Generally, when I got to the Health Center (Centre de Santé), I don’t do a whole heck of a lot. At first they wanted me to watch them do meetings with patients. They wanted to teach me how to give vaccinations and injections. They wanted me to essentially be able to run a meeting with a patient on my own.
They quickly realized this wasn’t going to happen.
It’s against the rules for PCVs to give injections (unless you’re a registered nurse), for which I am thankful. It took a long time to get this point across, because coming here as a health volunteer they assume I’m a doctor. They were actually shocked that I didn’t already know how to give vaccinations. But after many long conversations I got the point across that I can’t (and have absolutely no interest in) giving vaccines. I’d probably pass out on the spot. Needles don’t bother me but I can’t actually watch injections, on others or myself. I get light headed.
Along with not being able to give vaccinations, I’m really not qualified to be having patient consultations. Like I said, I’m not a doctor. And I don’t want to be. And despite feeling like I have a better general sense of health than the average Guinean, the doctors and trainees at the health center know better the common illnesses and their symptoms of Guinea that I do. I could recognize a case of malaria for sure. And some other common illnesses. But cases like these come in less often then people with injuries from moto accidents. So eventually they realized I wasn’t going to be a new doctor to lessen their workload.
This has left me with not a whole lot to do. As a Public Health Volunteer my job is to address health issues through education, not as a doctor. I’m here to inform people how to prevent Malaria, how to optimize nutrition for themselves and their children based on local foods, and teach the proper aspects of breastfeeding (when that should start, when new foods can be added in to the diet, etc.), among other topics. This kind of work doesn’t really happen at the Health Center, because there isn’t much of an obvious. Most days, there are few clients.
It has come down to me helping with Pre-Natal Consultations on Saturdays, which is our busiest day at the Health Center because it’s market day and so women come from the surrounding villages to go to the market and stop at the Health Center while they’re in town. Since the majority of women speak little French, the doctor still has to conduct these consultations herself. I am there to count out the pre-natal vitamins and malaria meds each women gets.
Last week, I got to actually do something! I helped fill out Family Planning Forms for women who had come in to the Health Center for birth control. I was given the big book that the doctor keeps the records in and then had to copy the information down onto the forms.
It was easy, mindless work, and I’d done it once before, but it was nice to feel like I was doing something. I had to write their names, ages, occupation, village, their requested form of contraception and what they actually got (which was always what they requested). I also had to write no a bunch of questions that the doctor said she asked them and that the response was always no. I’m a little skeptical of this, but I just followed her directions.
I had talked with the doctor about contraception before, and I’m still surprised how many options women have here. I thought it would only be the pill, but they can also get shots or implants. And all of the options are very reasonably priced; usually less than $0.50 USD a month. And that’s affordable by Guinean standards.
The downfall is how secretive women have to be to get contraception. They often can’t tell their husbands because they’d be accused of wanting it because they were cheating. So they have to sneak into the Health Center and have to hide away money to pay for the contraception. It’s a sad situation.
Thankfully, it seems like lots of women are going for it anyway. Almost 30 women got some form of birth control in the month of July, ranging in age from 17 to late 30s. All were married and had previous children. I’m not sure their reasons for using it, whether they wanted more space between kids or didn’t want more kids, but I’m happy to see that women are taking advantage of the opportunity to make the choices for themselves about having children. And I hope some of them have consulted their husbands and have their consent, but if they don’t, I’m glad they’re doing it anyway.