UP-CHDP in San Juan,Batangas

UP-CHDP in San Juan,Batangas

• Vision

The UP-CHDP , a partnership among the university, the government, and the community, dedicated towards establishing Filipino communities founded on the freedom, justice, and love of country that will nurture their resources toward total human development

• Mission

To develop a relevant and functional CHDP that will create social awareness among the people and provide an environment for sustainable development utilizing the Primary Health Care approach.

The 5-Year Plan Problem Tree

The 5-Year Plan Objectives Tree

Our rotation has focused on improving the attitude of our BHWs, as to building their confidence and competence towards managing patients with diarrhea by holding a diarrhea review and one-on-one preceptorials.

Medicines available in the clinic are paracetamol, amoxicillin, cephalexin, cloxacillin, and multivitamins. These are the medications commonly used and prescribed to the patients.

A Feeding program organized by the provincial office was formed, aiming to feed malnourished children for 6 months. This is held every Thursdays of the week. This would help in proper diet and food intake of malnourished patients in the community.

We started a research on traditional healers since the community has a strong belief in them. Interviews were done on several healers aiming to determine their beliefs and practices, if there are harmful or none. The referral system was also asked if there is so as to be able to check if there is a referral lag happening on difficult patients causing mobidity or mortality. The possibility to utilize them in primary health care was also taken into account.

CLUSTER 12

• Cluster 12 is composed of Barangays Laiya Aplaya and Hugom
• The cluster has 2 Health Centers

RHU 2 / Satellite – located in Laiya Aplaya

HugomHealthCenter

• 2 Midwives

Ate Ellen Buella (Laiya Aplaya)

Ate Grace Alvez (Hugom)

• Total of 24 BHWs

LaiyaHealthCenter

Laiya Aplaya health center is headed by their midwife, Ate Ellen Abella, together with 14 BHWs. Ate Ellen is very kind, competent and has good leadership skills. Whenever she has to make a decision, she first asks her colleagues opinions and arrive at a concensus. She is well loved by the BHWs.

The Satellite clinic is under renovation since a second floor is being built as to accommodate more patients. We temporarily hold clinics in the Barangay hall located in the Site. This is more convenient for us students since the place is just walking distance from our foster home. It is also more convenient to the patients since most of our patients come from the Site. The barangay hall has provided us one treatment room where we hold our interviews with the patients and do surgical procedures. The treatment room has an examination table and treatment table. There is also a medicine room where the midwife usually stays so as to assure proper disposal of medications including the advise on how to take the drugs and good record-keeping. The clinic has good record-keeping since files per family are organized per envelope. A case number is assigned per family and are all listed in a logbook.

A long table is located just near the entrance. This is where the BHWs stay, where they take vital signs, interview and examine the patients. The BHWs are all approachable and willing to learn. The have a good relationship with each other. If they are in doubt on a case, they ask for each other’s help.

A kitchen and dining table is also located in the barangay hall where we all have lunch together. All the BHWs help in the preparation for lunch, as well as, in tyding up the table. Cleanliness in the clinic is maintained by the BHWs. Every morning before starting the clinics, the chairs are arranged and the floor is swept.

The clinic has a lot of instruments. They have complete instruments for vital signs taking: BP apparatus, stethoscope, thermometer. The clinic has a weighing scale, height scale, tape measure, surgical set, syringes, IV cannula, lidocaine, blades, sutures, glucometer, Doppler ultrasound, diagnostic set. Sterility of the surgical set is maintained by using Cidex. Every minor surgery, ate Ellen prepares all the needs as well as sterilizing the equipments. There are abundant gloves, cotton, betadine, alcohol, agua oxygenada. However, the clinic lacks gauze that is needed in packing and covering wounds. Overall, the clinic is complete as a primary health care facility.

HugomHealthCenter

The Hugom health center is lead by Grace Alvez together with 11 BHWs. Ate Grace is a happy and approachable person. She is very responsible taking into consideration that she holds two other barangays of different cluster. The clinic is smaller than the barangay hall in Aplaya but is still able to accommodate the patients. The clinic however is already termite-infested including the tables and chairs. Record keeping is organized however the termites also infested some of the envelopes. The BHWs were able to rearrange and fix such records.

Though the clinic in Hugom is not as appreciable as in Aplaya, the BHWs are as responsible and eager to learn. Every morning before starting the clinic, the BHWs arrange the chairs and sweep the floor. The medicines are not as abundant as in Aplaya but the most needed drugs are available like paracetamol, amoxicillin, cephalexin and multivitamins. Minor surgery however cannot be done in hugom due to lack of instruments.

