Goodbye Dr Sarah, hello Dr Fiona!

The first few months of 2012 has been a busy time for the  N/a’an ku sê Lifeline Clinic in Epukiro.  Our Lifeline doctor, Dr Sarah France left on 19^th May after being with us for a year.  She has been replaced by Dr Fiona Thomson, who will be with us for 3 months.  Fiona is from Glasgow and is training in internal medicine.  She also has a Diploma in Tropical Medicine and Hygiene and has interests in infectious diseases and alcoholism; all of which are incredibly prevalent amongst the San Bushman communities.

Fiona leaves in August and we have another doctor coming out in July who will remain with us for a year.

Key facts for the first quarter of 2012·        

• From January to April 2012 the Lifeline Clinic has seen 1347 patients (23% increase on the same period in 2011)
• On average 44.5% of the patients are children
• On average 80% of the patients are San Bushman who continue to get their treatment for free.  All costs are covered by N/a’an ku sê Foundation.
• Cases ranged from common coughs and cold to Tuberculosis and injuries sustained from domestic abuse
• On average we have spent $42,000NAD (4000 Euros) a month on running the Lifeline clinic 
• We continue to be unsupported by governmet funding aand are solely reliant on generous donations.

  
  

Case Studies in 2012

Maria

Maria came to the clinic with TB in her lymph gland so we referred her to hospital in Gobabis (120km from the clinic in Eupkiro) to start her treatment.

When she was discharged she was being supervised by the State Clinic TB program.  One day she came to see us instead because of a “problem with her back”.  We discovered that she had spinal TB, the state clinic had diagnosed this, but unfortunately they had not treated it. They simply told her to see a Doctor.  Dr Sarah therefore took her back to hospital. Now she is in hospital in Windhoek receiving specialist care.   Whilst caring for Maria Dr Sarah noticed two of her four children were malnourished.  She therefore enrolled them onto our feeding program to boost their nutrition levels.           Zacheo Earlier this year a young boy called Zacheo came into the clinic with an abscess in his mouth as a result of not brushing his teeth properly.  We see a lot of this at the clinic so Jana and Lauren, two of our medical volunteers, had fun teaching all the local children the importance of bushing their teeth! They distributed heaps of tooth brushes and toothpaste. We are delighted that we have started our immunisation program. We extend our sincere thanks to Frabrizio Feruglio, Haig Babikyan, Alan and Jane Crack, Antony Clements and Rob Duijvelshoff who donated money towards a new fridge and fridge battery. We can now try and improve the local immunisation rates, protecting children from preventable diseases such as measles, polio and tetanus. The fridge is portable and therefore we can take it when we do our outreach clinics in the more remote areas of Epukiro.

Community Health Worker project

Late last year saw the launch of our Community Health Worker Program which was set up thanks to medical volunteer Dr Tim Thornton who spent 3 months working at our Lifeline Clinic.

  

The main aim of this project is to teach communities how to improve their own health by looking out for basic symptoms and treating them accordingly. We do this by training an individual in the community. Tim identified 5 communities that he thought would benefit from a Community Health Worker and within these communities he found 9 people to train up. These people are all San and all women. 

 So far we have taught them some basic health skills such as: 

• Identifying people who may have TB, (i.e. those with a cough for 3 weeks) and how to collect their sputum so it can be sent off for diagnosis
• How to treat diarrhoea
• How to recognise pneumonia
• How to treat burns and wounds 
• Identifying malnourished children by measuring their arm circumference
• Checking the children have had all their immunisations.

We want to specifically address Goal 4 of the United Nations Millennium Development which is to Reduce Child Mortality. Three major causes of death in children under 5 in the developing world are diarrhoea, pneumonia and measles.  Malnutrition also greatly increases the chances of dying from diarrhoea, pneumonia or measles.  By showing the community the correct early management of diarrhoea we can hopefully reduced mortality from diarrhoea.  Also by educating people on how to recognise pneumonia and encouraging mothers to take their children to a clinic early on so they can get antibiotics we can also reduce deaths from pneumonia. Immunising children against disease will also help.

Once a week our Doctor will visit one of the groups of health care workers so we can check their log book, discuss any problems they have or any patients they may have found and teach them something else. 

This year we will be looking at strengthening our community health worker project which was launched at the end of 2011 with ongoing training and support.  

Lifeline Christmas Party

On the 3rd of December, a group of us went to the Lifeline Clinic for the weekend to help our Dr Sarah to organise a Christmas party for all the children in Epukiro. This was not as hard as we thought actually, due to the beautiful preparation Dr Sarah and Nurse Anna had already made over the past weeks. 

The group of us, including four very helpful volunteers, arrived to decorate the clinic and dress up the children in little angel outfits which made them look adorable!

Just as all the town inhabitants had arrived and taken a seat in the clinic, the children arrived, dressed up and singing the most beautiful Christmas carols in English, Afrikaans, San and Herero, making more than one of us shed a tear or two. 

After the beautiful ceremony, Rudie, who dressed up as Santa for the occasion, gave out presents to each and every one of the children, while our volunteers were busy giving out cake and drinks outside.

The big surprise of the day was the water slide that Rudie and Marlice brought down for the day and which was very much enjoyed by all the kids!

Thank you to everybody who participated and a special thank you to Dr Sarah and Nurse Anna for organising such a special day for the children!

Click here to watch the video of the day.

Improving immunisation rates

Last year, Antony Clements, one of our medical volunteers  looked at the childhood immunisation rates. 

All children in Namibia should receive a measles vaccination at 9 months of age, but he found that only 67% of children locally were immunized against measles. This is below the level that is recommended for good immunity of the community (herd immunity) and is a problem throughout the Epukiro region.  Measles represents a significant cause (5%) of preventable deaths in children under 5 living in Namibia.

One of the problems identified for poor immunisation rates was that the San parents did not realise when their child reached 9 months or did not have the child’s medical card. There is also a reluctance of parents to take their children to the state clinic for their immunisations as they feel nervous about going or sometimes unwelcome.  

  

We hope that this year we will be able to buy a suitable generator for our fridge (to ensure vaccines stay cold during a power cut) so that we can also offer an immunisation service and improve the immunisation rate locally.