Following the medicines in rural Webuye, Kenya:
Abigail is overwhelmed. When she sits in our office in the HIV
clinic, her shoulders slump as though she is carrying a huge sack
of rice. You can barely hear her whispers as she recounts her
story. Her husband died three years ago, leaving her alone with
their three small children. Abigail never went to school beyond
5th grade, and she struggles to find even small jobs so
that she can pay for food and shelter for herself and the children.
She says that when her family found out that she had HIV, they
rejected her. Her mother sometimes watches the three young boys,
but she will not let Abigail or the children stay at her compound
for more than a day or two.
"I am all alone," says Abigail with a deep sigh.
Abigail's oldest son, Noah, has his HIV medicines in a special
bottle. This bottle has a chip in the cap that records
electronically the exact time that the bottle is opened each day,
and then my study team can download that information about the dose
timing onto our computer. My study team can see more evidence of
just how overwhelmed Abigail is - gaps of days when Noah did not
receive his medicine.
Much of my research in Kenya is focused on those gaps - how can
we find out when families are having problems giving children their
HIV medicines? And when they are having problems, what can help
For Abigail and Noah, my study team did a lot of work with the
clinicians, with social work, and with a local psychiatrist to get
this little family help with things like food support and treatment
for Abigail's depression.
It has been an exciting (read:
insanely busy) few weeks for my research projects. The reason we
find out all the details of Abigail and Noah's situation is because
we are following hundreds of families in Kenya very closely, going
to their homes, asking them all kinds of questions every month
about their adherence to the HIV medicines, and using these special
tracking bottles to record exactly when they are taking their
This week, we expanded this study to
the patients cared for at two new, rural clinics, both of which are
a two-hour drive from our referral hospital in Eldoret. As we
sorted out all of the final details of setting up our research
space and getting our materials in place, the most exciting part is
getting to know new families, learning the stories of more mothers
like Abigail and more children like Noah and figuring out how we
can help them.
My wonderful study team preparing
for our first official day of recruiting at the Webuye