I returned to Villa Mutirao PSF this morning to observe a little bit more. I spent a couple of hours in the Sala de Vacina, the Vaccination room, and then I sat in on a meeting of Equipe 49. The Sala de Vacina was, though a little sad to see all the crying babies, very interesting. The nurse that was working there was very kind and she explained for me all of the shots she was giving. I helped with the paper work part of the job, documenting all of the shots she gave. It was a little shocking to find out that the PSF did not have the vaccine for DTP, that all of the babies needed. They have not had it for a few months and were not sure if they would have it available by next month. Many of the parents were not too happy about this. When I asked why there was a shortage of DTP, the nurse said that she was not sure, but that she knew that the shortage was not just in the Villa Mutirao PSF, but in the whole region.
The meeting of Equipe 49 was also very interesting. The group was discussing their week and talking specifically about a few patients they have who have problems with drugs and the strategies they will be implementing this week to reach out to them. The whole team was involved, from their doctor, nurses, and social workers, all the way to their receptionist and their dentist! It was really nice to see a team that was functioning so well. There was conversation, exchange of information, and several different strategies proposed to attend the patients, both inside the PSF and when they do home visits. In some situations, it seemed nearly impossible for the team to be able to do anything and this frustration was visible in their faces, but nonetheless, the group persevered and ultimately designed a plan of attack. I am working with them again on Monday and I cannot wait to get started again! One question that has since crossed my mind though is the process of triage that the group uses to decide what patients need to be addressed and in what order. Also, I do not understand how the team can force people to be patients if they do not choose to seek help. I suppose it has to do with the Brazilian government's free public health care plan for all citizens.
Today was also a learning experience for me because I was able to see a Cais. A Cais is similar to a PSF, but it is a bigger type of clinic that is not so community centered and it also has an emergency clinic. If a person has an emergency and has public health care, then they are taken first to a Cais in order to be seen and then sent to a hospital with space for them if necessary. If there are no PSFs in the area, the Cais works in its place. Another difference though between a Cais and a PSF is that there are centers for the combat and control of certain diseases there too, such as TB, Dengue, and Leprosy. One problem that Cais's can have is that with the crowding in hospitals, the emergency centers, which are not designed for keeping patients for longer than twenty-four hours, often become filled with patients waiting for openings in the hospitals, sometimes for as long as months. There is also the ever-present problem here of the shortage of doctors. The Cais that I visited has two days a week that there are not a sufficient number of doctors present: Monday and Friday. It was great to learn about the Cais, even though I will not get to work in one, because it filled in some of the gaps for me in the story of health care here that I have learning piece by piece.
Jesus de Nazareth tonight was a little more involved than the previous nights because today one of the speakers was ME! The sisters asked me to share about my experience here and to talk about communication and its challenges here with the language barrier. I had to speak in Portuguese for the whole thing! This was the first of the many benefits of being a part of Model United Nations at Alma College... I was not even nervous to speak :)
 |
| These were the other speakers of the night, Sister Joana's biological sister, Vera, and her husband, Julio. |