TIMELINE OF ACTIVITIES

ACCOMPLISHMENT REPORT

Objective No. 1

COMMUNITY INTEGRATION

Objectives / Activities / Human Resources / Material Resources / Time Frame / Method of Evaluation
At the end of 6 weeks, interns should be able to be acquainted with the municipal officials, barangay officials, midwives, BHWs and other people of the community and immerse in their daily living / Courtesy calls to RHU 1, staff house, health centers and different houses under Cluster 12
Bonding activities with foster parent / Interns
Midwives
Barangay Health Workers
Barangay councillors
Barangay Captain
RHU staff
UP staff
Residents
Foster family
Laiya Aplaya and Hugom residents / Paper
Pens
Digital camera
Means of transportation ( Van/ Tricycle/ jeepney )
Foster home / 6 weeks / Interns’ grading sheets by the foster parent and BHW
Interns’ work checklist

KEY LEADERS

We were able to meet the key leaders in the barangay. We met the barangay captain in Hugom and Laiya Aplaya. We also had the privilege to meet the different councilors in Aplaya. We also introduced ourselves to the midwives in Hugom and Aplaya and able to bond with them in one way or another.

FOSTER FAMILY

Our foster family is the Abanilla family, cmposed of Ate Edith, her brothe Kuya Chito and her niece Kim.

Ate Edith

40/F, single, self-employed

She is the one who always accompanies us in our trips, may it be site survey or home visits. She is a very approachable and thoughtful person. She busies herself managing their resort, Island Sky and taking care of her niece Kim.

Kuya Chito

38/M, married, barista

Kuya Chito is Kim’s father. His wife is abroad. Parenting to Kim is with the help of Ate Edith. Kuya Chito is a responsible father and loving brother.

Kim

13/F, single, 2nd year HS student

Kim is the only child of Kuya Chito and Ate Vangie who is in Dubai. Kim was brought up by Ate Edith. She is a shy but kind girl.

The family was very accommodating in our stay. They seemed excited on our first week since it is their second time to accommodate medical intern. They were easy to get along with.

Bonding with the family also means bonding with the extended family. We were able to meet almost all of the siblings of Ate Edith and their own families since most of them live in the Aplaya area. The Abanilla family is closely knit. Every siesta time, they gather in their eldest sibling’s house and eat merienda together and watch TV.

OUR HOME

We live in Island Sky resort, managed by Ate Edith, co-owned with her youngest brother. The resort is just adjacent to Ate Edith’s house. It is well-maintained and is clean. There is a kubo outside the house where we hold house calls and long chats with the family and some persons in the community.

THE PLACE

Ate Ediths house is located in Balacbaca, Laiya Aplaya. The place is just 20 steps from the beach. It is a place adjacent to many known resorts such as Aquatico, La Luz, Blue Coral, Sabangan, Kabayan, etc.Marine life is very abundant in the area.

THE COMMUNITY

Balacbacan is a place where people is with blood-relation to the Abanilla family in some way or another. The source of livelihood is fishing and managing a resort. The community mostly have good health-seeking behavior considering the number of house calls we hold. The community also has a strong belief in traditional healers.

Insights

• Unity in the family

We are amazed of how united is the Abanilla family. Whenever one has a problem, they gather and talk and help each other.

• Camaraderie in the community

Exchange of Food – Whenever a group had a lot of catch of fishes, they share them to others. Some exchage the fishes for vegetables or other crops they have.

Support for Health – Whenever one becomes sick, a neighbor would advise him to seek consult to the health center or to a medico. Support for health is appreciated even up to the point that one may lend his car for free to a neighbor who needs to go to a hospital.

• Simplicity of life

Life in Aplaya is simple. If you are hungry, you can fish or get shells in the shore and cook them. Vegetable and fish vendors just pass by the road.

Recommendations

• Bonding with the family also means bonding with the extended family
• Spend more time with the community

Objective No. 4

DIARRHEA MODULE REVIEW

Objectives / Activities / Human
Resources / Material Resources / Time
Frame / Method of
Evaluation
By the end of 6 weeks, the medical interns should be able to re-evaluate BHWs in the assessment and management of diarrhea among children 2 months to 5 years old using IMCI / Clinics
Diarrhea refresher lecture
SGD
One-on-one preceptorials / Interns
BHWs
Midwives / Laptops
Cartolina
Manila paper
Pentel pen
Scotch tape
Test questionnaires
Pens
paper / 6 weeks / IMCI form
Paticipation in SGD

The review was conducted to be able to refresh the BHWs on the latest module discussed to them before proceeding to the fever module to be discussed by the next group. The review date was done in a not advisable day since the BHWs are busy in o the census tasked by the municipality and other tasks. Only five out of the fourteen BHWs in Aplaya attended the review.

A diarrhea case was presented to the BHWs by the interns. A discussion was held using Q&A portions and role-playing. Overall, the BHWs who attended performed well. They were able toa nswer our questions adequately.

According to the BHWs:

• They related that Diarrhea module is easier than the previous modules.
• Parents would tend to ask for the treatment without explaining the condition of the patient.
• They have difficulty in correcting the beliefs and practices of some parents.

Parents usually perceive that diarrhea cases always need antibiotics.

Parents useGatorade as an alternative for oresol.

Some mothers do not breastfeed to their babies who have diarrhea.

We were able to ask the BHWs on how they answer and correct the misconceptions of parents. They generally are able to explain well.