Tuesday, July 10, 2012

Outreach

Yesterday I was able to go on outreach clinics for the first time. A driver took 5 of us on outreach- 2 nurses, 2 nurses aids and myself. 4 of us were squished in the back of the truck so that we could fit- kind of reminded me of driving to clinical this past semester (except the bumpy roads made it even more uncomfortable). I didn't care though because I was just excited to be going on outreach and I am still interested in looking at everything we pass.

We held 3 clinics in different townships, starting with the one the furthest away and working our way back. The first township was called Zvimonja and was about an hour away. The clinic was held at a primary school. Women were waiting with their babies when we pulled up. First one of the nurses aids weighed the babies (to record their growth on growth charts) and then they were sent over to the 2 other nurses and I for vaccines. We gave them polio, measles, and other vaccines as well as Vitamin A. After all of the babies and small children were vaccinated, many of the women lined up to have their blood pressure taken. They needed theirs taken so that they could get birth control. The clinic provided 6 months of birth control for $1. I was kind of surprised how many women lined up to get it considering many of the women in the hospital are on their 4-5th + baby. I thought it was great however that these women have the opportunity to make choices about their families for an affordable price.

When the nurses aid was taking BPs of the women, I went over and took a few pictures of the school children that were gathered under the tree. Once they saw that I had a camera and was taking pictures, they all wanted to be in pictures. They were crowding closer and laughing and more and more of them kept coming. Some of the kids just stare at the camera and others pose and smile. I was able to get some really cute pictures of all of the kids in their red uniforms.

Next we went to Chigede. The clinic was held at a general store and mill in the township (the only building I saw there). Again women and their children were waiting when we arrived. Again, we vaccinated the children and gave the women their pills. After the women go through the lines, many stand or sit around chatting. It turns into a casual social gathering until everyone is done and they depart.

The third place we stopped was Stop. Yes, I had to ask twice because I didn't believe that was the name haha. This clinic was also at a general store and this time there was music playing and even more women and children. Everytime we set up under a tree (because it was warm out although one of the nurses was cold! it is their winter I suppose). A few young school boys crowded around to watch (by now they were out of school for the day). A couple of them started wrestling and messing around to get my attention so I would take pictures of them. This township was slightly busier with lots of cattle pulling carts around.

I gave all of the vaccines at each clinic so by the end of the day, I became a pro at giving injections and making babies scream! I even started learning Shona in order to tell the kids to open their mouths and swallow the polio vaccine and the Vitamin A. I also now say sorry with a shona accent- sore-y (role the r slightly too). This is what the kids understand after I inject them and then their mothers start laughing when I say it.

Today was back at the hospital. I am seeing so much here, I still cannot believe it. I try and write things down and look things up that I can't remember or don't know but there is just so much! I am excited though to finally be seeing things that I only ever read about in my nursing books. Many of the people here do not go to the doctor until they are very very sick. They think that if they ignore it, it will go away and they will get better. Or they try and go to the witch doctor. So, unfortunately by the time they get to the hospital, many people have advanced cases of whatever disease they have. As horrible as this is, it is an opportunity to see things that I have only seen pictured in books.

There seemed to be a lot of lung issues today (although there are basically everyday here because of the TB and pneumonia often associated with AIDS). Dr. Kajesi was very patient with me today and explained everything and had me listen to all of the patients lungs. I listened to a pleural effusion in one man's lung and I was able to percuss it successfully- something that I have really only done on healthy people in class. (this isn't a big deal at all, it is just exciting to be able to practice the little things and have them actually be diagnostic). I also saw a women with a barrel chest (again sorry this is probably only interesting for medical people and maybe not even them). Anyway, she had a textbook perfect case.

As a side note, I now walk to and from the hospital with my head down scanning the ground. I knew coming here that there were snakes here, and it was my biggest fear coming here. When I arrived they said I was in luck because it is not really the season for them. Although it is important to still not do anything stupid like walk through the brush or stick your hand down a hole. But yesterday, one of the nurses saw a snake by Dr. Kajesi's house (on my route to the hospital) so I am again very paranoid about seeing one. I don't think it is completely irrational here though because the three most common snakes are spitting cobras, black mambas, and some other equally deadly snake. And oh yeah, there is no antidote or venom. You die or if you are lucky, lose a limb. Anyway I hope everyday not to see one and I constantly look where I am going (for now).

The nurses I went to the clinic with- where we give the vaccines


                                              People crowding around to listen to instructions

School kids crowding around at the first stop

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