Saturday, March 27, 2010

A day at clinic

Well the"o" and the "l" key still aren't working so unless I copy-paste every single one- and this sentence took about 5 full minutes-  I still can't really update uness yu want t read a bg ike this. Which is hw I've sent a few emais.
I thought, however, that I'd make a few "picture-centered" posts.

Here are a few pictures from clinic at Thumbwe- a Thursday site. I gave my camera to Makwinja- the driver and he was totally psyched to take pictures. He got the hang of the camera very quickly. The following is a play-by-play of what happens at a typical clinic.

At the start of the day we collect all appointment cards from moms who are returning (already in the program and receiving therapy) and find their study cards on which we record all the pertinent data (length, weight, edema y/n, fever, cough, diarrhea, vomiting and any meds they are receiving).

Then the moms both new and old go get their kids weighed. This is Lydia, one of our nurses who is uber-competent. She's directing the HSA who is running the scale to do something. Makwinja, who loves making fun of Lydia was delighted to get a picture of her bossing someone around. 

Then the moms go to the height board to get length measured.This is the line for the height board. Malawians don't really understand/respect the queue so we spend a lot of time and energy trying to get the moms to "Panga mzele!" make a line).

If the child is new- we look at their height vs. length Z score to determine if they are moderately or severely malnourished. We also check for bipedal pitting edema to see if they have kwashiorkor  ( If the moms are returning we monitor the growth of the child to determine if they should graduate or if they need an HIV or TB test etc.

Sometime in the middle of clinic we have the nurses teach. During teaching they talk about the research we do, advise the moms not to share the food and talk about other issues ranging from cholera to family planning. My favorite part of teaching is the singing and dancing.

At the end of clinic (an average clinic takes about 5 hrs) we meet with the HSAs and discuss how clinic went. We mostly use this as an opportunity to remind the HSAs how important it is for them to spread the word about clinic throughout their villages.

After that we're done and we head back home where we enter data, re-pack our boxes, re-stock the food and other administrative tasks.

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