Frances Nelson Clinic

Observations:

In the first room we saw, there was an exam table with a pull-out leg rest, and plenty of space to do small, yet invasive exams. There was a computer, full size fridge, and plenty of storage space. The clinic also has a counseling room for mental health resources, and a full dental suite with the latest technologies. There is also lab support where blood can be drawn, and computers to keep track of blood supplies. Lastly, they have a room for eye exams.

Needs:

• Better hours – I originally had a hard time thinking of a need since this clinic appeared to have everything. I decided to look up their hours, and noticed they close at 5:30 every day except Monday, and are closed on weekends. This makes it very hard for working individuals to have time to go without taking off work. Perhaps they can open a lower-resource wing to help provide primary care during extended hours.
• Higher density – It doesn’t seem like they can help a lot of people at once since everything is so private and large
• Blood testing facility or technologies- blood samples need to be sent off and can’t be tested on site. On site testing would be much faster and potentially cheaper in the long run.
• Sense of community – this clinic lacks the sense of community the African clinics have. Although this Is not a medical need, it could improve moral in patients and employees alike.
• Education—although this clinic seems to have everything from a medical standpoint, it didn’t seem to put an emphasis on educating patients about nutrition, self-exams, etc., like the Sierra Leone clinic does.
• Dietician – to help obesity issues in the US.

Carle Clinic

Observations:

Carle Clinic has a NICU with a variety of technologies to help newborns survive, such as intubation, bilirubin lights, and even iPads for the babies to watch shows on. Carle also has state of the art ambulances with immediate access to intravenous fluids, as well as tools for a patient in cardiac arrest.

Needs:

• More affordable healthcare – while the technologies shown were great and lifesaving, they seemed very expensive.
• Larger pool of qualified employees.
• Inventory systems to keep track of all the supplies in the ambulances, NICU and other facilities within Carle.
• Emotional support and/or conseling for parents with chicken in the NICU (if not already provided). 

Sierra Leone Clinic

Observations:

This clinic is a pregnant mothers and small child clinic. It has an indoor and outdoor space, and opens at 10am. Before the clinic opens, all the women are singing together which shows a great sense of community. The women are taught about nutrition and self-exams. The clinic does not have a lot of medical devices. Women are measured and given rapid HIV tests. All health history is on paper. For the babies, weights are taken on a simple balance for both large and small babies. Sanitation was also minimal (gloves, antibacterial wipes), but sterile conditions might not necessarily be a top priority for the type of care they are providing (vs. surgery).

Needs:

• Ultrasound/blood test - women were measured and given estimates of how far along they are instead of more accurate procedures
• Genetic tests for pregnant women – I know these are usually done in the US to pre-determine any genetic diseases or development disorders the baby might have.
• Nutrition packets or vitamins for the pregnant women
• Any NICU technologies that Carle had would be great, but would also need infrastructure such as electricity and oxygen lines.
• Electricity infrastructure to support new devices
• Digital scale for more accurate weight measurements.
• more employees so more than one patient can be seen at a time

 

Nyakibale Hospital Emergency Department

Observations:

While watching the video, I noticed the room has six beds in it, unlike in the Frances Nelson clinic where there was one exam table with full privacy. I also learned that this emergency room was made possible by grants and donations, and it appeared that the main doctors were from the United States. They had a book on a table with patient information, and charts to keep track of patients. They had a new x-ray box and lights, as well as a designated orthopedic area. Supplies were stored in multiple areas, all of which looked very crowded and somewhat messy.

Needs:

• Improved privacy – the emergency room has small curtains to separate patients, but I think a better technology that is more soundproof or sturdy can help patients feel more comfortable. This is not a life or death need, but I think it is still somewhat important in the healing process.
• Income source – a way to fund the emergency room that is more sustainable and does not rely on donations indefinitely.
• Training- they had a manual to train nurses and doctors so that the clinic can continue to run when the American doctors leave. I think there might be more effective ways for training which can be very beneficial.
• Storage space – the cabinet they had looked very crowded. They need more efficient storage, especially as they continue to get more supplies and technologies. Technology to store information, such as patient info and the textbooks they have can also be helpful.
• Medical technologies – obviously, they did not have as many devices as an emergency room in the US. I am not sure what kind of injuries they often encounter, and what exactly they have, but there is also likely a need for more devices such as ones to transfuse blood, surgical tools, etc.
• NICU – unlike Carle, there did not seem to be an area or technologies that seemed baby-friendly.