Day 2: Start to set up pharmacy. This requires counting and bagging all the meds into a certain number and organizing the meds into categories in the pharmacy. People will begin to line up and we may get to start seeing people on this day.
~Stations~
People get a white card and their chief complaint and number are on there. Taking people in order is a very big deal and keeps peace/flow. The people are however quite considerate and very sick people do get seen faster. Lonnie & Pastor Prophete make that call and he is not challenged.
Station 1: Parasite Station
Anyone can do this station. The goal here is to get antiparasitic meds into the person so they have better health. Here’s the rub ~ no parasite med, no being seen. Some people have lack of trust of the medicine and will spit it out. You are supposed to watch them chew it and have them open their mouth to make sure. It isn’t that great tasting, we will also take this medicine on the last day. I may bring hard candy to help get the taste out of their mouth. Pregnant women, children under 3 and breast feeding women have a pink liquid to swallow. Some elderly have no teeth and this is also an option.
The translators are great diplomats with taking this medicine and assuring the people that it’s okay to take. I think we are asking them to trust us and apprehension is understandable. You also need to watch the pace and go slower at this station.
Station 2: Vital Sign Station
Usually someone trained in this does it, but really anyone can with simple instruction. The b/p cuffs are automated, and heart rates may also appear. Temperatures were also taken via an ear thermometer. You will hear our staff say “I think the machine is wrong!” The blood pressures can be off the charts. A b/p of 260/130 wouldn’t be surprising. Jim saw a temp of 105 w/ a boy with Typhoid. A translator may not be at this station, but nearby if you need help (usually from parasite station). Again go slower in these stations as triage gets backed up. Bring a watch w/ a sweep second hand!
Station 3 : Triage
This station will have a nurse or paramedic. You work with a translator, get chief complaint and associated symptoms. Do a brief exam and decide if they can go to pharmacy from there (for OTC meds), or if they need to be seen by MD or nurse practioner (CNP). If you think they need prescription medicine, they see the MD/CNP.
Station 4: The People “Movers”
This role can be done by anyone. It requires that you go to triage and “move” the people from triage to either the MD or CNP or to the education station. You will stand the whole time and wear a big smile. You communicate with hand signals. Usually there is no translator here.
While moving, you may also notice the clinic runs a (separate from FAME) vaccination and infant care education. Do not turn your back to these women….just trust me don’t. They are very funny and uninhibited people, who teach me things like “don’t turn your back on me”.
Station 5: MD or CNP
Not everyone goes here. It is staffed by an MD (either ours or a Haitian MD, from the clinic) or a CNP/PA. A nurse may be asked to see patients if they are short advanced practice nurses. This decision is made by the triage RN. They will order prescription meds if needed. They may also pray with the patient. This station will have a translator.
Station 6: Education:
This station can be done by anyone.
This is also a mandatory station. People would like to skip it, and just go to the pharmacy. It serves 2 purposes, to educate the community and to give pharmacy time to fill their order. Education be on community health, Christianity / principles, or personal care issues. Pam brought puppets last year that the community really enjoyed. Barb, a dental hygienist, brought a mouth and a bunch of toothbrushes and dispensed them after she taught oral hygiene. I brought a poster on seatbelt safety…..and changed it the first day I taught to “Things that Upset the Stomach”, as there are few seat belts in Haiti. :P You will have a chance to look over teaching aids before you leave the US. You do not have to have them printed. FAME will have a large teaching guide for your use. You will have a translator at this station.
This is Thonny he translates in the education station. Thonny has a very relaxed and smooth delivery. If I ever owned a company, Thonny would be one of my first hires in sales.
Station 7: The Pharmacy
People will line up on the bench and await their name to be called. Anyone can work here! Lonnie will work with a translator to make sure the patient understands how and when to take this medicine. Last year we were able to distribute rice, too!
Other services Offered:
Vision & Eye Glasses, run by Dorlus
Ear Wax removal station: run by staff (or Jill)
Sometimes we even have a respiratory therapist. Here is Sharon stimulating a baby to breathe and giving an treatment:
We will also go to church . Pastor Prohete and Lonnie will talk and we will sing 3 songs to the community. They serve real wine with communion.
Hang on for the ride of your life!
More pics can be found here: http://picasaweb.google.com/oslerfamily/FAMEHaitiOctober2008#
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