Important travel information before leaving for Cameroon

Here is some information I'm sure to need before leaving for the airport.  First, what does my hotel look like?  Here is a link you can browse through.  Looks like I will be in the center of downtown Yaounde!  hotel la falaise in Yaounde  /

What is the population of Cameroon?
     ~ 16.3 Million.  The 2 largest cities are:
 Douala = 2.8 M and considered the economic capital of  Cameroon   
Yaounde = 2.8 M and considered the political capital of Cameroon

I will be in Yaounde working with the GHSS and the CDC-Cameroon on the RTQII Initiative.  See earlier post for more information on this Initiative.

Next- what is the currency in Cameroon?
     The Central African CFA franc which is also used in Central African Republic, Chad, Republic of the Congo, Equatorial Guinea, and Gabon. The Bank of the Central African States which is responsible for the currency is based in Yaoundé, Cameroon.  The CFA is related to the French currency and the Euro.  Interesting.

What sort of weather conditions are awaiting my arrival?
   Well..... temps will be between mid-60s and 70s!  PLUS rain every day!! My trusty umbrella is already packed!  I'll take rain over  the 38 degrees C we've been having all summer..  (Ok my followers- convert that temp to F!!)

Information on the UNAIDS 90-90-90 Initiative and Goals

UNAIDS 90-90-90: AN AMBITIOUS TREATMENT TARGET TO HELP END THE AIDS EPIDEMIC

Ending the AIDS epidemic is more than a historic obligation to the 39 million people who have died of the disease. It also represents a momentous opportunity to lay the foundation for a healthier, more just and equitable world for future generations. Ending the AIDS epidemic will inspire broader global health and development efforts, demonstrating what can be achieved through global solidarity, evidence-based action and multisectoral partnerships.

Although many strategies will be needed to close the book on the AIDS epidemic, one thing is certain. It will be impossible to end the epidemic without bringing HIV treatment to all who need it.

As the world contemplates the way forward following the 2015 deadline for the targets and commitments in the 2011 Political Declaration on HIV and AIDS, a final target is needed to drive progress towards the concluding chapter of the AIDS epidemic, promote accountability and unite diverse stakeholders in a common effort. Whereas previous AIDS targets sought to achieve incremental progress in the response, the aim in the post-2015 era is nothing less than the end of the AIDS epidemic by 2030.

In December 2013, the UNAIDS Programme Coordinating Board called on UNAIDS to support country- and region-led efforts to establish new targets for HIV treatment scale-up beyond 2015. In response, stakeholder consultations on new targets have been held in all regions of the world. At the global level, stakeholders assembled in a variety of thematic consultations focused on civil society, laboratory medicine, paediatric HIV treatment, adolescents and other key issues.

Powerful momentum is now building towards a new narrative on HIV treatment and a new, final, ambitious, but achievable target:

• By 2020, 90% of all people living with HIV will know their HIV status.
• By 2020, 90% of all people with diagnosed HIV infection will receive sustained antiretroviral therapy.
• By 2020, 90% of all people receiving antiretroviral therapy will have viral suppression. 

HIV Rapid Test Quality Improvement Initiative (RTQII)

Between 2004 and 2012:

• Over 159 million HTC (HIVTesting and Counseling) sessions were provided with PEPFAR (President's Emergency Plan for Aids Relief) support using HIV rapid tests (RT). Working towards the elimination of new HIV infections under PEPFAR's Combination HIV Prevention strategy will require increasing access to and uptake of HTC and emphasizing efforts to ensure the accuracy of HIV testing. 
• In support of these efforts, the Laboratory, HTC and Prevention of Mother-To-Child Transmission of HIV Technical Working Groups (PMTCT TWGs) collectively proposed an HIV Rapid Testing Quality Improvement Initiative (RTQII), which has been approved by Ambassador Goosby. The RTQII aims to ensure the quality of HIV rapid testing and expand upon current in-country HIV rapid testing quality improvement work. The RTQII is comprised of the following five key action areas:

