December 2012 Update

We usually share with you several emails from our students. This time, I would like to do something different and share with you three rather lengthy emails from a single student, Tasiana. Tasiana is a second year nursing student at the Tukuyu School of Nursing. Just a few days ago she had her 25th birthday. She is the oldest of seven children and the only one in her family to go to school due to family financial difficulties.

First, a bit of background: In the first term of the second year of studies the students learn in the classroom about working in a rural community. Following the classroom learning experience, the students are organized into teams and each team is placed in a rural village for approximately a month. The students as a team need to identify the characteristics of the community and specifically public health issues and work with community leaders to recommend changes to the community leaders. Individual students work with families to identify health related issues and make recommendations to the families. The team is responsible for preparing a written report that is presented to the school staff. Each student similarly prepares and presents a report related to the families that they worked with.

I have changed the names of the patients mentioned in the emails.

From 6^th October I was at Mwakaleli Health centre for my community field work practice up to 3^rd November when I was back to Tukuyu NTC.

During my field work practice I was enjoyed very different things, I was passed through different families where I was get a chance to discuss with them concerned with Health problems which affect the family. During my field work assessment I was get different problems among of them are as follows. Some families have no pit latrines, lids for covering toilets, Also they are drinking unsafe water, Also some, families areliving in temporary house which has no window or small window so due to this they do not get enough Ventilation for health.

After doing my assessment I was planned on how to solve there problem I discussed with them and provide Health education on how to solve the problem according to the priority of the problems.

Health education provided on how to construct pit latrines and how to use it also I was demonstrated on how to prepare a lid for covering the toilet.

Not only also I was demonstrated on how to make water for drinking safe by using different methods, example by boiling, using three pots system and also by using water guard

Also Health education provided on how to build a house with a large windows and doors in order to allow enough ventilation. Because when there is a high population density in a small house it may leads into different diseases contagious diseases, upper respiratory discuses like TB.

Up to the time when I was back to the school all five families which I was supposed to care during my field work practice now is health they are boiling water for drinking , they has a pit latrines, they have good system of waste disposal, Because now they know the importance of using this things and their effects.

Also some of my families they was not knowing things concerned with family planning methods, when I was passing though it was observed that some of families have large number of children’s and the interval is very small. So though this one I tried to provide Health education concerned family planning methods. Now the mother is using injection method of family planning (Depo prover), and other are using oral contraceptivemethods. After each three months, she is supposed to come at Mwakaleli Health centre to get this injection.

Also During my field work practice I was get a chance to meet with Tegemea’s mother. And I was get a chance to go to Tegemea’s family at Mwakaleli.

All in all my field work practice was very enjoyable and was very interested . And now I’m preparing a book for those families which I was passed though it in order to submit to my tutor together with my group work practice . And also I am in preparation for my, coming semester exams.

Thanks for all and I wish you all the best.

Also I am very happy to tell you that our sisters and brothers who was completed their studies on August all was passed their final exams. I promise you that I will study very hardin order to improve my performance and when I will complete my final exams when my results come I wish to be a Tanzania one. May god be with me.

The letter above contains a reference to “Tegemea’s mother.”  We sponsored Tegemea at KCMC and she graduated in 2011. Tegemea assisted me in Tukuyu, getting the students started with email knowledge, Tegemea’s family lives in the village that Tasiana and her team were assigned to.

Tasiana’s second letter is dated November 21:

Hallow my friends I hope that you are doing well in your everyday activities. Back to my side I am doing well especially in my studies.

From the time when I was back from the community field work practice. I was preparing the report of community field work, I have already submitted my individual report even the group work report is alreadysubmitted it.

I was enjoyed when we was presenting a community health report to our tutor. It was very nice because we presented our report and our tutor asked some questions concerned the community , Disease which wasobserved from the community and what health education was provided to the community and what was our implementation and intervention done even our evaluation.

