Fast-Paced Education in the Field

24 May 2016

It seems just like yesterday that I came to Yida, but it’s already been three months and I’m getting ready for my RnR (rest and relaxation). What was different three months ago is my quick ability to analyze my stock now. I have done a full inventory, placed an international order, and assisted in an EPI vaccination and a measles mass vaccination. I believe the only things I haven’t experienced are the rainy season, malaria, and setting up a pharmacy in an ongoing new project.

Over the past couple of months, I have learned a lot about tropical diseases and treatment. As a pharmacist, I care about drug quality. More importantly, I care about the people getting these drugs in a resource-limited setting. These are people who have nothing and cannot afford any of the drugs. In Yida, MSF is the only facility within the locality (more like the whole state) that provides TB/HIV treatment. Hence, TB patients travel far and wide to get here for treatment. As we get ready to expand our HIV activities, I look forward to expanding my HIV/TB drug management in a resource-limited setting.

Leprosy (Hansen’s Disease): At the risk of showcasing my ignorance, I’ll admit that this is a disease I only heard about while watching the story of Jesus on TV; how He healed the leprosy-ridden patient.  Leprosy is a neglected disease and mostly affects the poor due to unhygienic conditions. Today, I was taken aback when I got a call to recommend counseling for a new patient.

This is not a disease studied in pharmacy schools in the USA, hence I was clueless. Thank God for drug information skills! I quickly grabbed the MSF clinical guidelines to read about the disease and see which drugs are recommended, then my Essential Drug Handbook. The information was too brief, so I decided to visit Google and search for published literature. However, it was hard to find recent articles, so I resorted to WHO, CDC, and MedlinePlus websites.

First, I needed to understand what causes the disease, symptoms, and treatment. The good news is that it’s curable and, if treated early, there’ll be no damage to skin, limbs, or eyes. WHO has been providing FREE treatment to any patient in the world with leprosy since 1995. Treatment for leprosy is a multi-drug therapy (MDT) consisting of dapson, rifampicin, and clofazimine. Since the disease is chronic and infectious, patients must be well-counseled and monitored closely to limit the spread. I’m glad all our patients can receive the needed treatment to be rid of this deforming disease.

Malaria: As a malaria patient, I can tell you all about the symptoms of malaria. But as a health professional, my knowledge of treatment is pretty limited. Again, this is not one of the diseases studied in pharmacy school in the USA. Therefore, I find myself reading extra to catch up with malaria treatment guideline in South Sudan.

Measles: We are currently doing a mass measles vaccination campaign in Yida Camp and, for now, my focus is cold chain. This is my first vaccination campaign and I want to learn all the tricks it takes to vaccinate hundreds of kids in 45oC heat without having a cold chain break.

Photo: Mirabelle Adamu-Zeh

Mothers and children queue to receive measles vaccines.

Photo: Mirabelle Adamu-Zeh

Cold chain equipment for vaccines.

Cold chain is a key component in any mass vaccination project. One will easily worry about heat affecting the vaccine stock, but in fact it’s the cold temperature inside the vaccine carriers and cold box that needs strict monitoring. Of course the heat as well. As the campaign picks up, I’ve been dreaming about frozen vaccines. I don’t want frozen vaccines…! Vaccines generally are very difficult to get to the field due to their sensitive nature, and are the only items I monitor twice a day. So, they better get into those tiny lil’ arms in good condition…!!!!

Photo: Mirabelle Adamu-Zeh

Mirabelle Adamu-Zeh

Children smile after receiving measles vaccines and yellow cards.

Mirabelle Adamu-Zeh

Mothers and children queue to receive measles vaccines.

A mind once exposed to knowledge can never go back to its original state, so I’m thankful for this opportunity to learn about these neglected diseases not only in books but in real life…!