It’s Market Day in Bulongwa. Every Saturday the market is crowded with people from the surrounding villages; colorful as usual with very fresh fruit and local foods; noisy with the big crows wearing white feather necklaces round their necks. The weekend market is one of my favorite places in Bulongwa. I went to the PIUMA VCT center near the market early in the morning and hoped that PIUMA members would come to the center after their shopping to register in PIUMA’s new medical record book.

In the first week of September, 2009, I arrived in Bulongwa, Makete, where the PIUMA office is based and I and all PIUMA members were so happy to meet each other at a gathering on 8th September 2009.

There are 197 members in PIUMA, most of the client live very far from the VCT center and when they come to our center for follow up, it often takes them four to five hours on foot.

When I arrived at the VCT Center after our first meeting, I realized I was facing a bigger problem than just the absence of a data recording system for members of PIUMA. In reality, for two years now , there was not even a common book for a short history or complaint of a single member who came to the center for follow up. Fortunately, the Clinical Officer of PIUMA had memorized well all this data, including treatment.

I thought PIUMA members would be happy if they could see the benefits of a medical record system in reality and how much they will be freed from a dependence on an individual Medical professional’s memory to ensure continuity of care. This is especially true because we cannot expect to have one permanent Medical person with PIUMA even though we hope that will be the case. Recruitment can be very challenging in a place like Makete. At the same time, I was remembering the clinic I started and that continues as a small NGO in Myanmar/Burma called “Better Burmese Health Care”. There are 500-700 registered patients in that small clinic and they have their own personal record book kept in the clinic. Four new clinics of that same NGO also use the identical recording system that I pioneered.

It is not so difficult to start record system for PIUMA. But for long-lasting progress, it is a keystone that each PIUMA member understand how important the record book is. So, after discussing with PIUMA leaders we started designing a medical record book for individual members which is based on the information from some medical record files started by the PIUMA former Medical doctor, Dr. Rainer Brandl, who made quite systematic records on the computer.

PIUMA leaders were very active and they have been working very well in binding A4 paper to become PIUMA’s medical record books. Now, 120 books are ready to use.

Every day, I am so happy to explain to every member about the medical record book system, to do basic medical clinical check up to every member, and to record their history. At the same time, it improves my language skills – my Kiswahili teachers are now PIUMA members. Happily, PIUMA member are willing to come and be registered as well.

For now, on market day in Bulongwa is for shopping, but in the future it also will be the day many people want to visit to PIUMA VCT center to register their medical record book and/or to do regular follow up. It will take time, but it really will be happen.



PIUMA's Medical Doctor 2009