The Kingdom of Swaziland

The Kingdom of Swaziland
Dreams Fulfilled

Why am I in Swaziland?

HIV is a global pandemic and claimed the lives of millions of people all over the world. One of my hopes is that there will be a cure for HIV during or after my lifetime. Not only do I believe in physical healing of HIV, but I also believe in spiritual healing by faith in God. God has called me to act on this issue and my work here in Swaziland is being done to bring Him glory. By the grace of God, I was accepted into the Minority Health International Research Training (MHIRT) program offered by the University of Alabama at Birmingham (UAB) School of Public Health. Due to my passion for HIV research and prevention, I was selected to conduct research on the barriers to antiretroviral therapy (ART) initiation among HIV-positive children 2 to 18 months of age in Swaziland. With the relatively high rate of HIV among pregnant women and the relatively low rate of children initiated on ART in comparison to adults in Swaziland, this a major public health concern within the country.

What am I doing?

Just to get an idea of what I will be blogging about, I will be implementing a research project on the barriers to antiretroviral therapy (ART) initiation among HIV-positive children 2-18 months of age in Swaziland. I will be carrying out the study at several different health facilities in Swaziland with my research partner and fellow MHIRT trainee, Chantal Harris, who also attends the University of Florida. Our main job is to carry out the study by following the research protocol with the assistance of data clerks, the primary investigators, public health stakeholders, and doctors associated with the project and ART initiation among children. The research project is also funded by UNICEF, which allowed us to hire data clerks to assist with data extraction, survey administration, and the facilitation of focus groups for the study.

Who do I work with?

My fellow MHIRT trainee, Chantal Harris, will be working on the research project with me all summer. She also will be living with me in Dr. Peter Preko's guest house in Mbabane, Swaziland. Dr. Preko is our host and mentor as well as one of the primary investigators of the research study. Dr. Pauline Jolly is also a primary investigator for this research project and also the director of the MHIRT program at UAB. Mrs. Nobuhle Mthethwa is another one of the primary investigators and is the National Paediatric ART Officer of the Swaziland National AIDS Program (SNAP) of the Ministry Of Health (MoH). We have four data clerks helping us to carry out the study, which are two Swazi women, Nelisiwe (Neli for short) and Nozipho, and two Swazi men, Ndumiso and Sibusiso. Two other fellow MHIRT trainees, Jessica and ShaCoria, are also here in Swaziland for 12 weeks, but they are implementing a different project (association between HIV status and cervical cancer among women) and live with a host family in Manzini, Swaziland. The UNICEF budget for the research budget also rendered us the opportunity to hire two drivers from Affordable Car Hire (Smangaliso and Sipho) to take us from clinic to clinic.

Friday, August 8, 2014

Day 69: Francis' Going-Away Party


Francis will be leaving Swaziland to start college as an international student at the University of Oklahoma in the fall! It'll be his first time in the U.S. Best wishes to him and it was a pleasure getting to know him! We've developed a close bond within a short period of time. He's such a great guy!


Day 69: Loc Maintenance

So I retwisted my hair today and it's a little thicket than it was two week ago! its beginning to lock, but the front continues to loosen up every time Lisa washes it! You'll probably notice that my locks are quite fuzzy since its still in the locking phases. It will become more solid and even thicker, perhaps in the next few months.
I don't know how I'm going to maintain my hair once I get back to the states. It's so cheap to get my hair done in Swaziland and the styles are so unique here! Luckily, I have a few friends with locks that can help me maintain my hair until I learn how to manage it on my own.


These are the hair products that Lisa uses to retwist my locks. She usually uses the locking gel in the top photo (Maximum Hold Mouldin' Gel Wax), but she ran out of that product today so she used the gel in the bottom photo (Extra Strong Hold Twistin' Gel Tofee). The gel that she used today she said was good for hair that is already lock and the top gel is better for people just starting their locks. She also uses the Moister Splash conditioning spray in the bottom photo on the left.

Thursday, August 7, 2014

Day 68: Chantal's Surprise Birthday Dinner



Chantal's new backpack
Today, I stayed at Baylor and created the database for the facility-level questionnaires and began entering the data. It was much easier to put this database together since the survey was a lot shorter than the questionnaire for the participants. The only issue I had was that a few questions in the survey were a bit confusing or misinterpreted by the senior nurses who completed that. So the research team and I have to touch base with the senior nurses to make sure they filled out the survey accurately and understood each question. Chantal's data clerks, Neli and Nozipho bought her a new backpack because her old one was getting too old and had a huge hole on hole at the bottom of the bag. lol.

After I completed the database, Chantal and I met the girls downtown for lunch at Spur. I told our waitress that today is Chantal's birthday and all of the waiters sang her happy birthday and gave her ice cream. Chantal still doesn't know that I planned a surprise dinner for her at House on Fire. I just told her that I have a date with Francis at that restaurant and that Smangaliso will be taking me there.

