Community Health at Schweitzer

This Thursday I went out with the community health nurses to do a PMI visit there. It was pretty fascinating. Allow me to explain. PMI stands for Protection Maternale et Infantile. It is the community health arm of the hospital and has been run for almost 30 years by a nurse named Maman Sophie who is famous throughout the region for her efforts. The nurses have a clinic here on the hospital campus where they do immunizations and weigh children. Vaccination is free up until 1 year of age, provided by the Gabonese government. They actually just got the Penta vaccines here (DPT, Hepatitis B, and HiB make it up, I think). In any case, it's a great early childhood vaccine. They also still use BCG vaccine against TB. The Schweitzer PMI have achieved great vaccination coverage for this region, averaging around 85% of kids vaccinated. For Africa that is an impressive number.

As I was saying they vaccinate kids here at the hospital, but also on community visits every Wednesday and Thursday. They have 16 towns around Lambarene that they visit on a rotating basis. When they arrive, they weigh all the babies. This was quite the scene Thursday as there were about 50 moms and babies waiting for us. They all rushed forward to get a little harness for their kid, then they strip them nude, load them in the harness, and hang the kids up on hanging scales. For some reason all the babies hate this and so there was a crazy ruckus with all these naked kids screaming and hanging on scales.

Once they get weighed, the nurses go through the kids' health booklets to see what vaccines they need. Then they give them out. Another wild round of tears. While the three nurses were doing all the vaccines, Maman Sophie and I did “consulations” together. Basically this means doing a little clinic visit together. We are in the midst of an intense gastroenteritis (vomiting, diarrhea) epidemic, so that was the majority of cases. There was also an impressive case of a little one with months of scabies burrows that the mom had not taken care of. Those things can really get situated in your skin if you let them. After Maman Sophie and I saw the moms, I would take them over to this ancient chest of drawers that contained all the medicines and would try to get out all of the medicines that they needed. At the end, Maman Sophie gave a talk about safe sex, family planning, dehydration, and education. It was community public health at its best. I really enjoyed getting out a bit and seeing how things work outside of the hospital. Its neat to see how this system of vaccination and triage works in Gabon and to note its success.