Centro de Salud....Santa Ana en Condebamba

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I have now been in this country for a WHOLE WEEK!! Isn´t that incredible, time flies when you haven´t got a clue whats happening! Well I started work officially on Tuesday 8th January 2008....but that isnt necessarily true, because no sooner had I said hello to the staff and seen the clinic, I was on the floor having fainted! now the reasons behind this are quite disturbing but nevertheless have to be told! that day, my third in south america, I had diarrhoea, this combined with not eating much breakfast (one bread roll and a glass of water) had left me will less sugar in my body that a flea and completely dehydrated. Now when your dehydrated, drained of energy and at altitude everything goes wrong.....simple things like standing up and walking apparently cause you to suffer from nausea, dizzy spells and eventually result in the subject passing out. There is a first time for everything!! But I stilll went to my first spanish lesson with jorge! what a legend that man is....unlike all the other staff in the office who look totally perplexed by life, he always has a smile on his face and is willing to work with my portospanglish....the language I believe I have invented!
Well the one thing that comes with diarrhoea that people usually dont realise is, along with the feeling awful, you do have to watch how you travel and time it perfectly....otherwise you get caught short and then you´re in big trouble!
Well its now wednesday and first day at work- take 2 is about to commence! I arrive at 8am (the opening time of the clinic)...put on my white coat, yes Ian I do wear a white coat and no Ian it isn´t cos Im actually an inmate at the local insane joint, and head over to the nurses part of the clinic....this room is about 4 foot by 8 foot...In that space they have a cupboard, a sink, a bed, a table with a baby balance, an adult scale complete with ruler, a cabinet with drugs and syringes, a table with minor emergency kit and thermometers, the list goes on really!
As you walk into the clinic you enter the waiting corridor (its not a room its a corridor) from left to right you have: the toilet, the dentist´s room, the admissions office (with pharmacy and filing cabinets on every wall) with the nurses office behind it, 2 gp rooms which do everything from minor surgery to gynea examinations, then the doctors office/staff room/kitchen! this all fits into an area the size of most peoples master bedroom!

My colleagues: Alejandrina, Carlotta (the nurses), Ruthie (the heavily made up admissions clerk), the dentists.....dont know their names yet, the interns Alejandra and Claudia (she is brazilian, very funny and likes the beegees 'if you leave me now, you´ll take away a little part of me. OOOOOOOOO no baby please dont go duh duh' is sung on repeat)

My work with the nurses is very similar daily, I observe and have recently been writing down or collecting these vital pieces of information: the subjects weight, height, age, temperature and arterial pressure.

So who are the subjects....pregnant women of all ages and sizes, and babies...lots and lots of babies! When I say babies i mean anything from 8 days old to 5 years old!
What do I do with them...I vaccinate, vaccinate and more vaccinations. most babies that come in to the clinic come in with the sole purpose of being vaccinated (TB,Polio, Tetanus, or topped up on Vit A etc). Remarkably out of the hundred or so ive seen they are all healthy (their wieghts vs age match up with the normal section on the graphs on the wall) and only 3 have had fevers!
Now for the most amusing part of the day.....taking the temperatures, with adults the temperature is taken orally, but now for the interesting bit babies and infants have theirs taken rectally....that isnt the amusing bit. The amusing bit is the babies just get on with it and only kick up a fuss with vaccinations, its the older toddlers that scream blue murder!! This is where my new found quechuan comes into play, and I can chant with the nurses several choice phrases which add up to the simple message of 'get it to shut up' but in a nicer fashion.

By 11am most days we are finished with patients and I then help in anyway I can. This could be filing the patients notes (lots of pieces of paper and forms stapled together). infact let me explain the filing system there are 24800 something registered patients...more everyday as more little babies join us at Santa Ana, and each one has a brown envelope with their number stamped on it. this brown envelope is filed in filing cabinets filled with identical brown envelopes...thats it. Or I produce history cards by tearing a piece of A4 paper into 1/8s and stamping it. Or I produce little packets to hold the TB tablets in, all the while practicing my spanish.
Then I take a micro home...usually waiting about 10 minutes for it at either end of the journey and have lunch.

However this is all likely to change next week when my mentor Dra. Pozo joins the clinic after a vacation and takes me round the clinic getting me involved with everything....all the while shouting at me to learn spanish. Well Im now off for lunch with Edith followed by an afternoon at the market so I will let u know how all that goes....and the marches which are happening all this weekend!

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