Saturday, February 26, 2011

La deuxiѐme partie: The Need to Nail Down the Support

Le 23 février 2011

Seems like I’ve been running out of inspirations to fill up my blog page these days. I’m stucked, frankly speaking, and it surely happens for some reasons. Today marks our second day to work at a community health centre (widely abbreviated to Puskesmas in Indonesian) of Gandusari, Trenggalek. On a été bien accuelli, but anyhow we can tell we’ve been spotting some unkind faces smiling around. But not all are detected, the list of those who deserve to be slapped may potentially extend. We should be more alerted next time. FYI, the list has had some lead figures’ name in it ha ha.

Aside from all the screwed up things, all is going well basically, all happy. The small group of 5 was laterly split up on a personal basis to run and assist the medical service at five diferent units, each for a week term. That’s how the rotation works. This week I’ll be working au cabinet médical (j’ai aucune idée comment exprimer cette phrase précisement en anglais, it’s kind of a GP’s consultation room). In it are 2 doctors and a nurse. The room is compact, but luckily it’s shiny. On average the daily patient visits revolve around 20-25. So I was partly relieved knowing this info he he. Most of the patients come with a number of diseases such as acute respiratory tract infection, non-dehydration acute diarrhea, hypertension, diabetes, gastritis, osteoarthritis, rheumatoid arthritis, dermatitis are on our daily menu. I felt somewhat funny cuz I nearly forget a series of drugs I had memorized the night before, you know most of the patients had multiple chief complains which led me to an utter confusion (as a newbie doctor he he) to pose the diagnosis. Thanks God I had dr.Mariana who helped me a lot with the art of prescription he he. She taught me also the drug combination to write into the prescription. That was way sooo refreshing. But shame on me he he.

During my last night’s shift with colleague, Achmad, we found nearly the same pattern of the diseases except for a case of CVA (a 60 something nan having difficulty to talk some 9 hours prior to her admission, BP 210/110, we found impaired 7th cranial nerve in form of labial palsy, weakness in left upper and lower limbs). We suspected her to suffer from hemorrhagic stroke. Since there’s none of diagnostic tools available in the centre and patient declined to be referred, we could only administer intravenously kind of neuroprotector which was actually insufficient. Shame on this fact. What bothers me often while working here is that the questionable use of AB in this centre. For example: a KID coming up with acute diarrhea would likely be treated with antibiotic(s) despite the absence of suggesting indications as such bloody diarrhea, mucous stool, diarrhea with seizure etc. So my biggest apology to all the paediatric professors, vos rѐgles ne sont pas valables ici. But all in all I’d suggest that the delusional use of AB here must be reviewed.

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