Lutheran clinic

Today Jose and I went with Jennifer and her mobile clinic. She works with the Lutheran church mission outreach. They have an ambulance that is stocked with medications and nutritional supplements. Every Tues, Wed, Thurs they go to the same village clinic, and on Fridays they alternate between two clinics. They use churches or church outbuildings as their clinics. The villagers gather around the building. The clinic starts with singing hymns, then a mini sermon and prayer. That is followed by a teaching lecture by the clinical officer or medical assistance. Today it was on bilharzia. Then the clinic starts. There is a section for antenatal (prenatal) follow ups, a section for the Under 5 kids (weight, nutritional status is judged with referral for those that are underweight / undernourished, check on immunizations and given if needed), a 'sick line', a family planning line (ladies on depoprovera, the main family planning method here besides condoms), a separate area for VCT (voluntary counseling and testing - for HIV), and a cooking demonstration. The cooking demonstration is held in a little outside 'kitchen' with a pot over an open fire - today they were showing the ladies how to cook ground maize and ground nut (peanut) flour together to make a more nutritious porridge for the children. One or two of the nurses are assigned to the 'pharmacy' to dispense meds and give shots. The immunizations are actually given by a HSA (health service assistant, provided by the government). The whole system is pretty well organized. They even bring buckets to use to wash your hands - and soap, too. Interestingly enough, almost no one uses them, and if they do, they don't use the soap! (Thank goodness we travel with hand sanitizer). Jose and Jennifer did blood pressures on the antenatal and family planning ladies. Those are the only routine vital signs done. The children in the under 5 clinic are weighed, of course. Whenever someone is seen in a different area that appears ill, they are sent to the 'sick line'. I sat with the medical assistant in the sick line and learned more about village medicine - there is always more to learn! I found out that the villagers make a local brew called kachasu - from fermented sugar, rice and /or maize - then distill it into a very strong alcohol. I suspect that there may be some more toxic substances in there than pure alcohol. However, the men can become really addicted to it, and they basically kill their liver. I saw 'scabies' in lots of forms, including infected scabies. And other weird rashes. Some chicken pox, worms, lots of arthritis and abdominal pains. Lots of upper respiratory infections, including a couple of little ones with probably pneumonia. One very sad case - a 5 year old with swelling in her jaws (parotid gland), weakness, weight loss, cough, runny nose and failure to thrive- not a whole lot different from the other sick kids except the parotid swelling and the chronicity of it all - we sent her to VCT and she is positive for HIV ('reactive'). Her mother has never been tested, so we recommended the child follow up with the ART (anti retroviral treatment) clinic and that the Mom be tested, also. Lots and lots of children today, mainly because of the under 5 clinic. The pictures: Jose taking blood pressures, the cooking 'hut' with some ladies in front, the inside of the clinic as they are setting up, and the ladies outside waiting for the clinic to start. I learned a lot about setting up village clinics. There is so much to do here. I hope I will return soon! To think they go every week to this same area and see 100-200 patients every week! And most of them are not 'repeats'. Enjoy the pictures, keep Jennifer and her team in your prayers - this is her mission for 2 years - to go out with this mobile clinic.