Ethembeni: clinic life

Ethembeni clinic: Yesterday, 7.25.07, we visited one of the 13 satellite clinics operated by Department of Public Health nurses. The waiting room was packed with women, men & children awaiting a visit with the nurse. Some to get ARVs, some for antenatal care, and many for other various ailments. The beauty of this place- is that it is operated by nurses- all 13 of the clinics in fact. The nurse I observed operated like a Nurse Practitioner. It was such a great thing to see, because as far as we have been able to tell- NP is not a role held in South Africa. These lead nurses in the clinics however, may not be called by this title, but they seem to act as such.

The nurse I observed did assessments, diagnosed & dispensed medications. I watched her do a routine antenatal (or prenatal) visit. She measured the fundal height, listened for fetal heart tone (not with a doppler, but a plastic device you put your ear up to- I am sure I should know the name of it), and she palpated for the position of the fetus. It was such a pleasure to see her in action, and was role in which I could totally see myself- especially if I could speak Zulu... Yebo.

As a former manager of a community health family planing clinic in Cali, I could not help but note the details of the procedure for seeing patients. There were no appointments. The patients came in on a first come, first serve basis, and waited as long as it took to be seen. There were 2 "clinicians"- the lead nurses seeing patients and at least one nurse taking blood pressure, weight & blood & urine type measurements. There were several lay counselors that were doing VCT: voluntary counseling & testing, for HIV testing, as well as counseling on medication adherence, & PMTCT: prevention of mother-to-child transmission, of HIV- for pregnant patients. There were front desk staff and the chairs for waiting patients spilled out onto the covered front porch. I read every detail on the wall when I was in the room with the nurse. There were antenatal care visit guidelines, STI treatment guidelines, diabetes medication guidelines, and an injectable contraceptive calendar- all hanging on the wall. Oh how it reminded me of my life at PP. I just love clinic life, and it was great to feel it in my blood again- even in the other side of the world. I wanted to start working there right away, if only I was already a NP...

Amazing to me how similar rural Msinga can feel like urban Richmond, California at times like this. Instead of me struggling with my Spanish I struggle with comprehending the musical language of Zulu. Practicing my humorous linguistic "clicks," oh so natural to the people here. My Sewanee anthropology professor & advisor, Dr. O'Connor would be so proud.