Wounds, pus, and fungus! Yum!

Today begins the medical clinic. I am joing a team from Charleston, SC. There are 14 people on their team, including: 1 MD, 1 PA, 4 RNs, 2 PTs, and the rest are non-medical people. We've set up the clinic in the preschool building, and turned it into three rooms (triage, doctor's "office", and pharmacy.

It's so interesting to see that kinds of complaints people come in for. The doctor has said that people really just want to go home with something (i.e. medication) because then they really feel like they've been treated. Also, he stressed the importance of actually touching the patient: listening to their heart/lungs, if they have bakc pain-examining their back, etc. He said that the experience in going to the doctor in Kenya is often one where the doctor does not even touch the patient and just prescribes, and the patient leaves wondering, "How does he know what's wrong?!?! He didn't even touch me!". (Now, he may have known without having the touch, but not all people know that, and it is much better bedside manner to actually connect with your patient and make them feel cared for in their own mind, i.e. beyond just giving them pills.)

Anyway, today I sat with the MD to observe while he treated and learn about what to look for and how to treat here. Today we've seen:

*tinea capitis, tinea varsicular, & tinea corporus (ringworn), which I think can be contracted from Lake Victoria (i.e. swimming & bathing in the lake). Essentially every kid brought to the clinic had tinea capitis.

*hives

*"chest pain woth cold" - this was a very common complaint. Sounds like bronchoconstriction to me. Possibly asthma symptoms as well. Lots of people have asthma here, likely d/t all the dust and the deisel trucks exerting coal black smoke.

*stomach pain

*I watched the MD drain a cyst. This patient was really happy to have this gone! It was on his right wrist and he'd had it since he was a little boy (maybe age 27-30 now?). MD used an 18g needle & 10mL syringe. ETOH swab the area, then insert needle and draw out fluid. Actually the contents of the cyst was more of a clear jelly consistency. It was really thick so it too some effort to remove.

*HA (headache)

*cough

*club feet

*athlete's foot

*soccer injuries x3 (knees)

*one man with a foot wound x2yrs. Very infected --> very swollen ankle. He was prescriped ABX (antibiotics) x 1month (received Cipro - ciprofloxacin).


Here's a couple pix:


patients waiting to be called to traige. Two pastors are preaching to them.


patients waiting after triage to be seen by the doctor/nurse/PA.


view of the "doctor's office". There are four stations. 2RNs, 1PA, 1MD for treating patients.


Pharmacy. I was impressed by how many medications they were able to get!

Can't wait for the next day of clinic!