As we mentioned in our last post, access to medical care in the Thomassique region is severely impeded by the issue of transportation. Most people in the region travel by foot or mule, and it takes many of them 2 to 4 hours to reach St. Joseph's Clinic when sick. One of our solutions is the Community Health Center (CHC) project, where people can get first aid and help with simple illnesses, but there are many patients who need to see a fully trained doctor. For this reason, the physicians of St. Joseph's conduct regular Klinik Mobil at various sites in the region. The establishment of the CHCs has been very helpful in facilitating these because the Community Health Worker (CHW) can help locate and organize patients, and the health center is a perfect facility for the consultations. Here's what happens at a Klinik Mobil, demonstrated by a recent day at our CHC in Dahlegran.

1. The CHW and members of the local Health Committee inform the community in advance that a Klinik Mobil will be coming. There is usually great interest in these clinics, so patients gather outside the health center to wait for our arrival. If at all possible, we try not to turn any patients away.


2. Our CHW (in Dahlegran, Mary Madeleine) intakes the patients, recording each patient's name, age, temperature and blood pressure. On this day in Dahlegran we saw 47 patients. At other such Klinik Mobil, we have seen over 110 patients in a single day!



3. The patient is seen by a doctor (here is our Clinic Director, Dr. Casseus) in a separate room. The doctor prescribes medications and provides medical advice. Sometimes patients have conditions that need further tests and attention, such as a woman seen at Barank yesterday with advanced goiter. In those cases, the doctor refers the patient to seek additional care, either at St. Joseph's or Zanmi Lasante's hospital in Hinche.

4. Before leaving for a Klinik Mobil, the doctor collects a box of commonly prescribed medications. An auxiliary staff member from the clinic (at Dahlegran it was our wonderful lab tech, Elizabeth) and ourselves staff the 'pharmacy'. We distribute and explain the doctor's prescriptions, and track the medications distributed.


Once all the patients have been seen, we pack everything up and get back in the clinic's Range Rover with our trusty driver Philip. Half an hour to an hour later, depending on the site and the weather, we return to St. Joseph's and finalize our record keeping.

For more information about our Community Health Centers, please visit the Medical Missionaries website (www.medmissionaries.org).