Daily Diary - Week 3

Well this week is somewhat shorter due to the public holiday on Tuesday and because of this most of the clinicians at Elim only worked half day on Monday. Our supervisor was kind enough to give us monday off.

Day 1 (Wednesday)

7:30 - 10:00

We (Jacomie, Rosy and I) worked on our health screening which we plan to do tommorrow. We designed a questionnaire which needed to be translated to Venda and Shangaan, the two main languages spoken in most of the villages that we will visit during community outreach.
I visited my case report patient (Mrs Mnisi) in the ward. Unfortunetly she is in a bad state and has a glascow coma scale of 3/15. They are still unable to lower her BP (214/138mmHG) and I am not able to do much with my patient untill the BP has been lowered.

10:00 - 10:30

Breakfast

10:00 - 13:00

I visited my ward patients (new surgical Ward) and they seem to be progressing well. The male patient I'm treating will hopefully be going for surgery next friday at Polokwane (fingers-crossed). He already has a leg length discrepancy due to poor management (skin traction) of a midshaft of femur fracture. The goverment hospitals are fully booked and have a backlog of patients awaiting surgery. They simply manage the patient in bed until they get a chance to be operated on. This is unfortunate, as most patient develop complications such as leg length discrepancies, pressure sores, contractures and general body weakness. As physiotherapist we do have a role to play in preventing some of these complication given the current situation in primary and secondary hospitals, but unforunately there are way too many patients to see for the amount of physiotherapy staff as is the case at Elim hopital.

13:00 - 14:00

Lunch

14:00 - 16:30

I spent the rest of day treating outpatients at the physiotherapy department.


Day 2 (Thursday)

7:30 - 15:00

The day was spent visiting four rural clinics for the community outreach progam.
Mr Matswiki, Jacomie, Rosy, four other health professionals ( 1 OT, 1 Optomitrist, 1 Speech therapist and Dietitian) and I went to see the following clinics:
- Mashau
- de Hoop
- Kurhuleni
- Marseilles











There was some sort of mix up with the dates and most patients did not pitch at the clinics. We did screening at Marshau (only 2 patients) and plan to revisit the clinic next week.
At Marseilles one of the nurses present at the clinic asked us (the Physio's)to see a patient who lived nearby. The patient has an unknown pathology that we were unable to diagnose. She has extensive tissue damage which limits right knee extention and flexion. The patient is being neglected by her family and she does not get food on a regular bases. The family is unwilling to help her due to internal family conflicts. The room is cluttered and there is a large step at the entrance which restrict her from mobilising with her walking frame. Intervention needs to take place to help improve her situation and try resolve the matter. I hope to revisit the patient next week to help change her environment so that she can be more functionally independant.

Day 3 (Friday)

7:30 - 10:00

We worked on our health talk and are finding it difficult to find someone who will translate the information leaflet and exercise instructions to Venda and Shangaan. This is delaying us but we hope to complete the poster and leaflets before Tuesday next week.
I was fortunate enough to observe and assist with the strapping of a 1 day old baby who has talipes equinovarus (clubfoot). Please see My other post on Interesting findings and Reflections.

10:00 - 10:30

Breakfast

10:30 - 13:00

I spent the rest of the day treating patients in OPD.
A patient approached me demanding I give him a Disability Grant. The patient was extremely racist and potential Psychotic and it was a rather scary situation. Please see My blog on SWOT and SPAR Notes for more details.