Sunday, 4 March 2018

FoCH team project monitoring and evaluation visit to Chitambo District

Visits to Rural Health Clinics:
FoCH team h visited 10 out of 11 rural health clinics on behalf of our Small Grant project on emergency care communications. We met key staff ...all young, eager, and dynamic despite working in some very challenging circumstances  and interviewed 17 staff about Knowledge into Action aspects (use of books and digital information provided by the project, as well as sharing of health information between colleagues and accessing our expert medical librarian services for additional support).


There was evidence, at all clinics,  of the emergency care guidelines designed by FoCH member Dr Bridget Innes, in collaboration with Dr Mwamba and colleagues at Chitambo Hospital. Thanks to Mr Mununga, Clinical Officer, and Mr. Zombe, Registered Nurse (Emergency Response) these are being posted up in all 11 rural health clinics as well as at Chitambo Hospital.

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Emergency care guidelines posted on clinic walls
There was also much evidence of uptake and usage of the books and digital resources provided by our project, thanks largely to the efforts of Matron Milimo in keeping track of these, and to Emma Theo, Medical Librarian, University of Zambia (UNZA) in providing Knowledge Broker support.
All staff interviewed reported being very interested in keeping up to date through use of books and digital (computer) resources. The recent influx of new, young dynamic staff is contributing to this.

Books in evidence at teh clinics

We also interviewed them about emergency radio services, particularly the functioning of the 4 Very High Frequency (VHF) radios provide by the project and noted any gaps in effectiveness of radio messaging.
We also checked on solar power needs to augment Consider Mudenda's existing report on this through direct sight of needs on the ground.
Everywhere we were astonished by the capability of the health teams and their well organised systems...lacking only in terms of resources.

Challenges of health delivery in Chitambo district:
During our visit to the remotest Gibson Rural Health Clinic, a sick child was admitted suffering from malaria, severe anaemia, and asthma. The clinic did not have any oxygen on site. However an intravenous drip is established with Aminophylline added. Even with the new VHF radio provided by our project, the health team was unable to reach the nearest neighbouring clinic, Mpelembe, to refer the child to hospital.
We were going to Mpelembe next, ourselves, but ruled out taking the child for safety reasons. When we got there we informed the staff to call Gibson. However, the ambulance was already out on another case. These are the challenges faced by rural health staff, in managing emergency cases. However we heard the next day that the child did eventually reach hospital.

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Sick child

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Gibson to Mpelembe, Gibson to Mpelembe.  Do you read?  Over and out

Meetings with Chitambo Hospital Health Leads:
We interviewed a further 14 hospital staff on the same above issues (use of knowledge resources and radio functioning).

We also, on  20th February 2018, met with Chitambo Hospital Health Leads  regarding their perceived support needs and where Friends of Chitambo could contribute in future.  This was  avery positive and insightful meeting, forming a base for strategic planning for future engagement.   A Strategic Planning WhatsApp group was formed to strengthen the friendship  ties between Zambia and Scotland.

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Friends of Chitambo meet with Chitambo Health Leads

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Group photo

Travelling challenges: Rough roads and rainy season! Rain brings out snakes. We saw 3 snakes on the road in one day. Clinic staff said they were getting lots of cases of snake bite but invariably snake bite serum had run out.

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Small blue snake on the road

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Nail in the tyer, time for a change

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Mr. Boniface Kapilia, Head Driver, to the rescue...Natotela sana mukwai (thank you!)

Torrential rain 

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