Wednesday, April 9, 2014

Sefula - Primarily Caring

Last week I had the pleasure of working with Aryn again and we headed to the Sefula Health Center. We had a great week and were really shown how successfully a rural clinic can be run to best suit the needs of the community. One half of the clinic is run as an out patient department and HIV clinic. They are equipped with a pharmacy, a waiting room, screening room, treatment room, adherence room, and HIV/malaria testing room. Patients flow through the clinic - starting in the waiting room, then seeing a clinical officer or nurse - getting appropriate treatment, then off to the pharmacy to collect whatever medications they have been prescribed. Considering that it acts as both an OPD and an HIV clinic it runs very smoothly. I was very impressed with the level of care that the clients living with HIV received. They are scheduled for routine visits to review their medications, any side effects, and how they are coping. There are counsellors available - especially for those who have been newly diagnosed.

The other half of the clinic operates in my eyes as their Public Health sector. They run clinics each day - antenatal care, child health, family planning etc. I was lucky enough to be a part of the family planning clinic and learned a lot. Many women of child bearing age come to the clinic to hear about safe sex practices, how to protect themselves from sexually transmitted infections/HIV, how to correctly apply condoms, and birth control options. The women all ranged in age - from 16 to late 30s. After the education seminar they are offered birth control as well as condoms. Many women chose to receive the Depo injection which lasts for 3 months. I aided the wonderful nurse in taking the clients vital signs, weight, and then administering the injections. These women also frequently get tested for HIV. One thing that made me so happy was the amount of women who were HIV negative - especially after spending so much time in the OPD department where the majority of care provided is to HIV positive clients. It was uplifting to see that their public health initiatives are working to prevent HIV in these young women. They are receiving correct information and are offered protective means. These women are also extremely independent and responsible for their own health. Many keep “exercise books” that document their health history and previous methods of birth control and the next time they should come to the clinic to update their birth control. 

One thing that I was the most impressed with is how well Sefula has been able to carry out Primary Health Care. I feel like in Canada that is an area that we have lost focus on as our main focus has become acute care. The clinic has definitely adapted their services based on the needs of the community. I also felt a complete lack of stigmatization towards any of our clients. The nurses were extremely accepting of everyone that walked through the doors of the clinic. I never once heard them refer to anyone as a “frequqent flyer” - a term many nurses use back home in Canada for clients who frequent the hospital. There was also never any reprimanding of clients for their diagnosis - another practice that I have witnessed back home. I think the thing that I was most impressed with at Sefula was the Family Planning clinic. Many people in Zambia are religious - which would make me think that services like these might not be available. I also thought that perhaps abstinence would be preached before offering other means of protection and it wasn’t. It was wonderful to see how many women showed up to learn and take control of their health.

- Robyn

This week Robyn and I were placed at the Sefula Health Center. Specific to Sefula, as of recently, is the idea of ART clients and OPD clients coming to the same place and waiting in the same line to see the clinical officer. As opposed to the hospital, where ART patients are in a separate area of the hospital. The clinic is trying to decrease the stigma that has been associated with HIV clients in the past. So far this has been working great for them and I’m curious to know how this effects stigma of HIV patients in the future. 

Something that stood out to me this week was the passionate and caring attitude that the health care workers (nurses, clinical officers, etc.) had towards the patients and their needs. The nurse Barbara was passionate with the staff and making sure that everyone was on the same page. She expressed to the staff how important it was that they attended staff meetings where they would be receiving important information. One specific nurse that stood out for me was nurse Precious. This lady was also a midwife who had done quite a bit of school but had not finished her Bachelors degree because it was too hard for her to be away from her family. In a few short days, I saw Precious show warmth and love to patients that I have been seeking to find in Zambia. Granted, Precious is in a different situation than nurses at the hospital. Nurses in the hospital typically have a ward full of 30+ patients to one or two nurses. During the day Precious can either be found running ante-natal or post-natal clinics, on the ward with new mothers or delivering babies! Minimal room for down time or boredom in her day! Kindness as a nurse is a pivotal characteristic and one that will never go unnoticed. Thanks for being so great!

One cute little tid-bit from our time at Sefula was on our last day. We were just about to finish up with our day when a lady walked into the clinic in labour. Precious left our ‘Under Five’ clinic to go and see how far the mother was dilated. She ran back to us and told us that the mother was just about to deliver! As we walked back to the clinic Precious turned around and says to us “I prayed for you two last night that today on your last day you would get to see a birth”. And a birth we saw! Robyn’s first magical vaginal delivery! The woman basically coughed and the baby came out! Precious at the bedside with her words of encouragement and us there to snuggle the baby afterwards, it was the perfect end to a wonderful week at Sefula! 

- Aryn

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