June 23, 2010
Today Yiwen and I went with Alex, the nurse in charge of all the community health workers, and Harold the driver to visit 5 patients. We got to meet and talk with 4 of these. I will talk about two and Yiwen will talk about the other two, so you will have to read her blog for this day too, in order to catch the whole story.
First off, the community health worker program was started so that men and women in the hospital’s catchment area, who are less able to get to St. Gabriels would be checked up on. Volunteers were asked for in the villages and these volunteers, after they were passed by the village headman, come to St. Gabriels for training in basic care. They are then responsible for checking up on sick people in their villages and reporting their status via SMS text to Alex. If some patients need particular care, Alex goes to visit them as urgency demands. Thus there is a network of health workers throughout the area covering things from home based palliative care to antenatal clinics.
On our second stop in this trip today, we visited a woman named Selina. The community health worker responsible for her is names Glay. Selina is about 46 years old and suffering from a lesion in the area of her left breast. She seems like a fairly happy woman, greeting us warmly and laughing sometimes with Alex. She has breast cancer and a mastectomy was performed in 2005, which healed completely, however now the wound has opened up again and a large abscess has formed, the border of which is growing and sensitive to bleeding. Alex suspects that the cancer was not full removed and that another surgery would actually make the wound worse. The bleeding is a consequence of the angiogenesis in the cancerous area, due to cancer’s increased metabolic need. Selina’s husband is helpful, learning how to help change the bandages on the wound and also how to appropriately dose her liquid morphine. I think the liquid dosing syringes/clamps would be great for this, since it is sometimes hard to explain how much liquid is necessary, and even harder to try and draw a line on the dosing cups the patients are given with a pen.