Sunday, 13 May 2012

Tracey Goes to Clinic

Treatment of in-patients, out-patients as well as clinic visits form part of the job description of a physio at Mosvold Hospital. In-patients and out-patients are treated on hospital property; clinic visits on the other hand take place at various outlying clinics. These clinics are run by Nursing Sisters, members of the health care team from Mosvold (eg. Dieticians, Doctors, Social Workers, Opticians etc) visit these clinics once a month to see patients for follow up or assessment.

Your average clinic day starts with the health care worker (in my case the therapist) phoning transport department and praying for a car. Once a car has been granted, the itinerary has been completed and you have piled all the necessary paraphernalia as well as other members of the health care team into the vehicle your journey to the clinic as well as your day at clinic commences (note the journey and the day are 2 separate parts).

The Journey
Depending on the clinic location you may end up travelling for as long as 1.5 hours on tar or gravel road dodging potholes, cattle, school children and few other mentally challenged road users. Due to the varying terrain you may find yourself transforming an Average-Joe Mazda Sting into a 4x4. In scenarios when there is limited transport and you have been assigned a driver from the Hospital you may find yourself forming part of the drivers dream to part take in Ingwavuma’s version of the Dakar Rally…a most terrifying experience indeed!

Meet the Mr Bean Mazda Sting. Don't be fooled by its atrocious colour, this car is a Transformer

One of the double cabs that we get to take to clinic

The common KZN Cattle Congress that has to be dodged on the road 


The Clinic Visit
Once you have reached your destination the real work starts. As therapists you are required to run an exercise group for arthritis patients. The size of the group ranges from 2 patients to 30 patients. The number of people in the group is dependant on the size and location of the clinic, the number of people in the area with arthritis and most importantly patient compliance. These groups are a source of entertainment for my patients and a humbling experience for me as the translators do not attend clinic. For this reason I am required to run the group using a list of phrases that I have written down and may not have always practised pronouncing. This is amusing as I have been learning Zulu as long as I have been in Ingwavuma (ie 5 months) thus my Zulu is far from good. The exercise group is structured-you come in, you greet, give your disclaimer (I’m from Cape Town, I’m English so excuse my Zulu BUT I am trying), you do your exercises using your phrases, you sign the patients card and give the “Buya”date (Buya: pronounced “boo-ya” is Zulu for return). The end of the exercise group marks the beginning of the "real" party J

As you sign the patients’ cards, they either:
A) Say thank you and walk home 
or
B) Go off at you in Zulu

Patients going off at you in Zulu either:
Bi) Complain about pain (pain which is chronic-duh, you have arthritis)
Bii) Ask for Tubigrip (Tubigrip is a compression bandage effective for certain painful conditions and swelling-not all arthritis patients need tubigrip, but 90% of arthritis patients at clinic are CONVINCED it’s the cure to life in general)
Biii) Tell you something which is not remotely related to arthritis as they do not have arthritis, therefore they have been referred to physio for an individual session NOT the group session.

My response to patients going off at me in Zulu:
Bi) If the pain is due to the arthritis I tell them in broken Zulu: the definition of arthritis as well as the management, prognosis and treatment thereof
Bii) Give them tubigrip as I have given up on convincing them otherwise. Due to the large quantities of tubigrip issued, I have dubbed myself “The Tubigrip Fairy”
Biii) Ask them to wait inside for me to see them one-on-one. These one-on-one sessions are often the most challenging as my Zulu is limited, the patients English is non-existent and the people who are willing to translate (bless their hearts as they are angels) are not always accurate. 

The individual sessions usually take the longest as I have to see some of the patients from the group as well as other individuals for follow up. Once again patient volumes vary from 2 individuals to 12. After all the individuals have been treated and the other members of the health care team are finished with their patients you can FINALLY go home. Unless of course, you have to do a home visit with the Social Worker which is what happened at my latest clinic visit.

Search and Retrieve
After the worlds longest afternoon of individual patients where I had to use a psych patient to convince 1000000000 arthritis patients (ie 3 out of 5) that they don’t need to come to Mosvold for an x-ray because we know how their arthritic bones look; I embarked on my first home visit with the Social Worker.

This home visit was different from any other as people living in Ingwavuma don’t have a “fixed” address consisting of a house number, street name and suburb. Instead they give their address in relation to something (eg. A school) so instead of saying I live in 54 Humus Street Newlands, they’ll say they live at Nansindlela School in the Ingwavuma area. I was always curious regarding the method used to locate both the person and their house when there are no street names or house numbers - all was revealed when we went on our search for our grade 6 client using The Voomsies style "Search and Retrieve".

This method of Search and Retrieve consists of me driving the hospital double cab around the Nkungwini area while the social worker stops random people on the street asking the where abouts of the child. After asking number of people we were pointed in the direction of a school play ground as school had just been dismissed and the client we were looking for was on her way home. We had to sift through a sea of little faces to find the girl. After much hooting, tip-offs from scholars and foghorning her name out the window we managed to located the client. 

Phase 1: Search = foghorn + hoot + point
Finding her was the easy part, the challenge was getting her into the car as this little lady applied the golden rule of life-Don't talk to/get lifts from strangers. In doing so she broke into a flat sprint to get away from our double cab-the glory of her impressive sprint was short lived by the barricade of classmates who blocked her. Once the girl saw the Social Worker she remembered her face and agreed to get into the car. 

When peace and calm had been restored I found myself taking the client home for the home visit. The road to her house was a narrow one, it could hardly be classified as a road.  It was more of a foot path flanked by bushes, huts and long grass. Nevertheless we transformed it into a road-or at least, we drove in faith because I sure as hang did not know what was lying beneath!

What the road was intended for-people walking.
What we transformed it into. As in all "tense" situations, my eye is twitching.

What our transformation can be compared to-Squeezing an elephant through an alleyway.


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