Wednesday, June 3, 2015

Challenges of Community Nurse Susan Makanga in Rawalo Village, Siaya County Kenya.

Challenges of Community Nurse Susan Makanga in Rawalo Village, Siaya County Kenya.   

Susan Makanga.
P. O. Box 517 Yala, Kenya
Tel: +254 729541177, +254 711161950

Profile Introduction
My names are Susan Makanga-Abwao. Am 38 years old, and married with three children. I was born in Butere-Mumias County, but now live in Gem Constituency where my husband comes from. Since 2012 I have lived back in the village among the community people of Rawalo in Gem Constituency of Siaya County.
Currently I work as a Community Nurse under Millennium Village People (MVP) NGO, where I cover an area of about 10km squared. I have worked as a Nurse in this area since 2013. 

Since Childhood I have always been interested in nursing other people to a point in my family they nicknamed me “Doctor.” Unfortunately, I never got the opportunity to pursue my passion due to lack of money and an early marriage. In 2013 I was selected by our Village Women group to apply to MVP to be considered for training as a Community Nurse. That selection came as a big blessing to me, because after passing their exam, I got the opportunity to be what I have always dreamt. I got the necessary training and I have worked to better the health of the people in this Community. Although the income I get from this work is very little, it helps me put food on the table for my children. In order for me to meet other needs for my family I am forced to supplement this income with other activities to be able to fully cater for my children’s needs, like school fees for one in secondary school, one in primary school and one still breastfeeding. It would not be possible to meet their needs through the income I generate as a Community Nurse.

Community’s Business engagements.
I cover about 200 homesteads with a total population of about 1200 people. These people have diverse business engagements, from small scale commercial farming, subsistence farming, teachers, small scale traders, carpenters, electricians, transporters and fishermen. A small percentage of this group is still school going. While the other percentage are young men and women; meaning that the population will grow due to customary early marriages in the Village. In addition to this there are many retirees who continue to come back to the village.
Although farming has been the backbone of these people’s economy, many of the young people are pulling away from this to start their own small scale businesses. This has caused a positive Social impact in the community as a number of families now have financial capabilities to afford daily needs. 

Community Nurse.
As a Community Nurse, my work involves working with people of the community to promote their health help them to prevent, to cure and to manage diseases, as well as provide home based Nursing and rehabilitative care.

Challenges Faced:
I face several challenges in my area of work. Since the area is still underdeveloped compared to some other regions, almost every aspect of the job is a challenge. However, there are  three major points that if I  had means I would address at once.

1.        Transport:
The area that I cover is full of Hills with no proper paved roads or paths where motorized transport or bicycles can be used. The only alternative left for me to access these homesteads of my patients is on foot. This severely restricts my work and slows me down a great deal. Many a times am unable to reach some patients who may be in need of medical attention on a particular day. If this issue of Transport can be addressed, then, I will be able to reach many of my patients on time and at the hour of their need.

Secondly, I have experienced many challenges when very sick patients come to my home, in the middle of the night seeking medical attention, which I could not address at home. These people required to be admitted at the hospital. Such cases have been very challenging to me. For example, about a month ago a pregnant mother came to my home at 2:30am when in labor. She wanted me to help her deliver the baby, but because my house is not equipped for such an exercise, it forced me to call for her a Boda Boda. By the time the Boda Boda came and took her to the nearest Hospital, she nearly gave birth on the way. By the time she reached Hospital her water had broken and the Baby was in the process of coming out. By this time I had also called another Boda Boda which took me to the Hospital. On reaching hospital at 4:00am, I found out that the Midwife was also not on duty, and so I had no alternative but to work with the watchman on duty to deliver the mother. I was very worried about the baby, but we did everything right and both the Baby and the Mother are healthy. I had to wait at the hospital till 8:00 am when the Hospital opened for the Mother to be assigned a bed. If I had transport then the outcome could have probably been different.

2.            Pharmacy
The other big challenge I face is lack of a Pharmacy. There is no Chemist in the entire area that I cover. In many instances I can do my tests and diagnose the problem. Thereafter I refer the patients to go get medicine at the Chemist. Unfortunately the medicines are at times unaffordable for them, or the chemist is too far for them to reach in their state. If I have to effectively meet the health needs of these people I will need to set up a Chemist for them somewhere which is near for them.

3.            Rehabilitative Care.
In this area, I do a follow up on HIV patients, TB patients, HP patients as well as other cases that are critical. In many instances I find out that the patients have run out of their medicine and are not in a position to make the long trek to the Chemist. These kinds of situations can easily be addressed if I had medicine with me or if a pharmacy was available within the area or  within the sub-location. Unfortunately, all I can do is to ask them to go for refill, even if they are not in a position to make the long trek.

This experience of follow-ups takes us back to “Transportation” and accessible Pharmacy. By addressing transportation in the form of roads, paths, and a accessible Pharmacy, then it can be easy to arrest many of these challenges.

4.            Communication.
The last challenge I have is to access internet either through a reliable phone or Computer. I have been using a phone which is unreliable. Many a times I cannot access internet as such am unable to submit my reports on time to the main office. Getting a good reliable Phone which can handle the kind of traffic for my work can help a lot. Alternatively I need a laptop or a Computer or all to enable me do my work effectively in providing healthcare services to the community.

Written by Susan Makanga-Abwao

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