Posted by: calloftheandes | October 26, 2012

Haiti Clinic Staff Learn Triage: Putting the Sickest Kids First in Line

Dr. Mark Nelson’s hope for a Haiti medical clinic is that all staff members will know what symptoms to spot among the patients waiting to see a doctor. It is called triage, a fancy French language term that basically comes to getting the sickest ones to the head of the line.

Those with expertise in diagnosis –that is to say, the doctors, are often “the last ones to see the patients,” Nelson explained, illustrating the need for training among all clinic staff.

“Those (non-medical workers) are the staff that we really wanted to help . . . to say, ‘Which is the kid with meningitis’ when there are 150 kids in line and the moms all say they have fever, they have a cough,” Nelson explained. He and his wife, Laurie, are medical missionaries with HCJB Global in Ecuador. The invitation to offer continuing education to physicians came from Samaritan’s Purse (SP) in Haiti while Nelson was treating cholera patients in Cité Soleil, near Port au Prince in 2011.

Mark Nelson (front of room) fielding questions and interacting with clinic staff at Cite Soliel

However, as Haiti’s cholera threat diminished and SP’s staff decreased, Nelson and a missionary friend, Dr. Murray Greenwood of SIM, needed to revamp their teaching curriculum to also include non-medical clinic staff.

“When we arrived we had to switch from teaching a large group of physicians (10 to 20) to teaching a medical staff at one clinic that included two physicians, two nurses, and a maybe another 10 ancillary staff who had no formal medical training,” Nelson recalled.

The clinic represents an evangelical church’s service and outreach to Cité Soleil, with an estimated population of 300,000 and sometimes described as the world’s largest slum. The Haitian staff’s care is a critical need in the greater Port au Prince area.

The missionary doctor duo,– along with Laurie, who is a pediatrician, have known each other for years and worked together in the same hospital complex in Dallas, TX. Nelson lauds Greenwood, an SIM missionary in Loja, Ecuador as not just a good doctor but a good teacher as well.

Dr. Murray Greenwood examines a Haitian toddler

“He really sees and understands the fine but very important points of doing a good physical exam and observing and seeing all the different things that we need to observe and see in children to diagnose correctly,” Nelson said of his colleague at the February-March 2012 training in Cité Soleil.

Greenwood concentrated on evaluating and managing fevers in newborns and young children, as well as explaining a host of other topics ranging from birth defects to how to tell a viral illness from bacterial pathology. Nelson covered initial management of poisons in children, evaluation and management of myelomeningocele (a type of spina bifida), diarrhea, asthma, the importance of physical exams of genital organs and tips on treating problems such as hernias and scrotal issues in newborns.
SP’s continuing education is ongoing and the Charlotte, N.C.-based ministry has partnered with HCJB Global on different occasions in the Western Hemisphere over the last several years.


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