|
Much of our work is educational, hygiene, dietary help and supplements, danger signs in pregnancy.
Measles and Tetanus are major causes of death in infancy. Besides education programs to discourage traditional pratices of cord cutting with dirty instruments and the application of cow dung to the stump, we are encouraging all children under five to be vaccinated against measles and mothers to receive Tetanus toxoid vaccination. Vaccination camps are held routinely in the communities .( see photos )
We have a western trained midwife to help educate mothers and liaise with traditional birth attendants to ensure best practice. Many traditional beliefs are deeply held and sensitivity is crucial to examine behaviour and seek motivational changes from the totemic and fetish practices that are currently used, e.g. bogus herbal remedies and often cruel physical practices.
Much of the domestic work, farming and fishing is undertaken by the women and besides antenatal and infant care, injury and rheumatic pains are common. Women's health and their status in society is a subject we are constantly trying to raise, and thus prioritise them during clinics.
Education and drama within women's groups by the midwives help explore gender issues in a safe environment, vital in a region where, despite the isolation, HIV/Aids continues to grow - though it is not often discussed. We use drama and puppet shows to convey sexual health messages devised and executed by village Health Care workers that are sensitive to the cultural boundaries.
Issues of grief and bereavement are also explored
as Mental Health has a low profile in these communities.
Dramas around measles and tetanus are undertaken prior to vaccination camps . Raising awareness of the benefits of immunisation and increase uptake is vital as fetish healers actively discourage vaccination in many areas.
Recent report of Vaccination and Antenatal/Contraception Training- :
We arrived on the 19th after the boat had passed through a terrible storm, nothing compared to Katryna, it was immunization day against Polio, a government sponsored programme, of course some of our HCW were part of the exercise. Training commenced immediately after we were able to assemble everybody.
Maternal and child health was dwelt upon and there was a brainstorm session about customs, taboos and culture as it affects maternal health in these communities. Taboos identified by the students were as follows:
1. Women were giving concoctions of local gin and cannabis locally called Indian hemp
as this was believed to hasten labour.
- Concoctions were inserted into the vagina also to speed up labour; this was identified by one of our TBA’s Margaret who you can see in the pictures performing a mock delivery on one of our male HCW dressed up as a pregnant woman, this same mock patient was also involved with me in a drama, the aim is to demonstrate to the HCW on how to attend to ANC cases, this you can see in the pictures.
- Another concern identified by the students is when a woman is in prolonged labour in some of the communities, the people believed the reason for her prolonged labour could be as a result of infidelity and until she confesses who is responsible for her pregnancy she will never deliver and this usually leads to a lot of complications during delivery.
- Students have identified puerperal bleeding as a common cause of maternal death in this area.
Margaret the TBA identified Tetanus as a common killer in these parts, she has seen so many cases and when asked whether she instructs her patients to take T-toxoid, she claims she does but most of the patients cannot travel to the health center which is a long distance from their home, when asked about Cord Hygiene, her response was that she hardly applies spirit to clean the cord because most of her patients don’t come back to settle her bills.
Emphasis was placed on immunization of mother and child, breast feeding, sanitation and cord sepsis.
The students so far have acquired knowledge and skills to be able to tackle health issues peculiar to their communities.
We normally take walk through surveys in each communities during our training session. We also have focus group discussion with the various community health providers from the chemist quack, native doctors to the various community TBA, this you will see in the pictures. The aim is for student to interact and have an idea of the various methods of healing, their benefits and complications.
You will notice the students being given practical demonstrations on family planning by the nurse aide in the health center and their instructor. You can see our water tank in the back ground with the students in the health center.
The final deal which was the 22nd of September was vaccination day, our trained mid-wife gave a lecture to the students on family planning (Pics show these) was very interesting for the student. This was followed immediately by the drama on vaccination so as to enlighten the villagers about immunization against tetanus and measles, which is our focus.
The mid-wife gives a talk to the intending vaccinees, after which the vaccination proper commenced. We targeted the children while they were at school and 210 of them were immunized against measles, 95 women were immunized against tetanus, bringing it to a total of 305 vaccinees. This little figure is as a result of the smallness of the town and poor information drive from their community chairman who was not around during this vaccination day.
The following were conducted during the exercise:
- ANC counseling given by me.
- Urine testing of pregnant women and examination.
- Free drugs such as paracetamol and vitamin A were given to all children vaccinated; haematinics was also given to pregnant women.
The participant during these vaccination programme were our trained mid-wife, myself HCW and community volunteers. Our next port of call will be on the 3rd to 4th of October were we will hold medical camps at Okpounou and Oboro. The 5th and 6th will be vaccination days at Akugbene and Okwama. All the participants that contributed to the success of this exercise were returned back by boat to their various villages while I and Clement the boat driver drove back to Warri.
Dr. Lawrence.
|
