Calla and Etelvina, the health promotor
Calla, Rebecca, the new volunteer, Vicenta, who does massage therapy, and Etelvina
Calla, Etelvina, and Israel, the new health promotor
Clinica CAIPES
Calla, Etelvina, and Israel, the new health promotor
Clinica CAIPES
29 September 2009
I have adapted to the work day routine of the Clinica CAIPES. There is a general schedule, however the quantity of patients ebbs and flows with the rain, as the rain brings more mosquito born illness, and people stay shut up in their houses, allowing illnesses to pass more easily as well.
We wake up in the morning between five thirty and six, with the sun. We have not needed to use an alarm to wake up since arriving. After waking up, each of takes a quick shower. I smear on sunscreen and insect repellent before walking up to the clinic. The walk to the clinic is short, only about five minutes long. Once there, we open the clinic and kitchen doors, and stack the chairs. We mop and sweep the entire clinic, which consists of a small entry way, two rooms in which to see general patients, a small surgery room, and a ¨women´s room¨ with a table designed for gynecologic exams. Additionally there is the pharmacy room and the bodega, where extra medicines are stored. Sweeping and mopping takes about a half an hour, after which we wipe down the exam tables and wash the dishes from the night before. After completing these morning tasks we heat water for coffee and make breakfast.
At eight we start seeing patients. Each patient gets registered in the electronic medical record. Each patient has a paper chart, where daily notes are written, but the electronic system tracks age, weight, some demographic parameters, diagnoses, medicines, and references written. We see patients alongside the health promotor. We first take a history, then take vital signs like pulse, temperature, and blood pressure, and then do a physical exam. We talk about our ideas with the patient, and then step out of the room to make a concrete plan. Making the plan usually involves a discussion, reading more in the textbooks at the clinic, or calling local or international physicians. Once a plan is made, and if we are prescribing medicine, we get the bulk bottles out of the pharmacy and pack the correct number in a baggie, and then write or draw instructions on a sheet of paper inside the bag. If we are prescribing a liquid medicine, like an antibiotic, for a child, we mix the medicine and calculate the dose before handing the patient´s parent the medicine.
We see patients all morning, and usually take a quick lunch break at around one in the afternoon. On most days there are more patients waiting to be seen in the afternoon, and we generally finish seeing the patients by four thirty. After seeing the patients, their information must be entered into the computer and their records filed away. At that point we tidy up for the day, close and lock the clinic and head back home.
Generally in the evenings we hang out with the children who live next door, or sometimes visit other people in the community. It gets dark by six thirty, so at that point we head up to the clinic again to heat up the leftovers on the gas stove from lunch for a quick dinner. We are generally in bed by eight, and will sometimes read by the light of a flashlight before going to sleep.
Special Event for People of the Third Age (Tercera Edad)
After Bela and I arrived, the clinic held an event for anyone in the community over age 65. People were invited via word of mouth and by home visits from the community health promoters.
On the day of the event, a Peace Corps volunteer from a neighboring community, three hours away, arrived and gave a charla about natural ways to relieve arthritic pain. She did a wonderful job. Her charla was interactive, and everyone in attendance participated in stretching exercises. After her charla, we moved to the lawn in the back of the clinic for music and dancing! The local band, four men who have played music together since they were young, played traditional songs. We danced and sang. The clinic chef, Niña Francisca, made sweet plantains and chocolate atol, a drink made of corn meal, for everyone. It was great fun and a great way to meet people in the community.
I have adapted to the work day routine of the Clinica CAIPES. There is a general schedule, however the quantity of patients ebbs and flows with the rain, as the rain brings more mosquito born illness, and people stay shut up in their houses, allowing illnesses to pass more easily as well.
We wake up in the morning between five thirty and six, with the sun. We have not needed to use an alarm to wake up since arriving. After waking up, each of takes a quick shower. I smear on sunscreen and insect repellent before walking up to the clinic. The walk to the clinic is short, only about five minutes long. Once there, we open the clinic and kitchen doors, and stack the chairs. We mop and sweep the entire clinic, which consists of a small entry way, two rooms in which to see general patients, a small surgery room, and a ¨women´s room¨ with a table designed for gynecologic exams. Additionally there is the pharmacy room and the bodega, where extra medicines are stored. Sweeping and mopping takes about a half an hour, after which we wipe down the exam tables and wash the dishes from the night before. After completing these morning tasks we heat water for coffee and make breakfast.
At eight we start seeing patients. Each patient gets registered in the electronic medical record. Each patient has a paper chart, where daily notes are written, but the electronic system tracks age, weight, some demographic parameters, diagnoses, medicines, and references written. We see patients alongside the health promotor. We first take a history, then take vital signs like pulse, temperature, and blood pressure, and then do a physical exam. We talk about our ideas with the patient, and then step out of the room to make a concrete plan. Making the plan usually involves a discussion, reading more in the textbooks at the clinic, or calling local or international physicians. Once a plan is made, and if we are prescribing medicine, we get the bulk bottles out of the pharmacy and pack the correct number in a baggie, and then write or draw instructions on a sheet of paper inside the bag. If we are prescribing a liquid medicine, like an antibiotic, for a child, we mix the medicine and calculate the dose before handing the patient´s parent the medicine.
We see patients all morning, and usually take a quick lunch break at around one in the afternoon. On most days there are more patients waiting to be seen in the afternoon, and we generally finish seeing the patients by four thirty. After seeing the patients, their information must be entered into the computer and their records filed away. At that point we tidy up for the day, close and lock the clinic and head back home.
Generally in the evenings we hang out with the children who live next door, or sometimes visit other people in the community. It gets dark by six thirty, so at that point we head up to the clinic again to heat up the leftovers on the gas stove from lunch for a quick dinner. We are generally in bed by eight, and will sometimes read by the light of a flashlight before going to sleep.
Special Event for People of the Third Age (Tercera Edad)
After Bela and I arrived, the clinic held an event for anyone in the community over age 65. People were invited via word of mouth and by home visits from the community health promoters.
On the day of the event, a Peace Corps volunteer from a neighboring community, three hours away, arrived and gave a charla about natural ways to relieve arthritic pain. She did a wonderful job. Her charla was interactive, and everyone in attendance participated in stretching exercises. After her charla, we moved to the lawn in the back of the clinic for music and dancing! The local band, four men who have played music together since they were young, played traditional songs. We danced and sang. The clinic chef, Niña Francisca, made sweet plantains and chocolate atol, a drink made of corn meal, for everyone. It was great fun and a great way to meet people in the community.
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