FIELD VISIT WITH PHM

Sanduni Dhanoddya Samarajeewa

25 August 2012

Post – 2

It was 25^th of August 2012.Another interesting day to get a new experience. On the day we were gathered for a field visit with Public Health Midwife. Selected area was the region of respective midwife who went with us. The scope of that visit was to inspect and learn about procedures for ante natal & post natal mothers.

                Initially we went to the PHM's office prior to the visit. At there, she was arranged her essential equipments such as tape, scissor, sterile cotton swabs, Thermos meter, stethoscope before going out. 

Also she taught us the way of arranging a PHM’s office. Following registers should maintain by a PHM.

1. Daily work register
2. Pregnant mother’s register
3. Monthly record of expected date of delivery
4. Birth & immunization register
5. Family planning monthly return
6. PHM – monthly return

Except above mentioned documents, family planning field reports, growth monitoring register and several registers should be there. Then she briefed us about all those documents.

Especially, there were 3 boxes on PHM’s table.

1. 
   Delivery set
2. Urine check kit
3. Postnatal box 
   
   

After all these we came out to start the visit. Initially we were supposed to visit a post natal mother. That was the PHM’s 2^nd day of first 10 days visit. PHM should complete at least 4 postnatal visits as mentioned below:

1.   From birth to 10 days  - 2 visits
2.   11 days to 28 days       - 1 visit
3.   29 days to 42 days       - 1 visit 
   
   
   
   

Then midwife introduced the mother and her history briefly. After that she examined the baby & cleaned the umbilicus. She also explicated the attachments, positioning and points to be remember while breast feeding with a demonstration of that mother.

   The PHM taught us the things we should examine considering to the baby according to the B part of CHDR.Then she started examining the mother. Following main examines she conducted before briefing to the mother regarding family planning and how to select the best method.

1.  General examination
2.  Breast examination
3.  Abdominal examination
4.  Vaginal examination

With that we came to the end of another wonderful journey with lots of knowledge.

  

S.Niroshan
22.08.2012
Post no 2

‘I am not a teacher, but an awakener’

A wonderful quote came from one of a famous American poet Robert frost’s mind…  of course it’s giving little bit energy when hearing the word awakener.. Especially to societies which desperately need that...it’s my fortunate I got a great chance to do that…!!

It was our second week of the awesome appointment… provides different and new experience in our medical career…among those experiences; this is a special one.’ Awakening’..!! Yes, officially known as health educational program.

We were ready to conduct a health educational program to ‘Shilpa children development centre’ situated in narahenpitiya...Prior to go there we all divided into small groups and prepared ourselves with different topics to deliver them.so, in our group four of us supposed to talk about ‘first aid management’ to a group of girls with the age group 16 & 17..

So, as for our task we prepared with our topic with collecting newly updated information from internet regarding basic first aid management in a situation such…cuts and wounds,burn,choking,subluxuation of teeth,faint,snakebite,animal bite(dog & cat) and fever..

So, once we reach there...They warmly welcome us and also they were ready to obtain what we are going to deliver... then we start with introducing ourselves... Asked information about what they already knew about first aid...Their experiences whenever they faced a situation above mentioned...Then we deliver the correct methods, precations...ect with live demonstration...Include jokes, laughs... Questions, doubts clarification..went as an interacting manner such an interesting way we tried to awake them adequately regard the first aid managements what we concerned..

Simply at the end of our task within the time given, we were so happy when we saw their bright eyes with some kind of a happy they show that they enjoy the time with us and got something valuable from us…its more than enough for us make our mind so happy other than the word they said “thank you so much…”

ANOTHER WONDERFUL EXPERIENCE.....

G.L. Sudheera Nayanamali

Post 3

Date of visit: 27/08/2012

Water treatment plant & sewage system-Raddolugama.

At the beginning of our 3^rd week, we went to see water treatment plant, Raddolugama. It took more than one hour to reach & we enjoyed very much while going there.

Raddolugama water treatment plant commenced in 1987 to supply drinking water to the housing scheme of more than 2000 houses. At present, it supplies 4500m³ of water to 2481 houses of  the scheme, Wijaya kumarathunga memorial hospital, police station, army base Seeduwa and Biyagama indrustrial zone.

Plant now contains 2 treatment plants .The second one opened in 2008.

