Over the last few months I’ve become known as something of a nurse.
All it took was for the word to get out that I have a stethascope, a blood pressure cuff, and I’m not afraid to use them. Since then I’ve, on occasion, had lines of people wanting to have their blood pressure taken, or their symptoms diagnosed, or their child looked at, or their cut bandaged. Most often I just listen, and then say “Why don’t you wait until the nurse comes up,” “I’ll look in my books”, or “here’s some soap, go wash your sore in the spigot.”
The last few days, my diagnosing day as a pseudo health worker went something like this:
We had some visitors bring medicines to give out. They were planning on bringing a doctor, but since he couldn’t make it, they asked if I’d dole out the meds, take blood pressures, and pose for their videos. The meds were mostly easy to diagnose stuff, and fairly safe…scabies cream, fungal cream, iron pills, antacids, lice shampoo, antihistamines, cortisone cream, and aceteminophen. But there is also hard stuff…high blood pressure medicine, asthma medicine, vomit medicine for extreme cases, etc.
SUNDAY we put the free medicine word out to a few people. I checked their eyelids and nails for anemia, looked at their strange rashes, and tried to decide between scabies cream or cortisone cream or fungal cream, took blood pressures, and stressed over amounts and doses. At the same time my coworkers treated lice, and gave out sulfur soap.
MONDAY more distant relatives of the first wave had heard about the free meds, so I had more talking and diagnosing. Good thing I’m getting better at medical terminology and body parts in my new language. We mostly gave out fungal cream, antacids, and iron pills.
TUESDAY was one for the books…and we’ll have to work with the village leaders to find some boundaries.
8am 2 pregnant women showed up to have their blood pressures taken, and to hear their babies heartbeats with the fetalscope. I gave them both iron pills, and told them to get more at the well baby clinic that the government runs in the village. They also had a skinny, under-nourished old grandma with them who wanted her blood pressure taken, and something to make her gain weight. They ate lunch, and finally left at two.
After lunch, the local midwife showed up with her grandson who had a chronic rash, and had cried so hard that his eyes had rolled up in his head. He is skinny, but healthy besides the rash. I said he was probably fine, that his mom needed to get more healthy food, and that they could try changing soap. It didn’t look like anything but skin irritation. They also brought a lady who thought she might be pregnant, and wanted a confirmation. I couldn’t help much. Pregnancy tests, which I don’t have, are $1.50 and a little out of reach for most people. I also gave the midwife some antacid. She stayed for three hours, talking about her husbands extreme health problems. I just listened sympathetically.
I took a nap. When I woke up, there were 10 people lined up on the log outside, and my poor husband was stressed. After taking blood pressures, and listening a lot, I could only give out antacids and acetaminophen. I’m out of iron pills for the lady with bad periods. I have no idea how to help the three year old who was diagnosed with bird flu in the city, but seems to be healthy now except allergies to birds, dust, and dogs. I didn’t want to give out malaria meds to the people with headaches because I don’t have tests. Finally, at dusk, they all left.
Since then I have between 5 and 10 patients a day. I’ll be happy when all of the medicine is gone, or I figure out how to give it to someone from here who knows the cultural clues. In the meantime, I’m working on finding good books and translating the others, training people how to use the stethascope and blood pressure cuff, and making up a wishlist for health worker medical kits (not just medicine).