Posted by Agya Poudyal
Each week, over the Nyaya Health team list, both a hospital update and community health worker program update is sent for reflections. Although there has only been one weekly update published in the past, the blog team would like to increase the frequency of notes from Achham to inform readers about our operations. This is going to be a series of monthly updates. Please find below my notes from last week:
We held a meeting with Dr. Amir Bista, Dr. Ramesh Kandel, staff physicians; Taraman Kunwar, Uday Kshatriya, Health Assistants; and Megha Giri, staff nurse concerning the distribution of the follow-up cards to the patients. The clinicians were positive concerning the idea and all agreed that it would be doable. I have finished the coding of the cards and once we receive the drop boxes for the registration desk in our hospital and the health posts we are ready to start the system.
COMMUNITY MANAGEMENT OF ACUTE MALNUTRITION
The weighing scales for Community Health Worker Leaders (CHWL) have arrived this week. I will hand them over to the CHWLs on Friday and ask them to start with the universal screening. Considering that there are 9 wards in each Village District Councils (VDC), we initially planned to weigh and measure all children by the end of 9 weeks. This means that we want to give one week to one Community Health Worker (CHW)/Female Community Health Volunteer (FCHV) to screen all children in their wards. But some wards are bigger than the others and the CHWs/FCHVs would probably need more than one week in these cases. Taking this into account it would perhaps be a good idea to set the time frame a little longer. It would be really helpful, if
you have any suggestions regarding how to carry out the screening and
by when to complete it.
Last week on Sunday, one of our CHWL came to our office room. At first, I was happy to see her on a day that wasn’t a normal CHWL meeting day. But when I saw the state she came in, my expression changed. The normally smiling didi was really pale and unable to move. The sweat beads dropping from her forehead said that she had a tough time reaching the hospital. She told me that she had been pregnant for two months and was now bleeding very badly. I asked if she had already seen one of our clinicians. She explained to me how she didn’t know if she was supposed to go to the Out Patient Department or to the emergency. We took her to the emergency room immediately.
Similarly, few weeks ago, we met a girl on the way to Bayalpata. She was lying on the road unable to move due to a stomachache. We asked her to come to the hospital as soon as possible. She came the next day and I saw her outside the OPD. After her meeting with the clinicians, I luckily spotted her going outside the hospital. I ran to ask her what she had been advised. She told me that she was supposed to get her urine tested but was going home because she didn’t know where she could do so.
Our CHWL didi (sister) and the girl had different ailments but they both shared a common problem. Neither of them could navigate around the hospital without help. I felt that patient navigation is one area that we really need to pay attention to, especially because our own CHWL didn’t know where to go in her situation. With things as simple as putting up signs we can do wonders. We have started to write down the names of the offices in each department but if we could come up with simple signs for people who cannot read and write and also to make it more intuitive for all patients, it would be wonderful.
Agya Poudyal is currently the Community Health director at Bayalpata Hospital. She has graduated with a MA in International Relations.