We found two index cases of malaria in the same village so decided to investigate there on Wednesday. It was easy to find the first case but there was no GR-ID on the household so we had to identify the six closest houses on the fly. While the nurses set up, Vincent (one of the drivers) and I headed one way to count occupied houses while Kate and Braster went the other way. Vincent is very familiar with this area and knows some of the people so he knew when several buildings were owned by the same family and when a house was empty. We found the other index case, who actually lived in a different location than what they reported at the clinic, then headed back to the trucks to reconvene. When we got there, we learned from Kate and Braster that a primary boarding school was just next door to the other index case and that one of their staff members was diagnosed with malaria the week before. We had to test everyone at the school since it’s the right and ethical thing to do (and it’s in our protocol), but we knew it was not going to be easy.
The school, God Cares Primary School, was set up and run by missionaries from Romania. All of the staff are European but all of the kids are from the area. The principal was nice but had a lot of questions for us about the study and malaria in general and I wasn’t quite sure what to make of her. But she let us use one of the preschool rooms and provided consent for all of the students on behalf of their parents. Some of the kids just come to the school during the day, but 55 of them board there full time or at least during the week and it was those students and the staff that we really wanted to test.
It was pure chaos for a while. Large groups of kids were hanging around outside, more of them were peeking in the windows trying to see what was going on. All of them were yelling. The teacher whose room we took over wasn’t very helpful in organizing anything. We were told that all of the students speak English (the European staff certainly don’t speak Silozi) but the youngest ones were very shy and difficult to understand so I left most of the interviews for the staff who could speak the kid’s first language. At times it was so loud that I could hardly think clearly and it seemed like there were kids everywhere. It was hard to keep track of who had been interviewed, who still needed testing, who was waiting for results and who was just hanging around because it was the most interesting thing they had seen in a while.
Eventually we worked out a system where Simataa wrote down the kids’ names, ages and genders then got them to sit in a few chairs while waiting for a nurse. As soon as one of the two nurses was free, they would get a kid from the line and test them and collect a DBS sample. Then the child would be sent to Vincent or Braster who would interview them. We had them wait in an outer room for their test result which was probably not the best idea since it made that room very loud.
We all worked non-stop for 5 hours at the school, plus another hour or so beforehand. I didn’t eat or drink anything for over 7 hours and sweated buckets in that hot, stuffy room. I ate “lunch” at 5:30 pm on the drive back to the office.
After the teams left, Kate and I finished up a few things at the office then went back to her place to make dinner. It was nice to take the time to make a good meal. I made pesto pasta with veggies and a salad on the side and felt like we ate like queens. Even after dinner we continued to work for a while, but the 12+ hour days were taking it’s toll and at 9 pm I called it since I was not being productive at all.