Nigeria: day 1 of site visits

Photos to come shortly…

9am pick-up, day 1. The driver retrieved us and brought us to the office first thing. My travel buddy and I had both enjoyed not-hot showers and a granola bar in our temporary hotel room, and away we went – weary from two days of travel, but eager to get going.

Our first stop, after a quick orientation at the main office, was the local government’s office in hopes of retrieving clinic budgets and the like (the local clinics are all funded by the government, at least in part). The lady we needed to speak with was not there (we had also not alerted her to the fact that we would arrive when we did), but what was there in the little square outside her office was groups of people, all dressed very nicely, singing, dancing, and celebrating, all in their own little groups. What did they celebrate? Someone in the group receiving their marriage license, of course (I don’t recall such celebration when Chris and I received ours…). It was pretty cool…such flavor, these Nigerians. I like it. A reminder to my stiff self to dance freely, openly, often. And to wear vibrant colors. The colors of their clothing – just beautiful!

Anyways, denied by the government, we headed to the first clinic on our list. Lots of staff interviewing ensued. At first they were less than receptive (not surprising), but as we made our way through the afternoon and poked a little fun at ourselves, they warmed to us and offered all the information we needed. It was fun…and eye-opening after traveling in so many countries where I’ve had to fight a language barrier – the connection is so much more fluid without that barrier in between. By the time we left, we shared smiles and handshakes, and my travel partner and I felt eager for the week to come.

Back up though, the interviews: what are they for, who did we talk to, what information did we collect?

So we’re working on a cost efficiency study that should, in theory, tell us if the costs of services have decreased following the introduction of a cell phone or tablet uploaded with health messaging for the clinic staff. They enter women into the system as clients, and given what they have entered, the system prompts for certain things. For example, if a woman is pregnant, the system will prompt for next visit, immunization, anti-malarials, etc. In theory, it’s a great way to remind staff of all the small details involved in comprehensive care. In practice, we have no proof that it does anything at all, let alone what we hope it does. So we’re here, trying to find the information that will tell us if what we think is happening is what is actually happening. We speak with the staff of the clinics – community health extension workers, midwives, nurses, laboratory technicians, cleaners, whoever is available – to request all sorts of information: how many hours they work, how many clients they treat per month, what services they offer. On day one, this took about four hours. By day three, we were in and out in just over two. Lesson learned in the research business: know not only the information you want, but the proper way to ask the questions so it’s clear to everyone involved exactly what you are looking for. We’ve gotten good.

Anyways, some scattered thoughts from the first day:

  • The clinic is quite primitive. Maybe more so than Mongolia? At least on the same page, but either way, it seems to do the trick given all of the healthy moms and babies that strolled through the door while we were there. It makes me chuckle all the more about everything we have convinced ourselves that we need…all the necessities that are really quite the opposite.
  • Brain drain is real. We met with a doctor (outside of work) and he explained to us an entire list of negative impacts that doctors leaving have on the public. The government pays for their education, and they leave the country. It’s tricky…I don’t blame them for wanting something more for themselves and for knowing that they can obtain it outside of their country…but at the same time, the need here is great.
  • People are people. It’s always a refreshing reminder to me when I travel. Despite all of the differences we can see in the world, at the end of the day most people out there are good, kind souls who just want to earn a decent living, share a nice existence with their families, and have a bit of time to enjoy. The context may be different, but the desires are much the same.
  • Two red eye flights in a row are not pleasant. There’s no way around that one. We were beat.
  • Developing country smell: I forget it as soon as I leave, but it’s so familiar to me every time I return. I love it.
  • They really do carry things – lots of things! – on their heads. I’m in awe.
  • They also carry people – the cutest, sweetest, tiniest, littlest people – on their backs. I’m in love.
  • Sometimes all you need when you want to change money is a little hut by the side of the road. Just pull up on the curb, pass the money out the window, and in will come your Nigerian Naira. No joke.

So that’s that. Day one in a foreign land. The exhilaration of travel never ends.

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