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Community Pediatrics August 2013. Maria Celeste Gomez, MD Marco Romulo R. Manzano , MD. 2 n d WEEK. 3 rd – 4 th WEEK. COMMITTEE REPORTS. OPD CHV Feeding Program Livelihood Program Finance. OUTPATIENT. 3 Wednesdays (August 7, 14, and 28) Holiday- August 21
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Community PediatricsAugust 2013 Maria Celeste Gomez, MD Marco Romulo R. Manzano, MD
COMMITTEE REPORTS OPD CHV Feeding Program Livelihood Program Finance
OUTPATIENT • 3 Wednesdays (August 7, 14, and 28) • Holiday- August 21 • Total No of Patients Seen: 97
Medications • Usual medications used/ Fast-Moving Meds • Mucolytics (carbocisteine / mucosolvan) • Medications for skin and soft tissue infections • Amoxicillin • Salbutamolnebule • Phenylephrine • Paracetamol • Multivitamins • Medications needed to be purchased • Cloxacillin • Mupirocin ointment • PND otic drops • Cefalexin • Paracetamol
Slow-Moving Medications • Clarithromycin • Cefixime • Phelylephrine • Phenylephrine+ChlorphenamineMaleate+ Bromhexine • Expiring Medications • Amoxicillin 125/5ml
Reportable Case • JC, 1 year and 10 months/male, Riverside • 2 weeks loose watery stools with no vomiting and fever with associated weakness, given ORS. Resolution of diarrhea after 1 week. 1 week PTC had productive cough and colds with recurrence of vomiting • Born full term to a 26 y/o G5P5 (5005) BW 3.3 kg at home by a midwife, no complications • No previous admissions, but prev had URTI and Furunculosis
Weight 5.5 kg (Z<-3), Height 65.7 cm (Z<-3) • HR 110, RR 40, Temp 36 • Weak looking, sunken eyes, with intercostal retractions, rhonchi, rales, hyperactive bowel sounds • A > PCAP C, AGE, Malnutrition (Severely underweight, severely stunted), Developmental Delay
Advised admission but opted to stay home • Inserted with NGT for trial feeding • Started on oral antibiotics and zinc • Advised follow-up
Flu Vaccination • Objectives • To promote disease prevention especially to the children at risk (enrollees of feeding program) • To enhance the skills of doctors and medical students in immunization techniques • Mechanics • Total of 11 children were vaccinated, and only 8 vaccines were used. • The flu vaccines donated by the Rotary Club of Pasig were utilized. • The ASMPH Clerks assisted by Pediatric Residents and Consultants administered the vaccines
Recommendation • A yearly vaccination for feeding program enrollees • Involvement of medical clerks were helpful to both the student and the patient
Deworming • Objectives • To reduce the prevalence of parasitic infections especially for those that are at high-risk (underweight, low-SES, crowded living conditions) • Mechanics • To provide 1 dose of Mebendazole for children enrolled in our Feeding Program who have not yet been dewormed this year
Recommendation • Have a MASS DEWORMING project for SEPTEMBER • Still with approximately >50pcs of Mebendazole tablets • Expiration is October 2013
COMMUNITY HEALTH VOLUNTEERS • Recruitment • Objective: to increase OPD census and for wider area coverage • Plans of recruiting Nagpayong CHVs • 1 area only (Montevilla Homeowners) • Representatives already met with Dr. Acantilado • Attendance of CHVs • Mostly 100% Attendance for July and August
Active CHVs • Fely Padilla • VergiePacuan • Carla Benbinito • Active Mother Mentors • Rea Llarinas • LollyTasareno • Luz Cambe • Carina Espiritu • GertudesBartolata
“OPEN SESSION” • Objective • To empower the people of the community by involving the CHVs and Mother Mentors in the planning session of which activities to continue and focus on for the month assigned (August) • To hear out comments, evaluation, and suggestions from the CHVs and Mother Mentors on the past activities and for the suggested activities by the past group • Target Population • CHVs and Mother Mentors
“OPEN SESSION” • Mechanics • To have a small “merienda” with the CHVs and Mother Mentors while informally talking about the activities done in the past month and the plans for the current month. • The residents will be facilitators in asking the opinions of the Ilugin volunteers which activities they like and which activities they find hard or not too helpful for them. • Any suggestions for all committees are welcome: • OPD, Livelihood, and Feeding
“OPEN SESSION” • Results and Evaluation • Would like to continue Exercise and Health Awareness for CHVs and Mother Mentors • Continue weekly exercise / Zumba sessions • Voltaire or Rachelle Vicencio as Dance Instructors • Happy Community with Happy CHVs • Have a wellness day where we will invite an IM resident to help our CHVs and Mother Mentors on their sickness and other ailments.
Would rather learn new skills for livelihood • Focus more on livelihood • KUTO PROJECT • willing to manufacture and sell CVCs • Will not be willing to do another round of treatment of schoolchildren due to health risk exposure and the method being very tedious • CANDLE MAKING • They enjoy and feel very confident in making and selling candles. • Candle making for August might not get in more returns because its demand is seasonal.
“OPEN SESSION” • Results and Evaluation • Focus more on livelihood • DISHWASHING LIQUID • This was another project also suggested by CHVs and was known to them several months or years back. • The idea of making and selling Dishwashing liquid from their home (either wholesale or retail “tingi-tingi”)made the CHVs excited because it is a product all are using everyday. • Need to get more information from TESDA on how to make this product and CHVs and Mother Mentors are willing and eager to learn it.
“OPEN SESSION” • Results and Evaluation • Focus more on livelihood • UKAY-UKAY • This idea was brought up due to lack of funds to start a livelihood project. • Pedia Residents and Clerks have come up with a joint plan to get donations (old clothes, bags and shoes) from TMC and ASMPH Family and these will be sold in verious areas to raise funds for the community. • Venues? Ilugin? Pasig Barangay hall?
Challenges Encountered • Desired Projects were put on hold • Dishwashing liquid: too short term focus on COOP and KUTO PROJECT • UKAY-UKAY no need because Rotary will fund a good and stable livelihood program like KUTO PROJECT or WATER HYACINTH HARVESTER • CHVs are not yet too keen on other people becoming mother mentors from Nagpayong (TRUST issue)
Enrollees CURRENT ENROLLEES (Jan-July) <2013 8 Jan-July 2013 23 August 5 GRADUATED (Jan-July) 7 DROPOUT (Jan-July) 20 ONGOING FEEDING ENROLLEES 36