The Abandoned Government Hospital. Notes.

I am posting my notes from the Hospital. I will formalize it later, but if you have any feedback I would love to know your thoughts/impressions.

Tour of Vacant Government hospital:
(With Cecelia’s husband)
Closed since strike in February 2011.
Operating room. Working last year. 2-3 procedures performed.
Doctor brings medications with him when he comes.
No utilization of National Service Youth Corp.
Cost of delivering a baby is 5000N. This can be pain in increments.
Staff: 1 MD, 6 Nurse, 1 sister (Mary Paulette), 1 midwife. The latter two are from the church. There is no system for pregnant women to get care in their own homes.
Observations: mold growing in saline bag. Used needles hanging in operating rooms. Supplies for sutures are available and look new.
Chart notes are sitting out in entrance from 1994. Kids with diarrhea, 1yearold with fever.
No mosquito nets or fans in the wards.

(CECLIA nurse: was working in the farm prior to coming over. Kids ages: 9,8,5,2y7mos)
There is no water available in the hospital. How can you care for people when there is no water?!
Card costs 200N for each person or child.
No one has been coming here since the strike started in February. The doctor comes weekly on Wednesday.
When he comes, he sees 2-5 patients per day.
Cecelia now sees and treats what she can. She mostly treats malaria. She also delivers babies when it is not an emergency. Usually there are about 2-3 deliveries per month. If it is an emergency, she calls the doctor and he comes from Onitisha and usually takes these women away to his private hospital there.


REFLECTIONS AND OBSERVATIONS
Emphasize short community trainings. Better professional training.
Provide home services.
People think the clinic in Aboebgu is too far away to get there. (It is a short walk).
Who are the local leaders that could promote health training for the general public?
What are the best ways to educate people about basic health care needs?
What are ways to provide transportation and home visits?
Motos equipped with basic supplies for home visits (DM, HTN, rheumatism, malaria, diarrhea, etc) Nurses come to health center in morning, then go door-to-door during the day. At end of day, return moto and lock up equipment.
Shuttle from each settlement to hospital once per week.

How do we ensure that the medicines are getting to the patients and not going to the doctor’s private hospital?
Provide scholarship for agreement that the doctor will return to Ebenebe for 5 years to practice. Same thing for nurses. Health educators. Provide salary and transportation while working. As part of the agreement, they go site to site.
How do we communicate with public?
Promote classes.
Spread word about services.
Reminders about antenatal care.

Basic Health Topics:
CPR
Hemorrhage
Malaria
Diabetes
High Blood Pressure


Would the current nurses be interested in teaching/mobilizing to educate women and groups?
Topics: infectious disease, antenatal care, nutrition, ‘


Can we make it cost effective to go to people’s houses?
How do we create abundance mentality for employees, patients, community?
How do we make sure that they think there is enough?


Feeling of hospital: the wards feel terrible - tight and cramped. 12 beds in a room, no circulation. The outpatient facility was comfortable. I think starting with one consulting room is a good idea. Administration? Interesting.