We started today, Tuesday, November 11, 2014. Well, we actually started over a year ago but today we enrolled our first participants. My staff had prepared all the material yesterday afternoon and we agreed on a time to start. Makendy came in early to drive us to the clinic, Haiti Health Ministries (HHM). It is only a 15 minute walk from the lab in Christianville but with all the materials we needed to bring along, we needed Makendy to drive us in the Everest. We left C’ville at 7:35 am and arrived at HHM five minutes later. Jenn, the OB-GYN nurse showed us the rooms we would be using today. We spent about 15 minutes getting our materials and laptops set up in both rooms. By 8:00 am, we were ready to wade into the crowd of people waiting to be seen at the clinic and start recruiting. But first, morning devotions. One of the clinic’s Haitian workers came out onto the porch waiting area and led the crowd in a song and prayer. Then Dr. Jim, an American doctor and the Medical Director, did a reading from the Bible, in Kreyol. Dr. Jim then gave a short sermon, still in Kreyol. He finished up with a prayer and I think he may even have asked for God’s blessing on our project. By 8:20 am we were ready to start recruiting participants for our project but it was also the time for the HHM staff to begin patient intake and measuring vital signs. It was not a good time to recruit. This was why Sandy, the Clinic Administrator, had advised me to have my team arrive early and start recruiting before devotions. In any event, Youseline, the Study Coordinator, began signing up people who expressed an interest in the project. We had set a modest goal of eight participants for our first day: four men and four women. By 8:40 am Dukens, a Research Assistant, took the first participant in our study (a man) through the informed consent process. I stood and watched as Dukens read the Informed Consent Document (ICD) while the gentleman followed along on another copy. Dukens answered the few questions that the man asked and then he signed the ICD. We had enrolled our first participant. Only 1,999 more to go.
In the meantime, Monise, the other Research Assistant, was conducting the same informed consent process with a woman in another room. Twenty minutes later, Monise had the women’s signature on the ICD and we had our second participant. The Research Assistant quickly started the specimen collection part of the protocol and then conducted the Behavioral Risk Survey. It was almost 10:00 am and things seemed to be going smoothly. There was nothing I needed to do. Well, there was one thing that I did not have time to do before we started. Buy telephone cards.
Part of the protocol is to give each participant a telephone card worth 250 gourdes (about $5.00) as a small compensation for their participation in the study. I had planned to buy the phone cards in Port-au-Prince on Monday after we picked up Madsen and two other people at the airport. But by the time we got to the Digicel store near Carrefour, the store was closed. I was stuck. Worse still, this morning Makendy had taken Madsen into Port-au-Prince and they would be gone for the day. I called Laura, the C’ville Guesthouse Coordinator. Sorry, she said, all the C’ville vehicles and drivers were out. No help there. I called Matt, a friend who lives at C’ville with his wife, Jessica. Matt has a truck. I asked Matt if he could do me a favor and drive me to the Digicel store in Gressier. Matt said sure. So I told my staff they were doing fine and that I was leaving to buy the phone cards for them to give to the participants. I started walking back to C’ville very worried that the Digicel store in Gressier might not have the cards. Then what? Matt and I drove out to the highway and down the road to the Digicel store. They had no telephone cards. The man at the counter said that Digicel was moving away from selling them anymore. Were there any available at the Digicel store in Léogâne, I asked. He did not know. I told Matt it was not worth driving to Léogâne and risk not finding cards there either. I was moving down the list and already was past plan B for plan B. Then Matt had an idea. Why not just transfer the money from my phone to the participant’s cell phone? It is easy enough to do. Although Matt did not know how to do it, every Haitian knows how because they do it often. And that is the solution that we found to my problem of phone cards for the participants.
Then I had my other problem. My staff and all of their materials were at HHM and there were no drivers or vehicles to bring them back. There was no way I wanted them to walk back carrying all that stuff. And it was not fair. When we planned the project, we knew that my staff would need a vehicle and driver at the beginning and end of each day. UF needs to hire another driver and we have told them that for months. But their attention has been consumed by the growing problem of electricity. There is only one generator operating in C’ville now and if that one goes down, there will be no power for the lab. In any event, my staff needed a ride back to C’ville now.
As Matt and I pulled into C’ville, I saw the other UF Everest parked next to the lab. Mille, who collects mosquitoes for the malaria project, had just returned from setting traps. I leaped at the chance and asked Meer if I could use Mille to pick up my team. Meer said yes and I was back at the clinic at 1:00 pm just as Dukens and Monise were finishing up with their last participant for the day. We were back at the UF-EPI Haiti Lab 1 Gressier at 1:15 and ready to start testing the specimens for Chlamydia, gonorrhea, syphilis and trichomoniasis. The lab work went smoothly but slowly. It was only our first day so I expected that. While we waited for the test results on the GeneXpert (a 90 minute test), I handed my cell phone to Youseline and instructed her to transfer the 250 gourdes to the cell phone accounts of our eight participants. By the time the results came off the GeneXpert, it was 5:15 pm; all eight participants had been tested. We had two positive tests for trichomoniasis. All the other tests were negative. One test for Chlamydia and gonorrhea (on the GeneXpert) was invalid and had to be repeated. It was negative.
So we had a good first day. I was very happy but exhausted. And tomorrow I leave for Baradères and my team will be on their own. I am confident they will do well.
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