february 2007 - medical camps

Despite the theft of our boat engines last month we were able to continue with the scheduled camps. Further enquiries seemed to point to criminal gang activity rather than militia involvement, but either way their return is now improbable. Though for now we can hire transport it has caused us to review how we deliver health care in rural riverine communities when security is such an issue.

Our new midwife and senior health care worker enroute to camp

We arrived ogriagbene on the 15th feb to meet the villagers celebrating the ogbogbo festival It is mainly for the youths of the town where different masquerades display their different skills such as chasing of the villagers with spears and breaking of bottles on peoples head by some of the masquerades though according to my informant, surprisingly without injury, despite last year we had to deal with a severe spear injury sustained during this 'celebration'.                                                                    Our first patient was a child with acute malaria with a temp close to 40 degrees centigrade,the father had been to the new hospital built in the village and had been charged an extraordinary, and indefensible  fee he could not afford. He had gone in search of a loan when he sighted one of our Health Care Workers.He could not  believe his luck, though I noticed the apprehension written all over him as I examined his child He was placed on quinine injs for a few days,by the third day the child was hale and hearty.

A total of 102 pts wwere seen here,32 were children with 52 females with 30 pregnant women seen in these group the rest 18 were males
we saw interesting cases here such as severe hypertension,a lot of malaria cases,the pregnant women had thier urine and blood pressures screened and were counselled by the doc and our local midwife about the need for cord hygiene,immunization,exclusive breast feeding
Every pregnant woman was taught these by our midwife,the need for complete immunization was emphasized
These would be difficult to achieve for now but with continous re-education we might get there 

 

malnourished child

Antenatal Clinic

A woman I had seen prior to these had lost about four of her children to tetanus,others had lost thier children to vomitting and stooling,we placed a lot of emphasis on education throughout the camps
Every ANC case was taught about immunisation,exclusive breastfeeding,oral rehydration therapy, and hygiene,because these are the factors that have been identified as major causes of infant mortality and morbidity in these areas
The majority of the children seen were treated for malaria which is the major infection and the number one cause of death in these areas.

 

TB case

Clinically, likely Immunodefiency

A young lady with Tuberculosis was seen. We had about two months of rifampicin, an anti TB drug which we gave out to her with some other prescription of other anti TB drugs were also given to her and would be monitored by a hcw as treatment is longterm and compliance often a difficulty without adequate monitoring , education and support.
 
Our next port of call was okpokunou where a total of 194 pts were seen, followed by gbalegoro,an urhobo village,with another 55 pts ,majority of these were cases of malaria,the usual array of cases were also seen such as diarrhoea and vomitting,respiratory tract infections.
Less common , though on the increase in these communities is HIV / AIDS. A young lady who gave a history of persistent diarrhoea,you could see that she had lost a lot of weight,has also been recieving treatment from a village chemist,in a good centre she would definitely be screened for HIV, and we advised testing, though retrovirals are hard to procure and expensive. The benefits of knowing ones HIV status when realistically little can be done is an ethical dilemma, but can of course help with lowering risk of transmission.
 

Dr Oghumu. 05/03/07