Treatment process

        1.pump from the river

The water resource for plant is Dandugan oya, a branch of Attanagalu oya. Water is pumped to 2 large wells near to river, and from there it pumps to the plant along 8kms.

        2. Aeration

Water is whirled in the air to mixed with O₂. Then water is oxidized and other harmful particles are broken down. During aeration Al₂(SO₄)₃ and Ca(OH )2 is added. Positively charged ions combine with mud particles and form mud floccules

          3.Sedimentation

During this process mud and other particles are separated from water.

          4.Filtering

Mud free water then comes to filter tanks. Small particles and parasites are retained in the filters. Clear water is then released in to storing tanks.

          5.Storage

Filtered water is stored in two large tanks .The tanks are covered by granite chips to avoid get heated from direct sun light.

          6.Chlorination

Chlorine gas is bubbled  through the water in storage tanks until the concentration reaches 1mg/L.

          7.Distribution

Pumps to regional tanks and then to houses.

Water is checked one in two weeks in regional lab.

Though it seems to be easy as above, producing drinking water is a complex project. If one mistake occurs, it can cause a mass disaster. And also we should protect drinking water.

 Otherwise all have to suffer a lot.

 

tudent /Date of Visit/post number (1/2/3/4 etc)

Blogger: Clerkship19th Batch group A & B - Edit post

Blogger: Clerkship19th Batch group A & B

Tharaka Jayasinghe
28/08/2012
Post no-02

THEIR EFFORT ON  MAKING COUNTRY  FREE  Of DISEASES

It was a 2^nd day of 2^nd week of our community medicine appointment..We had to visit  disease control unit of public health complex at Narahenpita..It is a eight story buildng which is finely allocated  for different health campaigns.

        They welcame us warmly & asked us to go to the 3^rd floor  where the anti malarial campaign is…Deputy director who is very cooperative person explained us about  status of malaria from 1911…According to him anti malarial campaign established at 2009..Up to now they have done lot of things to achieve their objectives,eliminationof Plasmodium falciparum at the end of 2012 and p.vivax at the end of 2014..From their  strategies of  anti malarial campaign  vector control methods play an integrated role..Entamology unit people  who are working with mosquitoes are doing great service by setting  window traps in homes,out door & indoor collections of mosquitoes at night in dry zone regarding to there field level investigations….According to deputy director, they have done all these things with limited resources,,up to 2014 they have global fund.But   beyond that anti malarial campaign’s fate is not written  yet…

       Then we visited to the national cancer control programme  at ground floor.Director ,friendly lady  explained us about their set up in Sri lanka ,According to latest reports men highly exposed to oral & lung cancers ,women to breast & cervical cancers.They stressed that 1/3 of cancers occur due to life style modification.1/3 can primarily prevented by early detection.To gain that they have introduced breast cancer detection programme,Pap smear screening programme for cervical cancers,also oral cancer screening risk factor model.I felt proud about them because their effort on  reducing incidence,morbidity & mortality of cancers is highly appreciated.

       Then we went to the 4^th floor auditorium.There is national programme for TB control and chest diseases(NPTCCD).But 1^st lecture was about dengue by the national dengue control programme.According to that doctor at 2009 case fatality rate was (CSF) 1.At 2012 it has reduced to half by their proper disease surveillance ,vector surveillance ,case management and community participation by publishing dengue control weeks and months.Nowadays due to the epidemic of dengue there programmes are widely distributed in urbanized areas.

              Finally  we got  to know what are the functions of NPTCCD.It provides curative ,diagnostic and preventive service to the community.They have introduced DOTS strategy all over the country...They works toto achieve their vision”Making Sri Lanka free from tuberculosis..

                    We were unable to visit anti –rabis and anti-filarisis campaign due to lack of time…How ever end of the day my head was full of facts. As Sri lankans we must appreciated their effot on making Sri lanka free of diseases..... 

     

Dharani Wijayawardhane
22.08.2012
Post 2

                         On 22nd of August,it was sheduled in the time table to hold a health education programme.We were supposed to visit an orphanage which was situated in Delkanda.From the time we got to know about this we were wondering how it would be.

                         We devided ourselves into 4 groups and got prepared to educate the children on 4 different topics.We decided to talk to them on reproductive health as the children's age group which was allocated to us were between 16-18 and all were girls.

