Biryogo Health Center - Day 1

This morning we got up bright and early to head to the Biryogo health center where we will be working this week! Today and tomorrow will be completely for observation and evaluation. We took most of the day touring the facilities and learning about the programs they had available. The health center definitely struggle with resources compared to their intake and there is a lot of work to do. With that said, they are doing great despite their circumstances. Their model is really cool. Not only do they provide healthcare but also social services and educational services. They have numerous community health education programs and a primary school where the children in the sector can go for a couple of years! The health center is like a small clinic that sees basic patients. There is only one doctor in the entire place and we only saw her once for a few minutes! The director and all of the other medical staff who oversee patient care are nurses. To start the day we met with the director of the health center, Veronica. She was very nice and welcomed us to her clinic. She explained that it was started by the Catholic church but it is now funded by the Rwanda Ministry of Health. The health center not only addresses health needs but they also offer patient education classes and have a social work program for patients who need it. She was very proud of her health center, which she should be! They are doing really great for the resources they have! But I will get to that later! After we met with Veronica we got a tour of the health center. We started in the the ARV clinic. ARV is what they call the HIV clinic. They use ARV (anti-retroviral) instead of HIV because of the stigma surrounding the disease. The ARV clinic was simply to distribute anti retro-viral medications to patients suffering from HIV. It was off to the side and offered a lot of privacy. That was a really great aspect about the health center! They weren’t just there to treat the patients but they also take into consideration the social aspect of disease which is very important! On top of distributing medication they had a counseling service for patients recently diagnosed with HIV. They helped them adjust to life with the disease as well as how to tell family and loved ones about their diagnosis.

Next we visited the waiting room. It was more like a waiting area, it was covered but outside. In this areas there was a window to present your insurance card and then a window next to it to receive your paperwork for the day. As you can probably imagine all of the filing and charting is done by hand so a patient received their file and that paper is passed from the office to the patient to the nurse to the labs and back to the patient (hmmm can you sense an infection control siren going off there?) We also visited the minor surgery room where patients go to get sutures, wounds cleaned and other minimal sterile procedures. There was also a TB section of the clinic but we just passed by it. They keep it fairly secured due to the nature of the disease. Finally we went to the vaccination and education portion of the health center. We didn’t see any vaccinations today but we had the privilege to sit in on a nutrition class for new mothers. This group had been exclusively breastfeeding their babies until today! The purpose of the class was to teach mothers how to properly transition their babies to solid food while keeping their diet balanced and nutritious. They had posters with diagrams of the steps a mother should take as well as comparisons between a healthy baby and a malnourished baby. It is a compliment here to say that someone is fat or a baby is fat! It makes the mother so happy. At the end of the class they taught the mothers how to make baby food from fresh fruit. We even got to see a mother feed her baby real food for the first time! It was really cool. 

After our visit we met with Waleed, our director and went over what we are going to do tomorrow at the clinic. We are going to spend 30 minutes in each section of the clinic in groups of two and simply observe. Our job is to look for anything that might contribute to disease transmission. For example, empty soap containers, needles disposed of improperly and so on. I’m excited to get started! It will be very interesting to see what we observe tomorrow! We already saw quite a bit while on our tour today that we discussed as a group. I noticed that the LAB had a single BAR of soap. That is concerning to me!!!

 After our tour we got to sit in on a nutrition class addressing proper nutrition for babies when switching to solid foods. They had about 40 mothers there with their children. They taught them the importance of early compliance with the suggested nutrition goals in order to avoid chronic malnutrition. After the information session they taught the mothers how to make simple baby food from local fruits. It was super cool because once the demonstration was finished the mothers got to feed their babies solid food for the first time! It was really fun! After our visit we got lunch and came back to the guest house where we had a two hour meeting addressing what we are going to do tomorrow. We are so lucky because each group (we are in groups of 2) get a Rwandan student with us to translate for the week! We are good friends with them too so it is so fun! I am paired with Suzanna and our Rwandan student's name is Elise. She thinks it is SO cool that I have a little sister with the same name! She wanted to see pictures and everything. We were given essentially a checklist of IPC standards that we will thoroughly go through tomorrow in each section of the hospital. From there we will identify the biggest problems and hopefully create realistic solutions from there! I love this applied work! It feels so good to use everything I have learned at BYU in real life!