The day started with the group venturing to RHU 3, where we met the midwife, primary nurse, dentist, and volunteers who run the clinic (the doctor was out on other business). Although most of the patients lined up outside were at the clinic for a tooth extraction (almost all of them!), there were a few women who had appointments for their prenatal checks. Our buddies weren't with us this day and so we were on our own, admitting the patients, assessing, and some of us assisting the midwife with checking fetal heart tones. Additionally, Rochelle and I were able to give an infant a few immunizations via IM injection in the vastus lateralis.
After a few hours at the clinic, we ventured out with the volunteers into various areas of the community to administer vitamin A supplementation to children under 8 years old. This was one of the most satisfying parts of the day, and we were really impressed with how the clinic spends time going out into the community in order to provide supplementation and immunizations to those who don’t have the opportunity to come to the clinic to receive them. Because many of the parents of these children work long hours or are unable to visit the clinic due to other circumstances such as lack of transportation, it is wonderful that the clinic comes to them and follows up.
Lunch followed at a tasty restaurant in the rice fields surrounded by a pond, full of huge catfish. The food was amazing (especially the mango salsa) and the atmosphere was beautiful and fun. We returned to the clinic after lunch and joined the nurse and other clinic workers for a lesson given to patients who had Tuberculosis and were currently on treatment or who had recently undergone treatment. The nurse went over the roles of each healthcare worker in relation to their treatment, and there was also an opportunity for us to ask the patients questions. We discovered that there are different categories of TB, and depending on the category, the patient will receive a different treatment (one of which requires an IM injection everyday for about 56 days, if I remember correctly…yikes). We also learned that a big issue is non-compliance with the medication; so, in order to try and maintain compliance among patients, they require the patients to come into the clinic everyday for their medication so the nurse can ensure it is taken. If this is not possible, a volunteer who lives near the patient can be put in charge of ensuring the patient is taking their medication.
Although there were slow times at the clinic, I really enjoyed admitting and assessing patients on our own, and it was really interesting attending the TB lecture and interacting with patients who had TB in the past. Additionally, going out into the communities to provide vitamin A supplementation was really a great example of effective and proactive community health nursing, and I am continually impressed by the primary community clinics here in the Plaridel.