                         WE discussed what we are going to do and prepared a leaflet to handover to them at the programme.It was a new and a different experience right from the begining.We had to wear sarees and we were there by 8am.

                         There were about 80 children in the orphanage and between 16-18 there were about 10 girls.We introduced ourselves and described what we are going to do.And also at the begining we gave each of them a piece of paper and a pen asking them to write any question.

                         First we gave a very brief description about the structure of the female reproductive system and what happens in the menstrual cycle.We gave priority to talk about personal hygiene during menstrual period and myths and truths related to that.We had to be cautious when talking to them as they are living in a different place unlike most of other chidren.So before starting to talk to them we got to know about the supplements(sanitary pads/towels) they are given.We emphasized about the importance of bathing and cleaning the perineal area during periods and about the risk of infections due to poor higiene.

                       We explained about taking good nutrition during the menstruation though there are myths saying it's not good to eat certain foods like eggs,meat.Then we collected the  pieces of paper in which they have written their questions.Most of them have asked about the menstrual cycle;irregularity of the periods,variation of the duration,truth regarding myths.For some questions we answered but for some questions we got help from our lecturers as they were very sensitive issues.

                       Then we described about the sexually transmitted diseases andhow they are transmitted.Finally we educated them about abuse,how to be safe and what to do if anyone has to experience such incident.

                       It really was an amazing experience which I have had in my life.

 CIFINS thinks They Should Not Suffer..

To hear about a visit to a place near Gangarama Lake was all enough to look foward to something good. Time table said 'Colombo Friend in Need', that made me guess its a counseling institute.

Somehow in spite of a heavy rain that morning (resulting unavoidable late waking up), we reached the place without delay.

The different kinds of artificial limbs hanging on the board itself said their story. Built up many years ago, Colombo Friend in Need has been serving the needy for over 175 years, being the oldest Charitable Organisation in Sri Lanka.

http://www.cfins.org/

Run with donations, this place produce tailor made  artificial limbs using plastic, metal, rubber all of which are materials from Sri Lanka. The hostel provides accommodation to people coming from far-away areas.

We were demonstrated about the different types of prostheses and some of which allow bending at the levels of joints. It was said depending on the user, the artifial limb can be equally effective as the normal limb if propeer training is there, which im sure you too think is an exaggeration only. But it was quite unbelievable to see the two young efficient employees in the work place were actually on prosthetic limbs.

Seeing this sure builds up courage and trust in the people who come to get their prosthesis made at CIFINS. 

It is incomplete if I don't mention this beautiful saying, said by a man in his later years of age, working in the city of colombo for 30 years, has not gone behind heaps of commercialized dreams, strong in mind confidently briefing to a group of 19 youths about himself,

'every night I go to bed, I think to myself, I'm happy, I did something worthy. The man barely walked in with aid is leaving the doors on his own, I'm the reason behind it..'

We all were inspired.

Thank you for your time for reading my blog :)

Name of student: Sachintha Satharasinghe

Date of Visit:        24.8.2012

Post number:       2

FOOD INSPECTION

23 of August we went to MOH office & at there we had lecture on Food Inspection.

PHI discussed about food act of 1980 &  he pointed out that importance of presenting such food act in sri lanka as a 3rd world country.

At the same time we could understand about that how this act contribute to ensure the supply of cost effective, healthy & disease free food to us.

The Food Act is the Gold standard on food safety & hygiene in country & it consist of four parts.

·         Prohibited food

·         Administration

·         Legal aspect

·         General aspect

In addition there are several Gazettes on varies aspects of food like food preservatives, additives etc

PHI discussed about importance of each section to ensure the safety & hygiene of food in

·         Production

·         Import

·         Selling

·         Distribution

At the regional level the MOH & PHI are the people who look in to matter regarding food safety & hygiene.

The PHI has power to

Inspect of food related institutions, transporting food & taking samples

Even seal the place.   

  Then we went to a field visit in Boralasgamuwa. At there PHI explained us what are the main steps of investigation

They consider about

·         Location& environment

·         Building

·         Place of food preparation

 

·         Equipments

·         Storage of food

 

·         Water supply

 

·         Waste management

·         Health condition of people who handling food

According to that PHI gives marks & grade them as

A-Excellent

B-good

C-poor

D-very unsatisfactory

thusitha saman
fms/r/2931