February 2007 Report
Summary:
The activity on the MIAM campus during the month was somewhat continuous, with both the molecular biology lab personnel kept busy and the various field work teams also out in the field most days.
Early in the month the deep well (borehole) pump supplying the campus and labs stopped working, but the pump was rapidly removed and replaced by a back-up pump by the maintenance team, with only several hours of water outage.
After the very heavy rains of January, the month of February had less rain and several dry spells, making the situation a bit more conducive to field work activity.
The USAID funded building project continued with good progress being made and no delays due to supply shortages.
Visits to MIAM by various people, including the WHO Country Representative to Zambia, led to more opportunities to show people the work being carried out here.
I - General Site Development and Maintenance
The grass continued to grow rapidly in February, with crews seen busy slashing grass most days. Trees, shrubs and flowering bushes showed good growth this month, enhancing the natural beauty of the campus! Many of the indigenous trees planted the first year are now growing well, while other flowering bushes are now well established.
A major crisis was avoided in the first week of the month when the deep borehole pump suddenly stopped working, leaving both the residential campus and the MIAM labs without water when the water storage tank ran dry early one morning. The quick response by the maintenance crew managed to determine the problem, and fortunately there were no difficulties in pulling the pump out using the continuous PVC pipe, and replacing the pump part that had broken down from wear. Within six hours of running out of water, the system was restored and functioning properly again - probably a record for rural Africa!
With fewer heavy rains, the frequent ZESCO electrical outages experienced in January were not as bad in February, though the back-up generator still needed to be used quiet a few times. The wiring of the lab with 3 phases of electricity was completed in February, with a much better electrically balanced building now. This allows for less dimming of the lights being noticed when the many air conditioner and fridge/freezer compressors cycle on and off.
II - Construction of Buildings
Considerable progress was made in February on the walls of the 10 bed-roomed dormitory and the kitchen/dining facility. The dorm had the reinforced concrete ring-beam poured around nearly the entire building by the end of the month, and the kitchen/dining facility had walls laid up to window level for about 50% of the building.
The third staff house (House 'C') continued to have internal work, with wall plastering and concrete floor pouring completed by month's end. The chimney structure was nearly completed by month's end, and a portion of the internal electrical work and plumbing remains to be finished. Due to the rains and high humidity, it will be two or three months before the concrete walls are dry enough to apply paint.
The fourth and final staff house to be constructed under the USAID-funded project was staked out on the site (House 'D'), and had foundation footers dug towards the end of the month.
The slow release of funds for the project by USAID led to cash flow difficulties in February, and thus the project had to cut back on the purchase of some building supplies.
III - Information Technology
The entire month of February we remained without the larger and better "C" band VSAT in operation, often leading to no or intermittent internet access during working hours, and making it impossible to use Skype for communication on most days. In addition, due to a grant that was due in February that required internet access for submission, many late nights were spent trying to get internet access, after the other users of the "Ku" band shared VSAT had logged off from other parts of Africa! Despite these frustrations, there was fairly regular email access throughout the month, using the lower bandwidth available with the back-up Ku band VSAT.
Although it had been hoped to have the C band VSAT back in operation by March 1st, and although the replacement part was purchased and received in mid-February, the restoration of full broadband service was not possible due to several small details that were still being solved at month's end.
In addition, the MIAM servers remained in-accessible by anyone outside of Macha, leading to difficulties accessing email when one was away for Macha at meetings in Lusaka.
During February, there was on-going discussion between MIAM and LInkNet as to how best to establish a system whereby LInkNet takes full responsibility, under a contractual arrangement, for providing internet access and local area network (LAN) support and maintenance to MIAM. Dialogue continues with a goal of developing a Service Level Agreement (SLA) by the end of March.
IV - Vehicles/Transport
MIAM had five vehicles on the road for most of the month, though the extensive new field work for the Epidemiology Pilot Study in the eastern section - with many bad roads and difficult and muddy conditions due to the rains - exerted a heavy toll on the vehicles.
