Their flight is 27 hours from Birmingham, with stops along the way in At-lanta; Washington, D.C.; Dakar, Senegal; and Johannesburg, South Africa.
|Heather White, bottom left on first row, and Kerry Upton, third from left on second row, traveled to Lusaka, Zambia, last fall to train clinic workers at the Kalingalinga clinic as part of the UAB-Zambia HIV Research Project. UAB Study Coordinator Allison Zerby, third from left on bottom row, is working at the clinic for one year.|
When they finally reach Lusaka, Zambia, the ride from the airport is congested and somewhat chaotic. “Most people drive crazy,” says Kerry Upton, a research nurse coordinator in Infectious Diseases.
Upton and Heather White, a research specialist in Infectious Diseases, made their trip to Africa this past fall as part of the UAB-Zambia HIV Research Project. Zambia is the sister site to UAB’s Center for AIDS Research, which has been ranked among the best in the country by U.S. News & World Report.
The project in Lusaka, Zambia is a world-renowned and NIH-funded AIDS prevention and research center. In the late 1990s, the Center for Infectious Disease Research in Zambia (CIDRZ) was founded, focusing on prevention of mother-to-child transmission.
Upton and White traveled to Zambia for two weeks this past fall to train clinic staff at the Kalingalinga clinic. They were teaching the clinic staff to set up and run the Adult AIDS Clinical Trial Group (AACTG) study.
“We presented the clinic staff with various patient-case scenarios,” White explains. “Our goal was to educate the staff and help them to anticipate and prepare for the diverse nature of problems that may arise.”
While challenges facing Upton and White were numerous, they were no greater than those the staff at the Zambia clinic face every day.
Approximately 30 percent of urban adults in Zambia are infected with HIV (50 percent of Zambia is urban). Most new and existing HIV infections in Zambia are in married couples. Additionally, sexually transmitted diseases (STDs) are common in those with HIV. Because many HIV-prevention programs do not target couples, often the couples do not realize they are at risk. Each day in Lusaka, more than 100 adults acquire HIV – and 60-70 of these get it from their spouse.
One of the keys to successful treatment of patients in the study is for them to keep continuing appointments, says Upton. But the large majority of Zambians don’t keep calendars and they don’t have watches.
“Time is not a big factor with Zambians,” Upton says. “Even asking them to keep up with their next appointment is hard. There’s no way to call patients and remind them, and many don’t have permanent addresses. Patients would draw us a map to their home instead of giving an address.”
Because time isn’t important to the Zambians, patients often have no concept of a medical regimen. “The doctors really have to train them on what to take and when to take it,” Upton says.
Despite such obstacles, more than 80,000 Zambians have received care at the clinic, and about 45,000 are on medication, says Michael Saag, M.D., director of the UAB Center for AIDS Research.
“So many people are on meds now and doing well,” Upton says. “I saw a significant change from 2003 to 2006 with regard to the number of patients in the clinic. That’s because there are not as many people sick and dying. Now many people can take one pill a day to manage their HIV with very few side effects. There now are empty beds at the clinic, and to the staff there that’s amazing.”
Upton and White will go back to Zambia again this year, as will another UAB team. They also will continue training Zambian clinic staffers here on campus during the year.
“It’s exciting,” she says. “The trip is brutal, but I feel like we’re making a difference and I know there are many people that don’t get that opportunity. I’m very thankful I get to do this.”