|This entry comes a day late (we’ve been working very hard and coming home exhausted)! Again written by our team leader Joel who has a hidden talent of blogging!
After the first day, we had a taste of the mission trip. We traveled to the village Rajpriya, a small village better than yesterday. At least it had a paved road with pot holes every few feet. We saw most of the transport using horses on roads .
Before we started the day, we joined the clinic staff in their morning devotions and prayers. A local singer sang for us and also performed an instrumental music on harmonica and ukulele at the same time.
Today, the arrangements at the camp were much better. The village people maintained lines most of the time. The camp was at a school. The students were still in class when we arrived and they all stood up from sitting on floor mats and greeted us in unison, “Good morning!” The school was dismissed early but the students were playing in the large compound in front of the school throughout the day. At noon, I saw them carrying plates and forming line to have their lunch served.
We started with the registration far from the school building under a large tree. Our 2 Pre-PA students were typing on their cell phones the names and age of each patient while the Indian team would issue a pink registration slip with the name, age, and other demographic information.
Each person was first triaged by taking their vitals signs and also asking them about their oral hygiene. A dentist from South India took a break from his private practice and joined our team. It was a lifetime experience for our team members to assist in the extraction of teeth at the camp. I saw one of our Pre-PA student putting pressure on the extracted tooth area and making sure the bleeding has stopped. Our RN team of 4 new graduates worked all day without a break. In one case, we had a high blood pressure patient of 204/113 or something like that. One of our RN's quickly realised the medical emergency, pulled the patient out of the line, and brought them to the attention of our medical provider team. The patient was immediately treated with Amlodipine. I could not find a glass to pour the water to take the medication, but one of the team members used a bottle of water directly. The patient was able to swallow the tablet. We advised the patient the possibility of stroke due to high BP. We gave her a 15 day supply of BP medications. We hope she will return to the clinic for follow up.
The medical providers saw interesting cases today. We had approx 4 to 5 critical BP levels by US standards. We were satisfied that our camp was able to diagnose them and start the medications; however, there is no system for follow-up. There is not much funding to provide transportation for these villages to follow up at clinic. Miss Lillian Wallace, a long term missionary from New Jersey and now a resident of India since 1956, suggested a mobile clinic. I believe they had all these facilities years ago, but now, the clinic has no funding . The clinic staff is working with 2 months of unpaid salaries .
Many young people had fungal infection such as Tinea cruris or groin itch. We were able to treat them with oral Flucanazole as well as the anti-fungal cream Miconazole. We educated them about the use of towels and a daily bucket bath. Showers are a luxury here, and if you say “take a shower,” they will have no idea what you are talking about. We also had quite a few children with ear infection and some with pus discharge.
Our 4th and final stop is the pharmacy. The registration, triage, and medical provider are the first 3 stops. The first day was chaos as we could not keep up with the pace. The people were standing in front of the bar windows pushing each other to get the medications, but today, we transformed the pharmacy stop to a CVS or Walgreens!! Well, something like that. Anyway, thanks to Martin Houle, a biochemist from Canada, for organizing the pharmacy to be the most efficient I have ever seen it!
We separated the pharmacy stop about 60 feet away in a separate class room. Our team was able to fill in the medications in brown paper bags. We had 5 of our team members help in pharmacy and 2 of the Indian team were standing at the window distributing the meds with instructions. There is always a concern whether the people are following the instructions for taking the meds or not. Most of the adults have no formal education. We tried our best to explain how to take medications like, “Take this red tablet once a day,” or, “Take this white round tablet only when you get fever.” A sad but better part was the 11-year old school children taking instructions for their parents .
There was less crowding at the pharmacy window today. Some of the standard medications we sought to give to everyone were Vitamin B12, Iron, and Albendazole (for worms). For BP, we had mainly amlodipine. For antibiotics, we used Cipro and amoxicillin.
We saw approximately 400 people today. We had lunch in the bus and it was delicious. We left early today at 4 PM. I was told tomorrow we have to travel 45 min to the camp. The camp is arranged in a remote forest area.
It’s 4 am now; I will stop now!