Acronyms in Amman: First Report

Takeoff
June 4, 2013

After 40 hours of travel, I joined Cherie in Amman last Thursday! The time since has been a rush of activity, unfortunately accompanied by less than steady access to internet and basic power (hence the retroactive blogging).

After a brief morning stop at my hostel, Cherie and I taxied from downtown to UNRWA’s Jordan Field Office (henceforth JFO) for our first scheduled meeting of the day: a security briefing on the basics of working in Jordan. Most of these are quite intuitive – dress well, don’t go to the Syrian camps without permission, don’t join demonstrations – though some of the information on recent foiled attacks surprised both of us.

UNRWA’s international headquarters is a brief walk just around the corner from JFO: both compounds are located in East Amman, in the manufacturing district near 8th circle. Flanked by high walls, all the security measures you would expect of such offices give way to an interior of gardens and UN-blue accents.

With visitor badges in hand, we headed to headquarters to describe our planned tests in more detail to Dr. Akihiro Seita, Head of Health Programs. A glance at UNRWA Health’s annual report can tell you all you need to know about Dr. Seita’s work here: aside from overseeing the implementation of several new health innovations, he is deeply devoted to securing UNRWA’s health services during times of conflict, particularly for Palestinian double-refugees currently moving into Jordan and Lebanon from Syria. We’ve been storming Dr. Seita’s inbox for months, and he has been an incredible supporter of our project.

Cherie has spent the past week laying the foundation for pilot testing by meeting with various officials at both JFO and E-Health clinics. One thing we knew for certain was that this trip would have to be flexible: though our SMS alert system was inspired by problems faced during vaccine stock-outs in Gaza, we were willing to adapt to the needs of the setting. In Jordan, UNRWA is facing a growing prevalence of non-communicable diseases, most notably diabetes (after sampling pistachio straw buns at a sweets shop downtown, I can’t blame anyone here – but this is a major worldwide problem in developing economies).

The adaptation we’ve decided upon involves texting defaulters, or patients who have failed to come in for appointments at their standard clinics. Agency-wide, UNRWA had over 10,000 NCD defaulters in 2012. Data for other defaulters wasn’t available in the annual report, though we did note roughly 400 pediatric defaulters at Taybeh clinic – parents who had failed to bring their children in for either immunizations or growth & monitoring appointments. Piloting our alert system with the population of pediatric defaulters will allow us to extrapolate for two other populations: parents awaiting immunizations in Gaza, and long-term NCD defaulters in Jordan.

After discussing this plan with Dr. Seita, he invited us to present at UNRWA Health’s weekly meeting the following Sunday. Here, we heard tales of the overwhelming demand facing clinics in the north of Jordan and the east of Lebanon as they absorb Syrian refugees: nurses regularly taking work home after 16-hour days, pharmacies struggling with unprecedented demand for free services. While the challenges are obviously tremendous, it helps knowing that smart people are working hard to alleviate the situation in any way possible. We met interns from Columbia’s Earth Institute studying whether these transient double-refugees knew of UNRWA services in Jordan, and searching for child-friendly spaces in Syrian refugee camps. As for our project, we were met with more positive feedback than we could have dreamed of – nearly everyone in the room brainstormed a new potential use for our system.

Tomorrow, we’ll be meeting again with the Jordan Field Office to confirm details of our pilot study before heading over to Taybeh clinic. Here, we hope to begin surveying patients on the methods they currently use to track appointments for their children, their mobile use habits, and on what they’d like to see in a SMS reminder. Be on the lookout for results soon.

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