Lunch at Spur on Chantal's Birthday
Chantal's Birthday Cake
After getting back to Baylor, ShaCoria and I think of a plan on how to get Chantal to House on Fire without her seeing the cake. But it was extremely difficult to hide our plan from Chantal! She was way too suspicious and followed us everywhere and she as questioning everything we did as if she knew we were hiding something from her! Even when went to pick up her cake, she noticed that I left Baylor and questioned me about it. So after work, Francis said that he was able to pick up and take us all to House on Fire since we had no other way to get there (at this point, Chantal still thinks that I am going on a date and that she and the other girls are just tagging along so that they can also get a ride home from Francis lol). Since we wouldn't have been able to hide the cake from her on the ride to the restaurant, we had to surprise her early on, right after work. Her first reaction when she saw the cake was "they spelled my name right!" lol. She noticed that I ordered her cake at the same place that we ordered Jessica's cake from and Jessica's name was spelled wrong, so she just had to point that out!

Birthday dinner at House on Fire - me, Chantal, ShaCoria, Jessica, and Francis (I'm not sure why the flash on my camera made it appear as if I had white stains on my jacket! lol)
We get to the restaurant about 2 hours later than the time we planned. As Smanagaliso said, there is no rush in Swaziland. Time seems to be unimportant. lol. The other guys that we invited from LCI came about and hour after we arrived at the restaurant (they were lost and thought we were at another venue). Chantal had no idea that we had planned a dinner for her until we go to House on Fire. I'm glad she enjoyed her night!

All of us at House on Fire! On the left from front to back:Jessica, Chantal, ShaCoria, and Glody. On the right from front to back: Apo, me, Francis, Richmond, and Yusef.

Wednesday, August 6, 2014

Day 67: Clinic Visits and Kente Fabric



Top Photo: Ghanaian Kente Fabric












I went back to a Ghanaian dressmaker that goes to Lighthouse Chapel International Church and requested a custom-made blazer for my godmother and grandmother to be made out of the fabric that I bought at Ezulwini Craft Market and the Ghanaian fabric that Dr. Preko gave me. Before leaving for Luyengo, I also secretly went with Simangaliso to order a cake for Chantal’s birthday tomorrow. I told Chantal that I had to go back to the dressmaker, Daniel from LCI, to change the measurement for one of the blazers. Although I did go back (but to only see the Kente fabri that was going to be used to make my dress), I also stopped to order her a cake without her knowing! Then, Chantal and I went to Luyengo Clinic to administer the facility-level survey there. After leaving Luyengo, Sipho took me to House on Fire, a restaurant near the clinic so that I can make reservations for the surprise dinner that I planned for Chantal’s birthday tomorrow! Since Chantal was in the car, I acted as if I wanted to just take pictures of the restaurant, and then made reservations for 10-12 people to attend her birthday dinner. I invited the drivers, Sipho and Simangaliso, as well as a few friends from church, Francis, Apo, Benni, Glody, and Richmond, and of course the girls (Jessica and ShaCoria) will be there. I’m still thinking of the best way to get her to the restaurant without it being obvious that it is a surprise.

Luyengo Clinic
Horo Clinic
After visiting Luyengo, Chantal and I also delivered the survey to the senior nurse at Horo Clinic. Then, we went back to Baylor where we met Jessica and ShaCoria to go back to the dressmaker because they both wanted another customized outfit to be made by the Ghanaian dressmaker. (ShaCoria was mad at me because I had forgotten to tell her that I was going to the dressmaker because she also wanted another customized outfit to be made for her). Then Simangaliso took us to see his puppies! Then, he took us to the hill that Waterford Kamhlaba is located so that we can take a picture of all of Mbabane. Waterford Kamhlaba is the United World College of Southern Africa and is the best school in Swaziland. Francis went there for high school where he was enrolled in the IB program (I did IB too). Chantal and I got a nice view of the city from Waterford.
View of downtown Mbabane on the way back to Baylor from visiting the dressmaker
House on Fire Restaurant in Malkerns, Swaziland

Swaziland National Museum Umsamo Wesive at Lobamba - on the way to Horo from Luyengo Clinic
Smangaliso's Puppies!

Me and Chantal by Waterford
Waterford Kamhlaba United World College of Southern Africa - the best school in Swaziland


Tuesday, August 5, 2014

Day 66: Distributing Facility-Level Surveys Continued

Chantal and I resumed with distributing the facility-level surveys to the other clinics within our study. We went to KS II first and we asked for one of the staff members to give the survey to the senior nurse for us since she wasn't in again. We also took down her contact information, as we did at all of the clinics we visited, so that we can follow-up with her. After visiting KS II, we visited Nhlangano Health Center and Good Shepherd Mission Hospital respectively to distribute the surveys. We will visit Horo and Luyengo tomorrow. Chantal's birthday is in two more days! So I am planning a surprise birthday dinner for her at Malandela's House on Fire, a restaurant in Ezulwini recommended by Dr. Sarah. I also plan on ordering Chantal a birthday cake tomorrow and bring it with me to the restaurant. I invited some of our friends from church, the drivers, and of course the girls, Jessica and ShaCoria, will be there. I plan on inviting Noeleen and Naoimi tomorrow as well.

