Monday (October 12) was our first clinic day in Antsirirabe (not to be confused with Antsirabe, where the Lutheran Hospital is located). After a two-hour drive on OK roads, we went off-road for the last hilly and bumpy final 7 km that took us to a Lutheran Church where the local pastor said 800 people were waiting for us. A team had supplied a clinic here in September, so word must have gotten around. They were gracious and patient as we set up and began to see patients.
The basic flow: (1) sign in, with weight and age; (2) see a nurse for BP and triage (what’s your main concern today?); (3) see a doctor, or Joanna, the NP working here for the year; (4) pick up your prescription at the “pharmacy.” “Pharmacy” is a table with all of our meds spread out, waiting to be put into bags as prescribed. I think we had three triage stations, three providers, and seven of us working in the pharmacy. The other two pastors with us directed traffic from one station to another.
We saw 607 patients that day before we closed up shop at 4:30. I worked as a runner in the pharmacy, taking filled pill bags to Jeanelle, our pharmacist, for a final check, who handed them off to an interpreter to deliver to the patient. I helped restock all the stations where prescriptions were filled. We gave out antibiotics, antifungal cream, analgesics, and many, many, many vitamins.
I thought we were doing very well, until at the end of the day we still had a stack of unfilled prescriptions! Where did they come from? We would need a better system for the next few days. No worries – Jeanelle had a plan for tomorrow. Also, a team would come back next week to fulfill all those prescriptions.
The doctors and Joanna didn’t need interpreters, so we were able to see many patients in a short time. Plus, there weren’t too many severe cases. Mostly headaches, hypertension, asthma (all that dust we were breathing) and infections. A few were referred for further hospital care, but the hospital is several days walk away and fairly expensive. I’m not sure what happened to them.
We had some very well done zebu of supper that night, along with some Three Horses Beer, a native brew of Madagascar. After supper and devotions, we filled hundreds of bags with vitamins and other medications to help facilitate a speedier pharmacy in the morning.