Monday, 22 August 2016

Day 7 & 8 SAMS Global Response

Day 7 and 8 SAMS Global Response
Sunday was a quiet day. We had several new doctors, translator and volunteers arrive, and we had to say good bye to several whose time with SAMS had finished. The new volunteers were welcomed in the morning meeting then sent to different camps to get a feel for the work. The new community triage officers were also being trialled at some of the camps. Thankfully it was quiet day at the clinic so they weren't overwhelmed, although one or two apparently found it quite challenging and didn't wish to continue. Things were a little eventful as we had to send a pregnant patient to hospital for an obstetrics review as she was at term. The practice in Greece is to induce labour if it has not already begun at this point. Given the conditions in the camps, this was judged the safer option than waiting for labour to begin naturally. An ambulance was called and the woman was sent to hospital accompanied by a friend. Her husband had to wait till the next day to go and see her, as the hospital wouldn't accommodate anyone overnight. 
Sunday afternoon we went for lunch in the nearby town of Sindos, it was nice to have the whole team together and not have to rush back off to clinic, and the new volunteers got to meet everyone.

In the evening several of us worked on the triage data to try and make it usable for producing analysis of our work the past week. Frustratingly there were still gaps in the data, and no common categories for symptoms, diagnosis or treatment which could be used to accurately categorise and analyse the data. We could show how many patients we saw by age, and the raw numbers which attended, but the more interesting figures for how many presented with certain conditions couldn't be provided as yet. Thankfully one of the new volunteers is an epidemiologist so they will be able to spend a lot of time making our data collection methods more accurate and data more useful.
The Monday morning clinic was extremely. We had another pregnant woman turn up at clinic, 41 weeks pregnant. She was referred to hospital for an obstetrics review and possible inducement. An 11 month old baby was brought into clinic with vomiting and diarrhoea, unable to keep any fluid down. We got the police to call an ambulance for the child and put the pregnant patient on the next shuttle to hospital.
This was cause for a massive argument when the shuttle arrived as the woman's family understandably wanted to accompany her to hospital, but almost all places on the shuttle were taken by other patients. Her husband wanted to accompany her, as well as her mother, but she was also looking after a young boy who had no one else in the camp. Eventually we compromised on the boy staying with the husband while the woman's mother went to hospital, but no one was happy.
We had one of the new community triage officers working with us this morning which made everything much easier. Mohanad was originally from Idlib, and had left several months before to escape the Assad regime's bombs, and the repressive rule of Jabhat al-Nusra who are present in many towns and cities in the province. He worked quickly to triage patients and kept accurate records, which freed me and our volunteer translator to see patients or do the other team leader tasks. 
A number of patients were angry and frustrated as their referrals for treatment and investigation had gone missing, or they had missed their appointments due to miscommunication or information not being properly handed over between teams. I spent a good part of the day chasing referrals or submitting new ones. Prior to two weeks ago, all recording was done on paper records, so keeping track of patients attendance and appointments was much more difficult. Hopefully the triage database that is being set up will solve these problems. In the meantime the refugees are left frustrated and powerless to change their situation except by getting angry at us.
In the afternoon the clinic was quiet so I took two new doctors, Jemma and Debbie on a tour of the camp. We stopped by the play and rest area that volunteers had built for the refugees at the back of building. What I had thought was an old warehouse was in fact an old supermarket which had a children's play area outside. Volunteers had drawn hopscotch squares on the ground, painted murals and created some benches and potted plants to make the area more inviting. The only people in it at the time were children, and the volunteers told us no adults were using it. There is a school at the back of the building in which lessons were taking place, and a library, although that was closed at the moment. The volunteers were putting in a lot of work, but their ability to involve the refugees seemed limited by the lack of translators, and it wasn't clear what outreach they were doing to the community to actively involve them in the projects they were establishing. 
On the way back to the clinic we stopped by the tent of the artist who drew the pictures of Syrian's journey into exile. He welcomed us in and showed us his drawings again, along with videos of what was happening inside Syria. Looking at the pictures accompanied by videos and songs about the suffering inside Syria was even more harrowing. He complained to us he was tired of waiting, tired of months with no information as to what would happen to them. Him and his family had left Syria over a year ago, and spent a year in Turkey before making the crossing from Izmir to Greece. He showed us a picture he took of his family all dressed in their life jackets, just before they got on the boat. Fifty eight of them had been packed into a boat made for twelve people. Thankfully they all made it safely across.

1 comment:

  1. Injuries may occur while playing games, street crashes or activities of day by day living that result in a sudden injury. In phenomenal conditions, minor twisting while at the same time walking around uneven surfaces may incite to ACL tears. ACL Tear treatment is the best option so visiting the knee specialist in mumbai will be a wise decision and helpful.