he could attend to me. So the meeting had to be temporarily suspended.

I interviewed the EHT, thereafter, he got the folder where he keeps the official tally forms, which contain monthly health records for the  health center. I scanned these for the month of September 2012 and the motorcycle log book sheets. I also took a photo of the motorcycle odometer.

I sat somewhere to have my breakfast which I carried along with so that I could have energy to ride on. I still had a rough road ahead.

I bade farewell and started off to the next health centre which is Masuku mission, another 30km from Simakutu. The road from here had ridges and stones in most places. The stretch from Masuku mission to Masuku terminal is the worst part of the road with ridges, rocks and is sloppy.

It took the whole trip from town to Masuku terminal (82km) about four hours. It’s a nightmare to ride along this Masuku road. The road network is the biggest challenge as far as in-person visits for data collection is concerned. However, the reception in the health centres is always positive and I was able to collect the important health data necessary for our evaluation.

- Samson Muchumba, Stanford Data Collection Officer, Choma District