The Toyota Condor, after being repaired in January with a major engine overhaul, ran well throughout the month, being used primarily for weekly business and purchasing trips to Choma, as well as some local field work trips. It's low suspension and clearance makes it inappropriate for many of the places now being visited for field work, since many of these roads are very bad.
The Hilux 2.8 had problems during the month, with the 4 wheel drive system not always engaging properly, leading to several episodes of getting struck in mud! Its spare wheel also fell off and was lost in the field, and by month's end the vehicle was off the road, having developed a bad wheel bearing in one of the rear wheels. The newer Hilux 3.0 saw heavy use on very bad and often muddy roads in February, but has kept running reliably, so far!
The old 1992 Toyota Hilux was sold in February to a person in Lusaka, after obtaining several bids for it as a "non-runner".
The three motorcycles were also used frequently during the month, and it is hoped that funds can soon be found to buy at least one or two more motorcycles, since the increasing number of projects require more frequent use of them.
V - Research Activities
The molecular biology lab remained a place where there was always activity during February, as the PCR work on the NMCC samples was being completed, and the PCRs related to the Fitness Study were being run. There was also on-going work being carried out on the urine/saliva studies for diagnosis, as well as various other sub-projects. A graduate student from Hopkins, Petrica Rouse, joined the lab for a three month experience, and quickly became very involved in running PCRs.
The insectary continued to raise anopheline mosquitoes, though mating had not yet taken place to establish a continuous colony. The air conditioning unit in the insectary had to be repaired, but was working again by month's end.
Field work continued on the GIS study, with prevalence surveys and mosquito collections being done in the various grids. However, the main field work in February centered on the preparatory work for the Epidemiology Pilot study, with many visits to local chiefs, headmen and village leaders, establishing community acceptance and an understanding of the study. Visits were also made to the District officials in Monze, as well as several contacts made in Lusaka with the UNZA Research Ethics Committee, to try and get the study approval process moving along!
Drs. Kumar and LeBlanc's Immune Response study continued in the Chitongo area, with follow-up made on several participants who had not been seen at the regular visit in December. In addition, due to community misunderstandings and some harassment of some of the older children in the study by other community members, a special community meeting was held by MIAM staff for education about the study and its purposes.
One of the special electrical "grids" with an attached "spark box" was set up and connected to a vehicle battery for several nights on the MIAM campus, and demonstrated that mosquitoes could be captured using this method. The large clay pots for mosquito collection that were bought in January for Dr Shiff's entomology project, were also successfully drilled, without causing any cracks.
Map "proofing" for the new Epidemiology Study area was carried out in February by the GIS Manager, with all of the randomly selected households now having been identified. It is expected that they can all be located on the ground once all approvals are obtained to start the study.
VI - Personnel
One of the recently hired lab scientists, Taida Kumwenda, decided to resign in February after she was accepted into medical school at UNZA. A potential replacement will be interviewed in April when Dr Shiff is next in Zambia
Dr. Thuma attended a week of malaria planning meetings held in Lusaka in February, and hosted by the National Malaria Control Centre and the Ministry of Health. All major donors for Zambia's malaria control plan were there as well, and the meeting developed the "Strategic Plan for Malaria Control" for 2007. There was good interaction with the new NMCC Coordinator as well as the Deputy Coordinator, and plans were made for a formal visit by Dr Thuma and Dr Mharakurwa to the NMCC in March to discuss ways in which MIAM can work with and assist NMCC.
VII - Other
There were several visitors to MIAM in February, including Mr. Alistair Grant, the Executive Director of Carramore, a lab supply company.
A group of visitors, including the WHO Country Representative to Zambia Dr Stella Anyangwe, as well as others from the CDC, Atlanta, Zambian Ministry of Health and NMCC, spent several days at MIAM seeing what is happening here, and listening to presentations by Dr Thuma and Dr Mharakurwa. They were particularly interested in the decrease in malaria caseload that the hospital has experienced in recent years, and there was much discussion about this and what may be the contributing factors.