Check In: Community Medicine

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Hello, 

How have you been? And how has the year been going?

So for the past six weeks, I have been on postings while trying to do every other thing. And I am just going to say I love this posting experience compared to the other ones because of two things: one, we get to visit a lot of places and two, we are not stuck in the hospital all day.

Saying stuck in the hospital is going to seem like I am complaining about being a medical student and taking my training for granted and all that, but I assure you it is not. For one, I like being on postings at the hospital even if it seems like everything just goes on and on, but for some reason, the visit to different places was refreshing. It was a break, a step away from the things we usually do. There was no clerking of patients, no presenting to consultants, no ward rounds and the hours were generally shorter. 

So Community Medicine is centred around public health, the community, factories/industrial health, government policies put in place and generally the ways to ensure that everyone is in a state of optimal health. It is centred more on preventive rather than curative aspects of medicine (well, almost). 

Now for the postings, it is divided into two; junior(urban) and senior(rural) postings. And for the last six weeks, I was on the junior postings. The junior postings are basically visits to places that have a direct or indirect effect on the health of people in the community, and then we had seminars (presented by the student) on the significance of the various places we have been to. Easy, right? 

One challenge we had though was the Monday sit at home that has been going on in the southeastern part of Nigeria, so it led to a lot of rescheduling and ultimately us missing a few trips at the end of it all, and the one that hurts me the most was we never got to visit 7 UP Bottling Company. It hurts so bad because I heard they gave out free drinks. 

We started our postings with a visit to the abattoir. There isn't a lot I can say about how and where they kill cows, but I have something to say about going on that visit. So the time of the visit was 6 am, and everyone was supposed to be there on their own. So I left my house around 5 am with the hopes of getting Keke Drop to the market, but by the time I got to my bus stop, I realized there was no Keke and they wouldn’t be out till 6, so I did the next practical thing, which is walk. Now Ogbete market is a big market, and the abattoir is at the back end of the market while I was walking towards the front entrance of the market. On getting to the front of the market though, I was denied entrance because the market doesn’t open till 7 am. The back entrance to the abattoir was open, but it was too far for me to walk and that was why I wanted to take the shortcut through the market itself.

I was lucky though, around 6 am, I got a Keke that took me to the back entrance and I found my way to my group. By the time I met up with them, I was tired, sorry exhausted. We concluded the visit and I was back home before 10 O'clock that morning. The most amazing thing was how I was somehow still standing having walked and remained standing early that morning. In fact, when I went to the group chat to announce my situation, only one person (Fred) was actively giving me directions and letting me know what was going on.

Another funny journey was when we went to visit Ajali waterworks, one of the stations involved in the purification and supply of water to Enugu Municipal. On our way to the place, the lecturer came in and told us that when we get there, we are going to see a big river, and I was excited. The journey was long, I was uncomfortable on the bus, and by the time we got there, I was tired. Then we had to get down from our bus and walk down a hill to get to the low lift pump that was situated beside the river, and when we got there, I was disappointed, so disappointed. There was no big river at all. But the water treatment plant itself was cool, and learning about the processes and seeing it myself was fun. There were a lot of jokes coming from my end, but I did enjoy the tour. By the time we got back, I was drained.

The most comfortable journey was the one to the Leprosy Center at Mile 4 Hospital, Abakaliki. We had to go to Ebonyi state and I armed myself with my earphones, a good playlist and a comfortable seat by the window. So at the military checkpoint on the interstate, everyone in a vehicle except the driver is supposed to come down and walk through the checkpoint. There were two checkpoints on the way, and my biggest flex (and also everyone on the bus) was that we didn’t come down at all or have to walk. We told them we are medical students, the bus is big and coming down is going to be stressful, and they just let us go. On our way back at a particular checkpoint, the soldier was like because we are medical students, does it mean that if we walk under the sun, we would be sick? The way he said it was really funny and I tried my best not to laugh seeing my seat was just opposite him and I was not in the mood to do frog jump. The visit itself was nice and there was a lot of myth-busting surrounding Hansen’s disease (leprosy) and people affected with Hansen’s disease. One important thing I learnt was that after the first dose of treatment, PAH were no longer capable of transmitting the disease, which means you can live with them, and integrate them back into society. Another interesting fact was how friendly the facilitators were. It is really not something you see in medical school.

Speaking of friendly facilitators, our visit to the Ministry of Health had something similar. Different people from the different departments of the ministry came to speak to us and tell us about their programs and the way they are helping to improve the healthcare and condition of the people living in the state. I had a crush on one of the facilitators that came to represent the department of Epidemiology. He made epidemiology so fun and interesting, telling us about what they do and how their research work helps in the control and management of outbreaks in the state. By the time he was mentioning hoping to ignite an interest in us towards epidemiology, It was safe to say I had an interest in epidemiology already, and it was him. Alright, moving on. The facilitator on leprosy, tuberculosis and Buruli Ulcer control is the most excited doctor I have ever met when it comes to teaching. Every other person came to speak with us from either a note or with some of their on-site tools e.g. the dose pole, used in the prophylactic distribution of Ivermectin and Praziquantel in other to control some neglected tropical diseases, she came with a PowerPoint presentation to talk about what she does. It was also an interactive class with joy in her face and the way she taught was beautiful. I was so happy to have witnessed her teach, it seemed like a blessing.

We went to other places like; Innoson Plastics where we did a facility tour and learnt the process involved in making plastics and see the different mould and processes involved in using those moulds, National Arbovirus and Vectors Research Centre where I learnt a mosquito cost between 150 and 200 NGN also we saw their insectary and other fun stuff they do there, we went to the Chest clinic, the HIV clinic, Enugu State Waste Management Agency(ESWAMA), and NPI Cold store involved with the storage and distribution of vaccines for the southeastern region.

The other part of the postings was the seminar we had to present, and it was fun. My personal favourite was the Environmental Sanitation group. My group presentation was on the last day, and it went well. Although there were a few omissions on our part, we had enough to do a good job. Although, I had to spend the rest of the weekend making corrections to the slides. 

Our visit to National Arbovirus and Vector Research Centre

I forgot to mention, I was the assistant group leader for community medicine, and I was involved with fixing seminars and ensuring our visits were on time and I have to say, I am glad we are done with community medicine because no more group leaders work for me.  

Happy new month.

I hope October turns out amazing and fulfilling. I know that I have been going on about the big projects I have for the year. Unfortunately, I had to let go of one of them because I don’t think I have all I need to pull it off yet. And for the other one, I can wait to unveil it here, even though I still have a lot of behind the scene details to iron out. I am really excited though, and I am certain it is going to be amazing when it kicks off.

With love,

The Estherian.