1.      Policy Engagement: Create an enabling framework for policy development

2.      Human Resource: Increase cadres of qualified testers through training and certification

3.      Proficiency Testing Programs: Increase uptake and coverage and demonstrate impact

4.      Standardized Register: Increase uptake and coverage and demonstrate impact  

5.      Post Market Surveillance: Monitor the quality of new kit lots

All seven selected countries, like all PEPFAR-supported ones, are presently implementing to some extent the different focused areas identified by this Initiative. However, because of inadequate engagements at national levels, insufficient resource allocations, coverage and consistency in rolling out quality assurance has been challenging. To this end, the RTQII will help synergize and leverage existing country resources and ensure long-term sustainability of the quality of HIV testing. 
The seven countries participating in the RTQII Initiative are:

Kenya

Tanzania

Cameroon

Ethiopia

Uganda

Malawi

Zambia

Off to Yaounde, Cameroon

Welcome to Cameroon

Before going into a new country, I like to learn as much about the culture, history, and people as I can.  I am going to Cameroon as a consultant to assist with training and implementation of the UNAIDS 90-90-90 Initiative. See below for details of this Initiative.  This is my first time to go to Cameroon and I am very excited to learn about the country and meet the colleagues I will be collaborating with.  

I invite you to follow my adventures and experiences through Cameroon.

  

Country Facts:

• Cameroon is located on the Gulf of Guinea, and a Central African country of varied terrain and wildlife. Its inland capital, Yaoundé, and its biggest city, the seaport Douala, are transit points to ecotourism sites as well as beach resorts like Kribi – near the Chutes de la Lobé waterfalls, which plunge directly into the sea – and Limbe, where the Limbe Wildlife Centre houses rescued primates.
• Cameroon, officially the Republic of Cameroon, 
• Its land bordering countries are Nigeria, Chad, Central African Republic, Equatorial Guinea, Gabon and the Republic of the Congo.
• Capital: Yaounde
• Population:  24.05 million (2017) (World Bank)
• Official languages: French and English
• Cameroon is famous for producing coffee, cocoa, cotton, bananas and oilseeds.
• Cameroon has 7 national parks. 
• Waza National Park is its most famous one with numerous elephants, lion, giraffe, antelope, antelope, and birdlife and has some of the richest flora and fauna found in Africa.
• What does the Flag stand for?
• The national flag of Cameroon was adopted in its present form on 20 May 1975 after Cameroon became a unitary state. It is a vertical tricolour of green, red and yellow, with a five-pointed star in its center.
• The red symbolizes unity, as well as the centered yellow star. Green represents hope and the yellow prosperity. Those colors combined are the official Pan-African colors. 

• 
  

Off to Kyiv, Ukraine

Where is Ukraine?

Ukrainian flag

 This will be my 11th trip to Kyiv, Ukraine.  I love the city, its rich history and culture.  I am collaborating with the National Ukrainian Medical Laboratory Auditing Team to evaluate the implementation process of Quality Management Systems into a cohort of selected laboratories.  The country and the people are wonderful and very friendly.  I will post on a daily basis and share my experiences (along with pictures).

   
Facts about Ukraine:

Ukraine is a large country in Eastern Europe known for its Orthodox churches, Black Sea coastline and forested mountains. Its capital, Kiev, features the gold-domed St. Sophia's Cathedral, with 11th-century mosaics and frescoes. Overlooking the Dnieper River is the Kiev Pechersk Lavra monastery complex, a Christian pilgrimage site housing Scythian tomb relics and catacombs containing mummified Orthodox monks.

President: Petro Poroshenko Trending

Capital: Kiev

Currency: Ukrainian hryvnia

Population: 44.83 million (2017) World Bank

Official Language: Ukrainian

• The name Ukraine is believed to originally mean "borderland" or "region". In English 'The Ukraine' used to be the form used now it is just called 'Ukraine'.

• Ukraine has an area of 603,628 km² (233,062 mi²), which makes it the largest country with its entirety within Europe.

• Ukraine shares land borders with 7 countries, Russia, Belarus, Poland, Slovakia,Hungary, Romania and Moldova.

• The capital city of Ukraine is Kyiv, which is home to over 2.8 million people.

• Ukraine became an independent country on the 24th August 1991 following the collapse of the Soviet Union.

• As of 2011, Ukraine was the world's third-largest grain exporter and used to be called the breadbasket of the Soviet Union. The country also has large deposits of natural resources including iron, coal, gas, oil, manganese and other metals.

• The world's worst nuclear power plant accident, the 1986 Chernobyl Nuclear Power Plant disaster, took place in the now abandoned Ukrainian town of Pripyat.

