Well, I have been in my placement proper and working for 2
months now. I should tell you all what is it that I do. To do that, I will give
you a quick breakdown of the hierarchy I answer to. So, at the top is the
Episcopal Church, for which I am serving as a missionary through the Program
YASC (Young Adult Service Corps). YASC sends us out to various programs and
parishes throughout the Anglican Church worldwide. So, as a member of YASC, I
have been sent to work for a program Called HOPE Africa. HOPE Africa is a
social developmental program that works within the Anglican Church in Southern
Africa (different than just the country of South Africa). HOPE is based out of
Cape Town. Now, Hope has their fingers in all types of pies spread out through
Southern Africa, and one of them is the Overstrand Care Center. They help raise
money and find donors as well as providing training and all kinds of things,
along with sending along YASC volunteers when they get them and they have the
proper skills. Which is exactly what HOPE has done in my case. So, to simplify
it, my “chain of command” is as follows; YASC> HOPE Africa> Overstrand
Care Center. Simple enough, right?
Now, the Overstand Care Center (OCC) is basically a Hospice
center located in Hawston. The medical system and area being what they are, we
receive a lot more than just terminal patients near the end of their life. We
get used for all types of things, from patients freshly on HIV/Aids Medication
that need a place to recover and start/ learn their medication regime and learn
about their condition, to amputee patients who are waiting to find alternative
accommodation/have their place adapted to their new lifestyle, to patients with
depression or other mental illnesses (who are non-violent) who need to be
monitored as they begin a new medication and need the time to balance out, to
stroke victims, to patients that are invalid or need assistance taking care of
themselves but their usual care givers need a break or have to take care of
issues or are going on holiday. We also receive the standard end of life
patients as well.
The OCC can, at max, house 15 patients, 6 in the male ward,
6 in the female ward, 2 in a private ward, and 1 in the Compassionate (end of
life) room. Of those 15 beds, only 7 are funded by the state, meaning that we
receive money to spend on food and other necessities for only 7 patients. I
have yet to see us really drop under 7 patients, with the average being between
9 and 11 since I have been here. The intended time for a patient to be in the
care center is 21 days. If the patient is still in the center after 21 days,
extensions can be given for up to an additional 21 days. That’s 41 days that
any one patient should be in the center, max, if they REALLY need it. That is
how it is on paper at least. In practice patients stay for as long as they can
and we have the bed space, especially if they do not have alternative
accommodation.
“Where do you fit in to all of this?” You may ask. “Well,
thanks for asking kind reader, let me tell you”. In the States, I am a
Certified Athletic Trainer (ATC), a medical professional that is trained in
everything from injury screening and prevention to injury rehabilitation and
return to play (and I mean EVERYTHING in between. We are kind of the Jacks of
All Trade when it comes to the medical field, especially sports related
injuries). They don’t have Athletic Trainers in South Africa. The closest I
could find (and what I end up telling everyone I am) is a Physio (in the states
we might call them Physical Therapists [PT]) that specializes in sports. Yes,
you there, the one in the back with the hand up, what is your question? “But
Mister, how can a Physio (let alone an ATC) help in a Hospice Center?”
Excellent question, and the truth is, my skills apply to this population better
than one might imagine. The care center receives visits from both a state
employed Physio and A state employed Occupational Therapist, but they only come
once a month (sometimes more, sometimes less). So into the gap I have stepped.
If you remember, we get all types of patients. A large
portion has been Victims of CVAs (stokes). It apparently goes along with the
higher rates of HIV and TB. Now, stoke patients are something that can fall
squarely within the scope of an ATC, especially one that is working in a PT
setting. Also, amputee patients can be equally served with some physio. While
they are not a population that I am used to, the skills and techniques I have
learned and used in rehabilitating and retraining athletes, can be modified to
help these patients. My time has been spent helping the patients in the center
by devising and implementing programs to help them recover and regain use of
their bodies as well as adapt to their limitations (easy example is in the case
of amputee patients, teaching them how to use crutches). So far the majority of
my services have been rendered in the inpatient portion of the care center.
There is also a Home Based Care service provided from the OCC as well, and I have
spent some time with them, working in the community employing my services
there.
As needed as the service is, as much as I am helping people
that have a very little chance of seeing a real physio, it is a limited
service. I am only one person, and can only do so much, along with the fact
that I am only here for a year. In an attempt to preserve my efforts after I am
gone, as well as improve the services already being offered, I have decided to
undertake a special project. I am spending time trying to compile and organize a
guide of exercises and stretches that the care givers of both the home based
service and the in center service can use. I will include different types of exercises
to use in various situations with all maner of patients, as well as some of the
basics they need to know for designing and implementing physio programs. I will
also work closely with the care givers to instruct them on how to do the
exercises as well as when to do them and how to best render this side of the
service. That is the main goal I would like to achieve with my time here.
What I have described so far sounds like it could take up
all of my time here and then some, and while it does occupy a portion of each
day, it is not everything I do. My other activities, in short, are anything
that is needed of me. I fall somewhere in between the care givers, the Nurse coordinator,
and a physio in the clinic. Whatever Martin (the nurse who coordinates
everything) asks of me, I do. This ranges from making phone calls, helping
prepare and dispense medication, doing administration tasks (I completely redid
and streamlined the manner in which they kept track of stats here at the care
center, as well as updated some of the forms), assisting in procedures (like
drawing blood or giving injections) and anything else. I also assist the care
givers in any tasks that I can, such as transporting and lifting patients, helping
with the meal times and snacks, taking and recording the routine observations
(BP, Pulse, temp, etc.), and anything else they need.
I have really enjoyed my time working here so far. I have
learned a number of new things, as well as been able to teach some of my
knowledge to those here. I look forward to continuing to grow and change the
work that I do here throughout the year.
