Teach and Travel: Rounds at Pommern Clinic

In the middle of my second week in Pommern, I got the chance to do a little volunteering at the clinic for the first time. We had taken a tour of the place on our first day in Pommern, but we hadn't done anything other than look around.

On Tuesday afternoon, I made a quick visit to the clinic with my teammate Kendra to check on a young patient named Elizabeth. Elizabeth just tested positive for HIV, and at age 4 or 5 she was very thin, frail, and petite. She was laying down and slowly eating a bit of food, which was apparently an improvement over her alertness that morning.

I found myself amazed by the "openness" of the clinic. It was perfectly acceptable to just walk into the in-patient area. No formalities of paperwork or walking past nurses, or even knocking before entering. My other team members, who spent a lot more time at the clinic than I did, also found that at the clinic they never felt "in the way." They were given tasks for assisting, and both Dr. Godlove and the nurses patiently explained answers to questions as needed.

That visit was quick, but the following morning I didn't have to be down at the primary school until 11 am, so I went with teammates Amy and Sonia to the clinic for awhile first. We started by going on "rounds" with Dr. Godlove, checking on patients who had stayed overnight. We learned that Elizabeth was going to be transferred elsewhere for care (probably Iringa, as Pommern is the best small-village clinic around). Another patient who had been admitted a couple of days before with pneumonia was discharged. A 70-year-old woman with late-stage AIDS had very low blood pressure and low blood sugar and was only semi-conscious. Sonia went back to the mission house to bring the woman some of her own glucose tablets to help raise the woman's blood pressure. Apparently that wasn't something the clinic had any access to themselves. Heartbreaking. Another woman had very high blood pressure, and I caught the Swahili words chumvi and chakula (salt and food) in Dr. Godlove's speech. Perhaps he was telling her that too much salt with her food was bad?

I learned how to take patients' blood pressure that morning and did that a couple of times. We also were able to serve as an extra set of hands to Dr. Godlove, though I felt like he could have done things twice as fast if we hadn't been there. Speed and efficiency just aren't the African way though. I must also stress how "rugged" the clinic here is compared to any American facility. It is one of the best rural clinics around (patients often come to Pommern having developed infections from other clinics), but the rooms and resources are extremely basic. Patients even have to bring their own bedding with them when they will be admitted overnight. Anyway, "rounds" took awhile and by the time we had attended to all the in-patients, it was time for me to go down to the school.

The only real way to explain what the clinic looks like is to just show you, so enjoy the pictures (ones with an asterisk were taken by Kendra, not me).

This is Pommern Clinic. It's a U-shaped building consisting of multiple rooms, each with its own purpose.

Patients wait outside the clinic to see the nurse or doctor.*

This is the first room the patients enter. The nurse takes down information about the patient. The patient then procedes to an indoor waiting area and may have lab work done, may receive medicine from the dispensary, or may have some sort of surgery.*

A sign in the room that indicates what the most common diseases are in Pommern.*

One of the common tests done in the lab is an HIV test.*

This is the dispensary. Medicines are stored and dispensed from here. Many of these supplies arrive as donations from the United States, delivered by the volunteers.*

The sign above the door indicates that this room is the women's ward for overnight patients.*

This is the birthing room.

Another view of the birthing room; notice the scale on the counter.

This is another surgery room.

The doctor is also responsible for dental work, which typically means tooth extractions. Routine dental checkups don't happen, so usually the only time a person comes to see the doctor for a dental problem is when the tooth decay has gotten bad enough that pulling the tooth is necessary.