I spent most of my time this week working in the WE-ACTx town clinic doing the study. Patients were scheduled for Monday when I was supposed to be at Nyacungu and it was my turn to stay. The study is going well and progressing along at quite a rapid pace so hopefully we won't be away from the shadowing/clinical experience and support groups for much longer.
Tuesday I went to Icyuzuzo with Dr. JMV. We had an interesting day as we found out the local private pharmacy is scamming WE-ACTx and the patients. The Icyuzuzo clinic and WE-ACTx town clinic are partner associations. When Icyuzuzo doesn't have the medications the patients need, they are sent to the WE-ACTx town clinic. If the town clinic doesn't have it, they are sent to a private pharmacy in the area that is under contract with both associations to provide meds up front to patients. WE-ACTx pays by prescription each month and the patients still get their meds without having to pay. The patients were being turned away, told to come back each day for months at a time because the private pharmacy told them they ran out of their meds. They'd hand them a card stamped by their business with the date and medication written on it. Then, they'd turn in the original prescription and get paid by WE-ACTx as if they had given out the meds. The only way WE-ACTx finds this out is when patients come back to the doctor and tell their story. A trip that they can typically only make once a month. The man who told us about this came to the clinic for his July ARV meds and was still waiting from the private pharmacy for his May and June ARVs! To properly stress the significance of this--ARVs are saving his life...without them he will progress to AIDS and die. Period.
Another report this week was from a patient who came back from the private pharmacy with the wrong meds. They charged WE-ACTx for the expensive, top of the line meds (in Rwanda) and provided the patient with a cheaper drug that wasn't even the same type of medication. Unbelievable. Dr. JMV asked me to pass the message along to Mardge and now WE-ACTx has another issue to add to their list of concerns.
On Thursday at the clinic, I met a nurse who has been on leave named Christine, who spoke quite a bit of English. I told her that was my mother's name and she jumped out of her chair, hugged me, kissed me and we've been family ever since. Don't worry Mom, she told me to tell you that since you're so far away she'll be my Rwandan mother and I am now one of her girls. She said she will keep me safe, and make sure I'm eating well...It was as if my mother had teleported into this Rwandan clinic exam room...hahaha. She is bringing me a picture of her family as a gift, 'so you will know your new Rwandan family'. I need to find a picture of my family in return for her, which should be interesting since I don't have one on me, nor do I have any still left on my sim card in my camera, or have access to a printer...hmmm...
Every time this woman left the room she'd slap my cheeks...it's tough love all the way here... and when she left for the day she hugged and kissed me again and gave me a flower she'd brought to brighten up her office that day. The people here continue to amaze me. Something as simple as having the same name makes you family here. True, there are many Rwandans who are extremely interested in mazungos as it is a sign of privilege to have white friends, but today it was clearly beyond that.
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