Hello everyone,
Ali and Alexa here! This past week we had
the opportunity to have our clinical placement in the Limulunga Health
Centre. For those of you that don’t know,
Limulunga is the royal village where the king of Barotesland has his
palace. Even though Limulunga is a rural
village, the health centre still caters to many people because it is the
closest healthcare access for the people also living around Limulunga and into
the flood plains. The Health Centre
consists of an ART clinic (HIV clinic), a tuberculosis clinic, a maternal child
health clinic, an outpatient department (walk-in/emergency), two small male and
female wards with three beds each, and a small maternity ward. When we first arrived, we marveled at how
many resources and clinics were available in this rural community; however, we
soon realized that because of the vast population the centre caters to, the
centre was always packed.
Throughout our
time in Limulunga, we were able to do HIV and malaria testing, work with
maternal child health, and see patients in the outpatient department. The rains
have been very heavy in Zambia this year, and along with that rain comes a wave
of patients suffering from malaria. We spent most of our time in the outpatient
department and were thankful the nurses were receptive to us and willing to
translate what the patients were saying. We were amazed at the scope of practice
of the nurses at the centre. They are quickly assessing, diagnosing, and
prescribing medications needed to treat the conditions for many patients in a
short period of time.
We noticed that
the nurses have a different knowledge and skill base than we do back in
Canada. This was apparent in one
particular case that stuck out to both of us.
A school-aged child was brought into the clinic. He was unresponsive to
our efforts to wake him up. He tested
positive for malaria and presented with a very high temperature, and both a
fast heart and breathing rate. This was
the sickest child either of us had ever seen.
We were extremely concerned about his well-being and wanted so badly to
scoop him up and take him to the hospital in Mongu. We were having a hard time adjusting our
thinking and couldn’t help but consider what we would do for this boy if we
were at home. The nurse on duty, on the
other hand, stayed calm and knew exactly what to do with the limited resources
she had. She used the boy’s shirt as a
cloth and ran cold water over it to start cooling him down. She then administered an anti-malarial injection
and, to our surprise, left the boy lying on the bed and continued seeing other
patients in the room. We were too
nervous about the boy to concentrate on the next patients, so we kept a careful
eye on him, reassessed his vital signs, and continuously cooled down his
cloth. After about thirty minutes, the
clinic was closing. This meant that the
boy had to be moved to the overnight ward and to our relief, when the boy was lifted
up to be moved, he opened his eyes for the first time!!
Upon reflecting
on this experience, we agreed that while we do have some knowledge of malaria
and malaria medications, the Limulunga nurses are experts on this topic because
they see this disease often and know what to do. We were impressed with how calm the nurse remained
and respected the fact that she knew this boy was extremely sick but was able
to multitask having an acute patient while maintaining the flow of the
clinic. We left the Limulunga Centre
with a great respect for the nurses and how well they are able to manage a vast
population in a low resource setting.
-Ali & Alexa
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| This was the walk to the centre |
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