Day 1

Off to visit the first of 5 labs to conduct a post-assessment.  In addition to myself, there will be other Ukrainian National Training Team colleagues assisting me with this audit.  I am looking forward to seeing each of them again.

Afterward the assessment:  WOW- this lab has made incredible improvements since the baseline assessment.  Due to confidentiality issues, I cannot discuss specifics or share pictures, but I can share the following picture of the door to the Laboratory (below).

Day 7 in Kyiv

It's Saturday and I am free all day to be a tourist.  As part of the U.S.-Ukrainian Assessment Team, we conducted post- assessments at the laboratories who volunteered to be a part of the Country Project: Preparing Medical Laboratories to Earn International ISO 15189 accreditation.  We were ecstatic to find so many improvements to the Quality Management Systems in each of the laboratories.  These improvements were based on our findings from a pre-assessment conducted last year.  Implementing improvements in any setting and organization is tedious.  This was an international project, which adds another layer of commitment and potential barriers.  However, this time, the U.S. consultants were mindful to research cultural characteristics of Ukraine and its peoples prior to planning the training approach and methodology.  Selecting the appropriate Ukrainian laboratorians to participate in the training was also done including those professionals accepting of new concepts and open to "change".  Suffice it to say:

The right people + culturally appropriate methodologies + trust and respect + mentorships = A Successful Improvement Project augmenting improved health care for Ukraine.

Of course, this project also demonstrated fiscal responsibility and use of PEPFAR and other funds supporting this project.

Collaboration between two unique but different countries and their respective citizenry further promoted a personal bond and camaraderie between  all members of the team.  In addition to a plethora of discussions on laboratory issues, there was also time for discussions and sharing of personal stories, hobbies, travels, etc.. Lifestyles, expectations of gender roles, marriages, and children were also shared creating even stronger bonds.  Turns out- all laboratories and their staffs have identical challenges with proper identification of patients, writing SOPs, Fire and Biosafety regulations, and balancing work and family time.

Below are pictures last week from Kyiv.  Due to confidentiality respect, the majority of pictures are related to outside the lab.  It was a week of cold temperatures - minus 6 to minus 12 degrees Centigrade and lots of snow and ice!

Street Musician in subway 

Funicular running from upper to lower Kyiv City

St. Andrews Cathedral

Entrance to Laboratory caption

Training Classroom on Process Mapping

View inside a laboratory

Dr. Cathy Presenting at the International Meeting in Kyiv

Sunset before the snowstorm

International Womens' Day

Oct 20th is celebrated in Vietnam as International Womens' Day.  All women are celebrated for their care and love of their homes, children and spouses.  The streets had a plethora of flower stands with flower arrangements lining the entire sidewalks all over town.  The participants attending our workshop bought my colleague and me these beautiful flowers to honor us!

Cooking Class in Hue, Vietnam

I've wanted to take a cooking class in Vietnamese cuisine for several years and my schedule allowed time for that on this trip.  The chef at la Residence Hotel in Hue met me and together we went to a local market via rickshaw travel.  After purchasing the foods and spices to prepare the dishes I selected we returned to the kitchen and began cooking.  Complete with apron and a white chef's hat - I felt quite honored to be in a real Vietnamese kitchen.  The following are pictures beginning with the rickshaw ride to the market and ending with enjoying a meal cooked by myself (with assistance).  I received the recipes (in English) to try to re-create the same dishes back home and also a certificate which I will proudly share with my friends! 

                         

 

Back to Vietnam October 2017

This trip takes me to Hue and Ho Chi Minh City (Saigon).  I am excited to visit Hue as I have worked with university faculty from Hue but have not been to see their school or their city!  HCMC I have been to many times and have many friends and colleagues I look forward to seeing, working with, and learning from on this trip.

Back to Vietnam: 2017

I've missed filling in and updating my travels for about 4 years!  I started traveling about 90% of the time and just didn't have time to do much of anything other than wash clothes and repack for yet another trip 'somewhere'!  Not traveling so much now and will diligently work to add all my trips and observations!

This is my ~20 time to visit Vietnam and this trip is to Hanoi.  I will collaborate with my Vietnamese colleagues and the many friends I have made over the years.  This is very exciting.