REPORT ON MOBILE CLINIC PROGRAM
IN DUONG HOA COMMUNE, HUONG THUY DISTRICT , TT- HUE PROVINCE
10th January/ 2009
I. Objectives: To provide free general health care services and medication for needy poor people especially woman and children in the poor and remote areas in Vietnam and to identify cases (heart surgery, corrective surgery, chronic diseases) for referrals and long term care because serious medical needs.
II. Background and problems:
Duong Hoa is about 65 Km far towards Hue city, it is one of the poorest communes of Thua Thien Hue Province. Annualy, the Government has to provide relief of food in 4 months. The local people earn their living on growing forest. The land is barren, the roads are difficult to move, academic standard of the local people is very low. There are about 10,500 households, among them there are 7500 poor ones. Realizing the difficulties and the urgent need of villagers on health care, FHF financed the Mobile Clinic Program in this commune on January 10th, 2009.
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III. Sponsorship:
-Mr. Doan Phung / VASF
IV. Planning:
Before carrying out the program, the representative of FHF, Mrs Nhi, submitted necessary documents to the Competent Authotity of Health Public Department, Foreign Affairs Department, Red Cross Association of TT- Hue to inform the trip of MCP 77 and conducted meetings with the local authorities of Huong Thuy District, Duong Hoa Commune to plan for the implementation of the program. Duong Hoa’s counterpart would be responsible for identifying 350 needy people in the villages of the commune, delivering them the medical ticket in advance, and sending two officers who will co-operate with FHF in order to guarantee safety for the medical team and the patients.
The medical team was comprised of 11 members including 5 voluntary doctors and 1 pharmacist who have extensive experience working for Hue Central Hospital and another hospital in Hue, 3 staff of FHF and 1 American volunteer. To guarantee safety in using medicine, the medicines were purchased in Hue City, and the final work was to rent a car with 12 seats.
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MCP medical team:
1/ Duong Quynh Nhi, Rep. of FHF.Hue
2/ Le Thi Huynh Sa, Doctor
3/ Nguyen Huu Tuan, Doctor
4/ Bui Thi Khanh Ty, Doctor
5/ Nguyễn Thị Tảo, Pharmacist
6/ Tran Thi Bich Chau, Doctor
7/ Hoàng Thị Tâm, Doctor
7/ Huynh Hy, Volunteer (US)
8/ Nguyen Huu Binh, ( FHF staff )
9/ Nguyễn Thị Thuận Khánh, ( FHF staff )
V. Implementation:
The medical team started at 7am on the 10th January, 2009 in Hue, and after 60 minutes by car we arrived at Duong Hoa Commune. The MCP was organised in the Infirmary of Duong Hoa Commune. At 8.15 the medical examination began, every patient who came for examination was provided one medical ticket in advance, and entering to see a doctor under the conducting of local officers. After finishing the medical examination, they moved to the nearby pharmacy to receive medicine for free. With the help and co-operation from the local committee, the medical examination was carried out smoothly and achieved the good results.
In one day, we examined and delivered medicine a total of 352 visits of patients.
Diseases/Health Conditions |
Cases Treated |
Helminthiasis ( Giun san ) |
19 |
Bronchitis ( ho hap ) |
54 |
Cardiovascular |
8 |
Skin |
16 |
Lung |
51 |
Nutritional Deficiency |
130 |
Fibrosistis, Arthritis ( viem mo |
18 |
Hypertension/High Blood Pressure |
33 |
Trachoma |
10 |
Encephalopathy (vegetative nervous disorder, vestibule disorder, neuritis, ) |
37 |
Digestion ( constipation, colitis, gastritis, enteritis ) |
89 |
Anaemia |
8 |
Other ( Osteomalacia, toothache, degradation of spinal column, tumour, suffer fron grave, bubo, sciatic nerve, asthenic…) |
100 |
TOTAL (mutually inclusive count of all conditions) |
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All diagnoses of diseases and conditions were made clinically.