Also I have interested that when I was at Mwakaleli for our community health field report I was meet with a family who have five children. Among of her children was called Patient N  who was in standard four but shewas discontinued from school because she is a pregnancy. And she is 14 years old Patient N was already stated Antenatal visit. I Advaice her even his parents that, because Patient N is under 20 years old so sheis supposed to come to a big hospital early as possible because Mwakaleli is a Health centre. So if there is need of operation during delivery it will be difficult. Because there is no operating theatre there. And she isunder 20 years so the reproductive organ is not already well developed so now Patient N and her mother was already come at Tukuyu Hospital before 9 month. Because now she have 8 months up to now she is atTukuyu District hospital . I continue to provide managements which is needed for her as possible including remainding her on individual birth plan and complication preparedness.

Not only but also I would like to tell you that I have already completed my semester 1 level five semester exams. My examination was vey nice and I would like to say that next week we will be at home for thebreather.

Lastly I would like to say thanks for your cooperation. Last week our principle said thank she have already received money for our school fees even pocket money is already given to us.

Thank for all may God be with you in your daily activities

A clarification on the letter above – “standard 4” level is similar to 4th grade.  It is not unusual to have, what appears to us a mismatch with age and education level. This is primarily caused by families inability to pay for school fees and uniforms, resulting in temporary drop out from school.

We received her third letter on December 14:

Hallow my friends. I hope that you are doing well in your everyday activities. Back to my side I am doing well especially in my practical work which I am practicing at Uwemba Health Centre.

From 22^nd November 2012 when we closed our school I was at home for one week helping my mother on digging farm for planting maize and beans.

But two weeks ago I was at Uwemba Health Centre for my practical work in order  to keep me busy in my studies, I was at female ward for one week where I was met with a case of abortion. Patient A who is a woman of 24 years old was got abortion at her home which is far from the Health Centre. Patient A was a gravida 2 Para 1 and this pregnant was of 24 weeks. But after abortion Patient A was got Post partum Hemorrhage which lead her to get Anaemia when Patient A come at Health Center  she was having all signs of Anaemia and when blood is takes  for Hemoglobin and send to the laboratory the result was 6g/litre so doctor ordered blood transfusion two unit. And also nursing management done to the patient was to transfuse that blood to the patient and also nutritional status. Vital signs including, BP Even Bed bath was done Health education provided to the relative and patient on that importance of eating vegetables even fruits.

Up to the time when Patient A discharged the condition was improved and HB level was now 12g/litre in general the condition was good compared to the admission time.

And also in maternity ward I was interested with a mother who was com with labour pain.But the mother was already take local medicine before coming to the hospital. But when the mother comes she was on second stage of labour.We tried to assist her on delivery. But when the baby delivered the baby was black in colour due to that local medicine and the baby was so tied. The Apgor score was 7/10 and after 5 minutes was 9/10.A few minutes later the baby was having difficult in breathing we give injection x-pen 0.5mn I/M and also we give oxygen therapy.

So now the condition of mother and child is good. Also close observation was done.Even vital signs done to the mother and child.

Also I would like to tell you that I remember last month I was write  a report concerned with Patient N who was a pupil of standard four but now she was discontinued from school because she is a pregnancy.

She was at Tukuyu Hospital from the time when we closed our school. So now I was communicated with Rebeca Bafta because she is at Tukuyu . she told me that Patient N was get Operation, because she was 14 years so during labour she was not able to push a baby  and General condition of Patient N and her baby is going well.

Lastly I would like to thanks you for your cooperation and I would like to send to you many greetings from my mother and my young sisters and brothers.

Also I would like to tell you that there is a long distance from where I am I living to the town where Internet café is available.

Even transport is difficult, so now I have get a chance to come to Njombe town where Internet Café is available.

I wish you all the best in your everyday activities.

I hope that you have enjoyed reading the three interrelated emails from Tasiana. These young ladies work and study very hard. They will have a good future for themselves and their families and will make wonderful healthcare workers.

Visiting our students in Tanzania causes me to be more appreciative of all the opportunities I have had and for which I did not have to work nearly as hard.

Again, I want to wish all of you a Happy Holiday Season.

Tony van Werkhooven

for Linda, my buddy of many years