A Random Morning at the Chest Clinic

I was welcomed at the door by a patient I had seen last week and wanted to see the doctor even though it wasn't his clinic date. It made me think of a new proposal that they start to reinforce that a patient see the same doctor every time, instead of the doctor that is available - it makes the doctor more invested in the outcome of his/her patient and it reassures the patient that they are seeing a doctor who knows them and cares about their treatment. No clinic card and number, so a quick search in the GHIS and I had all the information I needed. Oh how I love that system :)

I sat with Dr Abiot and helped him enter patient information into the GHIS. I'm not supposed to - it's against the rules (that I created), but I missed working in the clinic, and it's the one thing that I know is always appreciated. I enjoy working with him, seeing familiar patients progressing in their treatment and learning new things. I can read an x-ray now (unless it's tricky or not so clear), know the routine for TB diagnosis and treatment, and am familiar with what to prescribe for an itch, a cough or a pain... Saw my first case of TB of the spine today, who knew? I was thinking it would be interesting to pull the files on the patients that I first saw when I arrived at the clinic in February - we started at the clinic together and with a six month treatment schedule, all of them should be cured of TB by now!

I played phone tag with Roland (HSDU) all morning trying to coordinate our long overdue meeting... 9 am... (somebody slept late because of flu meds and I wasn't going out in the pouring rain) 10am... (dry now, but another meeting came up - and I missed the email suggesting 11am because I was in the clinic) 11am... Ah yes, finally 11am. I dropped off essentially the final copies (well, final copies to be reviewed by the two of us) of the deliverables for my contract - seven module development guides - and a terms of reference to hire somebody to do "my" Chest Clinic job at another facility.

After my meeting at HSDU, I sat on balcony of clinic listening to discussion of the day's news: Roger Khan (I don't know the whole story, but I think there is drug trafficking involved, he is a businessman with lots of influential and interesting connections, currently being held in the States and the latest in the saga - his lawyer has been charged with attempting to "eliminate" the prosecution's star witness)... Fine man's gang is claimed to have committed over 47 murders based on weapons found at the site of their takedown - not actually sure whether this is based on forensic evidence and definitely some passionate balcony sitters on the subject of whether they can be blamed for all or if coverups are involved... complaints about the doctor's disappearance and needing to get children to school, food to eat for lunch...

Impromptu discussion on my love life in the triage room with a nurse - thinking that I should find a Guyanese man to marry (probably related to the same plan to keep me in Guyana). She essentially told me that I should find a black man because he would be more likely to treat me like a queen. In a somewhat paraphrased quote and minus the Creolese (which I can't speak and definitely won't attempt to type), "I've seen what you to do to the men in this clinic. They sit and wait and watch you from behind when you walk, and like to watch your front too. They like your shape, your size, your height, your skin, your smile... They'd do anything to have you. They'd kill to have you." A little scary, a little flattering, a little bit of uncomfortable subject so we switched to a reflection of my time in Guyana...

It was interesting thinking back to what I expected when I first came to work in the clinic - computer literacy, negative attitudes towards the system, current state of the system... I like to think that I've accomplished something. Computer literacy has definitely gone up. The GHIS is no longer "your" system, it's THE or OUR system (I love it!) The computer hardware leaves a lot to be asked for and there is still some relunctancy by certain staff to use the system, but overall, I can see the change in the users and the potential for the system to work, and work well. I have shown them the way, given them the tools they need and I have confidence in them that if they want it, they can do! Now just to get over those computer issues, office tensions and management problems... sigh*

Time for lunch now, I guess, but I'm not really hungry. A trip to Oasis for air conditioning, wireless internet, good music... and cherry juice, chocolate icecream and a brownie... Quite a day...