Helminthiasis was diagnosed by Doctor Sa and Ty. Bronchitis was diagnosed by Doctor Tuan and Chau. Cardiovascular diseases were diagnosed by Tam and Sa. Skin conditions were made by symptom on patient’s skin and typically includes the following conditions: Eczecma, dermatophyte ( nấm da ), scabies, pruritus, spotted scabies, weeping scabies, filarial itch, favus, and etc.
Lung diseases was diagnosed by doctor Tam, Ty, Sa through symptoms which declared by the patients, to take blood pressure, listening to breathing rate; however, it is difficult to distinguish among Lung diseases and Cardiovascular diseases without some tests so if there are patients who are in doubt these disease, they will be introduced to Hue Central Hospital or other test laboratory in TT _ Hue for tests after that the patients or these laboratories will send result to us and typically includes the following diseases: pneumonia, pleurisy, tubercular...
Nutritional deficiency cases were made by doctors through:
1. For children:
- Checking weight, height comparing with age, checking fat layer under skin, colour of skin, eye...
2. For adult:
- Checking colour of skin, eye, weight...
Fibrosistis and arthritis cases were made by through symptoms which declared by the patients and they are shown on patient’s body.
Finally, 10 cases of serious medical conditions that need referrals and long term care. 15 cases were referred to Hue Central Hospital for tests.
VI. Financial summary:
Cost of Medicine |
5.500.000 |
| Expenditure for the Doctors | 900.000 |
| Pay for hiring a bus | 750.000 |
| Pay for drinking and lunch | 550,000 |
| Pay for copying a medical ticket |
130.000 |
| Banner | 100.000 |
| Nylon package | 50.000 |
| Print picture | 50.000 |
| Total: | 8.030.000VND = $480 ( 1USD = 17.000DVN) |
VII. Medication List:
For children:
1. Oral antibiotics - children dose (Amoxicillin 250 mg, Amoxicillin/Clavulanate ... )
2. Fever, pain (Paracetamol liquid and children dose tablets)
3. Cold medicines - children dose (Paracetamol + decongestant + antihistamine ...)
4. Topical antibiotics (i.e: Neosporin)
5. Eye, ear antibiotics (i.e: Cortisporin)
6. Thuo^'c so^? la~i (Mebendazole)
7. Thuo^'c bo^? (liquid multivitamin for young children, and tablets for older children)
8. Antidiarrheal (loperamide - children dose), electrolyte supplement.
For adults:
1. Oral antibiotics - Amoxicilin, azithromycin, Amoxicillin/Clavulanate, Metronidazole, Sulfamethoxazole/Trimethoprim)
- Amoxicillin: strep throat
- Azithromycin: pneumonia, bronchitis
- Metronidazole: for some intestinal parasitic infection
- Sulfamethoxazole/Trimethoprim: for urinary tract infection
Oral antifungal (fluconazole -- for yeast infection)
Oral antiviral (Acyclovir) - need only small quantity
2. Fever, pain (Paracetamol - adult dose, Ibuprofen)
3. Cold medicines - adult dose
4. Eye antibibiotics, medication for dry eyes (like Artificial tears)
5. Thuo^'c bo^? (vitamin A, B) -- Vitamin A and B is more popular in VN
6. Antidiarrheal (loperamide)
7. Medications for stomach ulcer (ranitidine, omeprazole)
8. Topical + vaginal antifungal (clotrimazole)
9. Medication for itch (hydrocortisone, betamethasone ...)
VII. Conclusion:
In this MCP 77 we realized that the basic health needs is rather high in this commune and there are more our MCP for them so that the poor can access to health service. They need us have more MCP in the year because one a year for them is still few. So our MCP program is very useful and effective to them.
VIII. Pictures:
Attached files
Hue city, 17th January, 2009
Reporter
Duong Quynh Nhi