Crash Course on Clinical Management of HIV in Central Asia

By Cho-Yau Ling, MPH ’12 in Health Policy and Management

I am doing well in Almaty, though I can’t say I’ve been here much in the past month. I have been traveling with the data collection team to conduct our baseline assessment of care and treatment services in Central Asia. In the past month, I have been to six sites with the Kazakhstan team and one with the Kyrgyzstan team near Bishkek. Each trip has been eye-opening for us as we try to understand the care and treatment system in Central Asia. I wrote about this in previous updates, but the assessments have taught me an immense amount about research, specifically how to develop and implement study designs.

With the assessment team in Kyrgyzstan visiting a famous archeological site called Burana near Bishkek.

I’m also getting a crash course on clinical management of HIV in Central Asia. Prior to these assessments, I could not tell you why one would start a preventive course of co-trimoxazole or when a patient should receive anti-retroviral therapy (ART). While this is the not the main objective of my practicum here in Almaty, learning about the World Health Organization’s and the Ministry of Health’s guidelines for care and treatment has been fascinating. I also never thought I would be able to read a person’s medical chart and identify discrepancies between the medical staff’s recommendations and the various guidelines concerning care and treatment of people living with HIV.  It makes me want to be an infectious disease specialist, if it weren’t for the many many more years of medical school that I would need.

We are currently at our last data collection site in Almaty’s City AIDS Center. Today during our site assessment, I realized how much I have gotten out of this practicum. My Russian, while still not amazing, has improved dramatically since the first month I arrived. This is especially true for my Russian reading skills. Secondly, I believe I have applied the knowledge I have gained from my classes concerning management, biostatistics, and epidemiology to my work in Central Asia. I find the knowledge from my coursework to be immensely helpful when we are selecting medical charts for our sample in the assessment. I have also realized that the main source of discrepancy between what is written in the research protocol and what is happening in practice stems from poor supervision and inadequate skills among the staff. I repeatedly studied these issues in my Strategic Management and Organizational Behavior courses and I am glad that I am able to identify these problems as they play out in real-life situations (though I would be even happier if they can be fixed for the sake of the patients here).

On a lighter note, ICAP Central Asia had a very good staff retreat three weeks ago. I was glad to meet the teams from the other ICAP countries and New York. I am still amazed at the camaraderie and good-humor of our ICAP team here. I loved it and I’m only beginning to realize how much I will miss my co-workers when I leave my practicum in December.

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