Days 11-12: Busy Clinic

Monday was crazy. The main registration/ billing person was out sick so I had to learn pretty fast and assist the head nurse as we managed the influx of people. Not only did we have a lot of walk-ins, but 2 local schools decided to bus in their students for check-ups. The school pays for the students' consultation fee.

Here I am with Miriam (to my right) the head nurse who knows everything there is to know about the clinic and who paaatiently taught me reg. and billing procedures (as well as some Swahili) on Monday and Victoria, a physician here at the clinic, to my left.

Tuesday was a little lighter in terms of patient flow but I was still busy as I pushed to finish my patient records project. This is a shot of me and Mariam, the Queen of Registration and Billing (she does more work in a day than most of us in a week) after I FINALLY finished re-alphabetizing the old charts. The charts themselves are to our right in the boxes; what you see is about a third of them. The clinic opened in 2006 and so far there are 24,500+ patient records on file.

To our right at the top is a picture of current President Kikwete and to the left, the older gentleman, is Julius Nyerere - the first leader of Tanzania after the country gained independence. Many offices in TZ display both photos as Nyerere is on their currency as well. The interesting thing about him is that, as President, Nyerere was outspoken about trying to make sure his family did NOT follow him into politics and pretty much prevented his son from running for national office. This was in order to protect Tanzania from "big man" politics that has infected so many other newly independent African states.

Next I worked a little in the diagnostic lab (the clinic runs HIV, pregnancy, urinalysis, stool, and blood sugar tests, among others plus pelvic and abdominal ultrasound exams) and called it a day. Not many people seem to get HIV tests (a small handful a day, at most)... may have something to do with the fact that they have to announce they want the HIV test done and pay for it in front of all the other patients. The clinic is too small for private conversations with the patients and written forms are not the norm because of the high illiteracy rate among patients in low-cost healthcare settings. So, the norm is loud - and very public conversation.