written July 14 Last day field
Still a lot of adventures for our last 3 deposits.
Abomey We left Friday, July 2 in the morning to go to Lokossa. Normally work at the depot but it would be too easy, although we had a little challenge for the end of our study. Indeed, we learned that the depot manager was on leave for 1 month ... hard to make an inventory of a deposit when the main staff is absent. We therefore had to find another deposit in a week ... Not easy when you do not know any team in the south. But we were very lucky because Dr. Tokpo Simplice (former coordinator of Nikki who is now the Ministry of Health program neglected diseases) has made contact with his fellow physicians and coordinators of the south we found a small deposit. We changed to Lokossa Avrankou was our 12th and last deposit. So
Friday, July 2, we met with the DDS and the pharmacist SMC Mono-Couffo. Always found interesting when you see the little information they have on deposit. The pharmacist SMC agrees that it lacks a true pharmaceutical expertise in deposits. But there are too few pharmacists in the public sector in Benin to address this problem. The partners could have an interesting role to play at this level (training and monitoring teams, ...). But it is also necessary that there are pharmacists who work in their teams! An instructive example: the program Palu-Alafia (lutte contre le paludisme), il y a 5 partenaires qui se sont mis en consortium mais ils n’ont pas été capables d’évaluer les besoins en antipaludiques pour cette année. Nous arrivons donc en saison des pluies et il y a rupture d’antipaludiques. Ceci peut s’expliquer par le fait qu’il n’y a AUCUN pharmacien dans leurs équipes… Alors qu’ils travaillent sur la chaîne du médicament…ABERRANT et ENERVANT !
Bon nous avons donc dormi à Cotonou le vendredi soir pour nous rapprocher de Porto-Novo, notre destination de la semaine suivante. Nous avons retrouvé l’effervescence, la pollution, le bruit de la ville de façon un peu brutale… ("What we're well north!")
After the match Ghana-Uruguay (we had two match: one in the TV, the other between 2 ... Benin), we were invited to go see a concert Tiken Jah (Reggae, International). Concert was to start at 20h, where we arrived at 22:30 ... which had not yet begun ... We are waiting ... until ... 1:30 in the morning to see the beginning of the concert organizers had not paid musicians and others in the evening ... Ah well we will remember our first concert of African Sleeping ... at 4am for a 6am wake-up ... really can not rest in the anchoring of the ocean!
Saturday we moved to Porto Novo, Benin's capital ... well now rather Verdun. Indeed, the city is full of work since early July for the Independence Day August 1 (it will never finish in time!). In addition, it is the rainy season and very few roads are paved here ... result: gridlock not possible in the middle of "pools" muddy ... we thought we had finished with the track is missed ... really exhausting! ! Especially when you're scared the car drowned at any moment! And the rain is really to go!
Otherwise, the week went well. We were welcomed by the family of Dr. Tokpo. Really nice. We left to eat pork grilled ... yum-yum Adjarra.
And for the work we have finished our last two deposits in a week!
Monday, Tuesday and Wednesday Adjohoun direction. Introduced built by the state but this time fitted with shelves made of concrete. Not practical for storing drugs and loss of impressive space. The storekeeper was unable to answer yes or no to our questions ... a peu fatiguant à la fin ! Le taux de satisfaction des formations sanitaires au dépôt est une catastrophe (46%). Ils nous disent que c’est pas de leur faute, que c’est la CAME, que c’est les formations sanitaires qui commandent mal…mais nous pensons vraiment qu’il y a aussi de vrais problèmes de gestion. Et c’est vraiment énervant de voir comment ils n’assument pas leurs responsabilités…c’est toujours la faute des autres ! Comme toujours dans le sud, le dépôt n’a aucune autonomie financière vis-à-vis de la zone. Il est donc très difficile pour nous d’évaluer les dépenses réelles du dépôt pour évaluer le coût operation. Hence the importance of monitoring of expenditure by the office area! This deposit made no margin on the sale of drugs until this year. They are now applying a factor of 1.1 but without any justification, just because they saw it was like that elsewhere ... Yet a small study of operating costs is not that difficult to do and would apply a multiplier adapted to deposit without harming the health facilities!
Wednesday, Thursday, Friday Avrankou work, our last filing. There were no movements of stock between February and September 2009. When we ask them why, they are more evasive ... we finally understand that the depot manager (accountant and office area) was left to manage the office area alone (and accounting CAR No. 2 absent ) and thus has abandoned the deposit. Moreover, health facilities were still in the CAM and not exclusively to the depot. In short, filing truly functional since September 2009. The store is divided in two. A real deposit and a reservation ... and how you say that the reserve meets all the prefectures except storage: no electricity, no shelves, no pallets, no ventilation ... cartons of medicines are stored on the ground, in bulk, dust and heat ... The deposit may be good ... but after such treatment, the drugs are safer! Unable to recover the costs of deposit (book 2 absent rainy days the staff does not work!), Cash book not updated since March 2008 for drug purchases !!!!!!! It's not their fault, the RAC is not there !!!!!
That we finished our 12 depots. Well, the logistics was folk but we managed. This week
feedback to central health authorities and the CAM. But not easy to catch them now: vacation, supervision, training, meeting ... but we hope to see Thursday and Friday. We prepared our refund information ... we're curious to know what they will say. We will see Dr. Adonon to know how it will evolve in the coming months the ministry (overhaul the way) and make contacts for PSF37. Tonight
Day July 14 at the Embassy of France ... We will eat Ferrero Rocher!
