Today we finished up our clinic work in Arenal, Belize providing care to over 110 infants, children and adults in our traveling clinic over two days. Students did an amazing job triaging patients, conducting histories and physical exams, coming up with differential diagnoses, and providing education based on the final diagnosis. We identified a pregnant woman who had signs of preeclampsia who we sent to the hospital and saw many different symptoms, conditions and abnormal physical findings. There is a lot of learning going on here!
On the way back from Arenal we toured the San Ignacio hospital, one of the four public hospitals in the country. The hospital serves about 55,000 people and has a staff of 13 physicians and about 50 nurses. In this facility they have a small emergency room with 9 observation beds plus 2 cribs and 7 maternity beds. Three years ago, San Ignacio Hospital earned designation as “baby friendly,” meaning they do many things to support breastfeeding with new moms.
Prior to departure from Knoxville, an engineer colleague posed a question for us to think about while in Belize, “What technologies, devices, needs, problems, and/or challenges can our nursing student’s identify that the College of Nursing’s Health Innovation & Simulation Lab and /or the University of Tennessee at large might be able to address?”
Here are some of our thoughts….
- Some people in the community do not have access to clean water, so some sort of low cost water purification system is needed. Also, they need some sort of testing device that can indicate if water is contaminated or not.
- The community lives many miles down rugged dirt roads and residents have to pay $40-$50 to get transportation for emergency or health care; this community needs some sort of emergency response system and transportation support to help people access clinic and hospitals.
- Community members demonstrated a lack of education on prevention of disease, health promotion, and family planning. Since it is difficult to get health education worker out to this rural area, it might be beneficial to have some sort of educational technologies (video or video chat) to provide health education.
- Provision of a transportable ultrasound device/x-ray machine to improve diagnostic abilities in remote areas.
- We saw a lot of skin conditions. Many are treatable with common medications and improved sanitation of contaminated clothing/bedding. It would be helpful to have an APP or picture reference book for the health care workers that can help with diagnoses of skin conditions along with standing orders/supplies of certain topical or oral medications to treat these conditions.
- How can we better educate woman on the signs and symptoms of preeclampsia so that they know to get themselves to a hospital before the condition worsen and outcomes are poor?
- Can we develop a mobile lab and pharmacy that could rotate visiting rural communities to conduct lab tests (like urinalysis and glucose) and provide medications to people who are unable to travel to the cities?
- Many people cook with open fires in their houses. This is dangerous from the standpoint of potential fires and exposure to smoke in the houses/huts. We need to develop a low cost ventilation system for these households.
- Many animals (chickens, pigs, horses, dogs) roam free-range in the community. Could some type of low cost system be developed to prevent contamination of the water [river] by these animals?
We loved serving the community of Arenal over the past 3 days and look forward to learning about a new community, Ontario Village, tomorrow!