CAT Tools…Meowww

September 14, 2010

This past week I began working on my CAT tools (Community Action Tools) in order to start gathering information about the different clinics/ hospitals run by el Municipio. I created a questionnaire geared toward patients to measure demographics (ex: where patients live, if they have medical insurance, are they employed, have been tested for HIV/AIDS before etc.). The questionnaire also measures the patient’s knowledge about HIV/ AIDS (ex: vias of transmission, ways to protect against HIV).

I began administering the questionnaire with patients at a clinic called Zumar, which is located in the northern edge of the city, in a very impoverished sector. I originally prepared the questionnaires to be filled out individually by patients. I soon discovered that it was much more feasible and effective to sit down with each patient and help them fill out the questionnaire. In Zumar, the waiting room is a large open space with hundred of chairs, which made it easy to sit next to a patient and to have some privacy while talking with them. I prefer administering the questionnaire in a private space so the patients feel comfortable answer questions truthfully and to ask questions without fear of other patients overhearing.

For a part of the morning, I had the option of using the psychologist’s office where patients are given HIV/AIDS pre and post conserjerías. With each patient, I did a mini charla (talk) to reinforce their knowledge of HIV/AIDS, to counteract any false knowledge and to answer any questions. I always start each mini charla by asking the patient “Cuéntenme, que sabes sobre VIH/SIDA”  (“Tell me what you know about HIV/AIDS”). This way, the charla is more of a conversation and less of a lecture.

After reviewing the results of my first 40 encuestas/ patients here are some of my main findings over two days at Zumar:

• 70% of patients attending the hospital are female
• 47% of female patients are between the ages of 10 and 30 yrs
• 82% of the patients have children
• 40% of the patients have between 2 and 6+ children
• 72% of patients believe that HIV and AIDS are synonymous
• 60% of female patients have been tested during 1 or more pregnancy
• 97% of patients believe that HIV/AIDS is a grave problem in Guayaquil
• 40% of patients believe that HIV can be transmitted via mosquitos
• 30% of patients answered that if one of their family members was HIV+ they would prefer that they kept it a secret
• 47% of patients answered that they believe that only drug users, sex workers and homosexuals should be concerned about getting VIH

This information gives me a good idea about what information should be provided in future charlas at Zumar hospital. It is clear that a majority of the patients attending Zumar are 1) Female, 2) are between the ages of 10-30, 3) have btw. 2 to 6 children and 4) have a limited knowledge about HIV/AIDS.

Within the province of Guayas there has been a feminization of the HIV virus. A majority of the new cases of HIV are housewives who are infected with HIV via their husbands or by one of their sexual partners. When speaking with both men and women during my mini-charlas, I emphasize this information – specifically to show that all patients should get tested regardless if they are married or have multiple partners.

Today I spent the majority of the day working on a new encuesta, which will be given to doctors working at the clinics/ hospitals run by the Municipio. The encuesta has a few main purposes:

• to measure the doctors’ basic knowledge of HIV/AIDS
• to analyze why the Municipio has such a low number of patients being tested – Are the doctors promoting the test? Are the doctors ordering the test regularly for patients or just for a select group of patients?
• to measure the number of tests which are available in each hospital per month
• to measure if doctors would like to receive more information about HIV/AIDS patient services and how to support patients living with HIV/AIDS

With these encuestas, I will be able to gather information about the process of HIV/AIDS testing within the Municipio run hospitals. More importantly, I hope to zero in on how the Municipio can be more effective at HIV/AIDS testing.

Outside of work, I have been spending a lot of time exploring the city. I’m starting to feel more confident on how to get around using public transportation and less paranoid about getting robbed (yet I’m still keeping extra vigilant about my surroundings). Another volunteer who works at the Infectious Disease Hospital was taking the bus home the other day when three men with guns robbed the whole bus. She lost about $5 but was pretty shaken up by the whole situation. Another reason to carry my wallet and cell phone in a hidden place or tucked within my shirt. I have been wearing a fannypack underneath my shirt with all my valuables.

Tomorrow I will spend my second day doing encuestas with patients at Hospital Maria Elena y Jacobo Ratinoff in the barrio of Puerto Lisa. I also have a meeting in the afternoon with my counterpart and my program manager to go over my encuestas and to discuss the possibility of organizing an HIV/AIDS conference for doctors on HIV/AIDS. I hope to host this conference at the Peace Corps Guayaquil office with the help of other volunteers who work at Fundación VIDHA, the Infectious Disease Hospital and the Red Cross. Currently, the Municipio does not have a good working relationship with the Ministerio de Salud (the government run hospitals which are funded by President Correa). This is due to a long standing feud between President Correa and Guayaquil’s mayor Jaime Nebot. My counterpart, Dr. Farhat, thinks it’s a great idea to have the conference in a neutral space (not in a Municipio run building) – that way we can invite doctors from private, city and government hospitals.

Wish me luck! xoxo

Love,  Lee