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Infectious Disease Institute Clinic Patient Care

Working in clinical research, it’s easy to forget sometimes that patients are at the heart of what we do. Not so at the Infectious Diseases Institute (IDI) in Kampala, Uganda,  where the Clinic for HIV patients or ‘Friends’ as they are called here is literally right in the center of the building. As I sit in my office thinking how best to approach my assignment of strategic planning for IDI Research, I can hear babies crying in the clinic below; IDI focuses on adults rather than pediatrics but some of the mothers bring their babies with them if they can’t get someone to watch the children on the day they have an appointment.  As a specialist clinic, IDI treats many patients who have failed first line therapy, and conducts research to optimize second and third line treatments as well as prevent and treat lethal co-infections.

I will be spending three months at IDI working with the new Head of Research, Dr. Andrew Kambugu and his senior management team to develop an optimal business model that balances internal innovation with external revenue-generating research. On Tuesday afternoon, I heard music and singing floating through my office window.  I’m a musician myself and couldn’t resist the temptation to go downstairs to the clinic and investigate what was happening.  IDI’s Music, Dance and Drama group was giving its weekly performance to entertain and educate Friends who were waiting for their appointments with a song and dance about Discordant Couples living with HIV, in which one of the couple is HIV positive and the other is HIV negative.  IDI has started a special clinic for discordant couples focusing on prevention of HIV transmission to the negative partner.  A Friend who is in a discordant relationship also made a speech talking about his personal experiences and how these relationships can work and both partners can stay healthy. The waiting room is a welcoming place; as well as the Music, Dance and Drama performance, there is an art and craft stall where Friends can make and sell beautiful things, staffed by an artist-in-residence.  I know what all my family will be getting for Christmas this year.  As part of the Resource Center and Marketplace, computers with internet access are provided in the waiting room for Friends to search for information and jobs; many people face discrimination and lose their jobs if they are diagnosed as HIV positive so the IDI Clinic helps them to find alternative employment and sources of income as well as providing anti-retroviral therapy (ART).  In addition to providing holistic patient care, the IDI clinic has also adopted practices that optimize the use of scarce resources.   Electronic Medical Records have been implemented with the dual benefit of saving space and improving data management.  Task shifting, or triaging patients by the type of appointment so that the busy doctors focus their time on the most serious cases, nurses handle routine check-ups for patients doing well on ART and pharmacists handle refills, is helping optimize use of clinical staff time.   Although I’ll be spending my time working in Research, I won’t forget that it’s underpinned by the work of the Clinic.

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