Nhlangano Health Centre
More photos of Nhlangano
Good Shepherd Mission Hospital

Leaving Nhlangano Health Centre and on the way to Good Shepherd Mission Hospital

On the way back to Mbabane from Good Shepherd, Chantal bought grilled corn on the cob, a popular snack for Swazis, on the side of the road for 6 Rand each (they can be 3 Rand each at some places such as the Kombi Station).

Pizza Inn, located in the food court of Corporate Place, has the buy one get one free special every Tuesday. One box of pizza is usually around 59 Rand, so Chantal and I bought two Margaritia pizzas for the prize of one and split the cost. I also took a photo of the other Americanized restaurants that I frequent: Spur and GreenChilli (but it's been a while since I've eaten from GreenChilli)

Monday, August 4, 2014

Day 65: Distributing Facility-Level Surveys

Chantal and I decided to begin with distributing the facility-level surveys to all of the approved clinics for the research study, which is one of the areas of focus in the research protocol: to access the organizational factors at each facility that the study is being conducted in terms of ARV treatment and HIV-related services among patients. All of the senior nurses from each clinic that we have conducted the study in are expected to complete the facility-level survey we created. We also plan on giving each facility a few days to a week to finish the survey and follow-up with them through a phone call before we come back to the facilities to collect the completed surveys. Meanwhile, Ndumiso scheduled interviews with cases today from caregivers with patients at RFM Baylor and the other two data clerks, Neli and Nozipho stayed at Baylor in Mbabane to transcribe and reorganize data. Since the girls and I wanted to plan a trip to Mozambique this upcoming weekend, we need visas to enter the country. Before we went to the clinics, we went to the Mozambique Embassy to see if it was possible for Chantal to get a visa although her passport expires in less than six months. We confirmed that our passports need to be valid for at least six months in order to apply for a visa, so we decided no to go so that we won't leave Chantal behind. Also, Chantal's birthday is this upcoming Thursday (August 7th) and we want to be with her during her birthday weekend.

High Commission of the Republic of Mozambique in Mbabane, Swaziland
We started off at Lobamba Clinic and Matsapha MSF Clinic. We were successful at getting a senior nurse (or an equivalent) to agree to complete the facility-level survey. Then we went to King Sobuza II (KS II) Clinic, however, the senior nurse was not in today so we have to come back tomorrow to distribute the survey. After visiting KS II, Chantal and I went to RFM Baylor to distribute the survey to the senior nurse there. Then we visited Siphofaneni Clinic and Hlatikulu Baylor Satellite Clinic, which were two of the farthest clinics out of all the other facilities we visited today. We went to Hlatikulu last and none of the senior nurses were there to report information about the facility from 2011 to 2012, which are the two years we are targeting within the study. So instead, we gave the survey to a representative from Baylor Headquarters who knew about the facility within our study period.

Below are photos that I took of each clinic that I didn't get to take pictures of previously. Today was my first time visiting Siphofaneni Clinic and Hlatikulu Hospital.

King Sobhuza II (KS II) Health Centre
Siphofaneni Clinic

Hlatikulu Hospital and Baylor Satellite Clinic
Picture taken on the way to Hlatikulu Hospital from Siphofaneni Clinic

Picture taken leaving Hlatikulu and heading back to Mbabane

Sunday, August 3, 2014

Day 64: First Sunday at New Church


Lighthouse Church International (LCI) moved into a bigger venue. This is also may be my last Sunday in church if the girls and I plan on going to Mozambique next week and then we are going to Cape Town our last weekend here, which is in two more weeks. I'm amazed at how quickly this summer passed! I've been in Swaziland for over two months now and I feel like I've just been here for a week. I'm truly going to miss it here and the amazing people I've met on this journey.
Pastor Joe and Francis on Francis' last Sunday at LCI before he leaves for the States next week! Francis gave his testimony in front of a large group for the first time! I'm so proud of him and I'll miss his company. I'm so excited for what God has in store for him as he goes off to America to study at the University of Oklahoma. We definitely will be keeping in touch. After church, the rest of the youth group and I were planning a dual going-away party for Francis as well as for me and the girls. Since Francis is leaving Swaziland first, we primarily planning a party for his leave.


Top photo: Dr. Preko's daughter Gabby (on the right) and her best friend Precious (on the left). Bottom photo: Dr. Preko's son, Caleb

ShaCoria and I originally planned to hang out with Francis and Richmond at Mbabane with Chantal as well (Jessica decided to stay in Manzini). However, Francis couldn't make it and since Francis was Richmond's ride, Richmond wasn't able to hangout with us either. So Lena allowed Chantal, ShaCoria, and I to use her car to go to the Pub & Grill at The Gables in Ezulwini. I ordered the Chicken Schnitzel, which is the meal I usually get at every restaurant I visit here.