In the Field

Starting on monday we began working on our projects. I had a chance to visit the Prerana clinic a few blocks away from the PHRI house. We have started getting everything organized for what I hope will be a relatively soon opening. From what I understand supplies are being ordered and there is just a bit of paperwork that needs to be completed before we open. For those of you who haven’t been forced to read my IRB or protocols, I will be comparing the performance of a rapid diagnostic kit to other methods established for detecting a Trichomonas vaginalis infection. Trichomoniasis is a sexually transmitted infection (STI) that can cause vaginitis and a few other more serious complications. Although it doesn’t get a lot of recognition, it is actually the most frequent nonviral STI. It has been considered a possible suspect in causing greater susceptibility to HIV, cervical neoplasia, and preterm birth, although its main symptom remains to be vaginal irritation, which can either self-resolve or continue to create greater problems. A sexual partner can pass it to the other even if that person has just been treated, creating the “ping-pong effect”. Therefore it is imperative, when trichomoniasis is detected, both partners must be treated. One of the problems is that most clinicians use a symptomatic approach to diagnosis.

The current method for diagnosing this disease utilizes a microscope. You can observe the specimen on a slide and look for, what I consider to be “cute”, little swimming balloons wiggling around in the saline. This method is not very accurate and the other methods such as culture and polymerase chain reaction (PCR) have their own flaws. The rapid test might perform well in India and if so, its implementation in developing countries can be considered.

Since we got here, Aaron and I have observed that the pace is very different than that of back home. The atmosphere is just seems more relaxed, less stressful, even if there is a lot of work being done. Also, it has become apparent that the social network within PHRI is very strong and an important aspect of the work environment. If we want everything to run smoothly with our projects, it will be important for us to solidify the relationships we build with other team members.
On wednesday, we joined the staff in a trip to the villages to hand out reports of lab results. Everyone seemed very curious as to our presence there. The smaller children were very quiet and a couple even cried because they were scared of us. The older children were completely distracted by our presence. Instead of paying attention to their lesson, they cluttered into doorways waving at us and wanted their picture taken. Some even stood on their desk to get a better look and wave. Inside one of the classrooms, the staff performed a maternal health education and disease prevention skit for the women in the village. The women seemed to respond well and laughed during the husband’s part, which tries to reinforce the importance of getting the husband to participate in the process. Shalini advised me that the women become very shy and will hold their heads down when there is discussion of contraceptives or when the condom is brought out.

For lunch, we stopped at a nearby lake and unfolded mats to have a picnic. Everyone sat together and passed around the meal they brought. I’m not sure if it was smart for Aaron and I to participate since we didn’t know how everyone’s food was prepared, but we both enjoyed it thoroughly.