qmr 3 july-sep 2014...
TRANSCRIPT
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NOWSHERA HEALTH CENTER Union Council Taru Jabba
Third Quarterly Morbidity & Progress Report
For the Period of July-‐September 2014
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Morbidity Report from 1st July to September 30tht 2014
The center treated a total of 2894 patients from 1st July to Sep 30th 2014 for a variety of medical conditions. This
low turnout can be attributed to the month of Ramadhan in July. Although the majority of our patients come from
the IDP community, we also cater to the local populace who find it convenient to seek treatment from here as
compared to government health facilities that do not issue free medicine. A total of 2532 (87.4%) were women,
362 (12.6%) were children. Of the children 227(62.7%) were male children while the rest 135 (37.3%) were girl
children. There were no adult male patients. Although this is primarily a women’s clinic, we do not turn away any
male patient should they present at the premises with a medical problem of primary health level.
MCH Statistics: In this reporting period, 266 women sought antenatal care while 155 came for postnatal
follow ups. Family planning services were provided to 96 women and in this period 26 women sought advice and
guidance for both primary and secondary infertility issues with the latter showing a regular dominance since the
beginning, a fact that we have often speculated to be attributable to their depressed state of mind in lieu of their
current circumstances of being uprooted from their homes and displaced to a new place. Given their displaced
status, their eagerness to expand their families is both surprising and sad at the same time. A majority cite the
reason to have a child despite their uncertain living conditions is to compensate the loss of a child or two due to
terrorist attacks that seem to have affected every second family we come across.
Distribution of Types of MCH Services Provided
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The main services sought in our MCH center are a range of gynecological pathologies which were
provided to 934 women. They include
Gynecological Presentation Amenorrhea 124 Dysmenorrhea 153 Leukoria 186 P/V Discharge 59 P/V Bleeding 51 Ovarian Cyst 67 Irregular Period 113 Polymenorrhgia 58 PID (pelvic Inflammatory Disease) 110 Fibroid 13
Total 934
Primary Health Statistics: A total of 1333 women and children were treated for a variety of primary
health problems; most of which are the result of poverty and unhygienic living conditions of the patients living in
this community. The most common complaints were diarrhea (12.3%) and generalized body aches, weakness and
malaise (12 %). The latter are a group of symptoms that often have no real pathology so we take these as a sign of
the depressive circumstance they live in. Hence we prescribe these patients vitamins as placebos that augment
their poor diets. Other ailments presented were:
Primary health Presentation Anemia 158
Abdominal Pain 103 Respiratory Infection 125 Enteric Fever (Typhoid) 81 Dyspepsia 101 Vomiting 82 Scabies 98 Food Poisoning 6 Urinary Tract Infections 123 Hypertension 69 suspected Meningitis 0 Burns 9 Acute appendicitis 0
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Jaundice 52 General body aches and weakness 161 Diarrhea 165
Non-‐RTA related injuries were presented by 15 patients. Our location of the main road means that we are often
presented with road traffic accidents every now and then. In this 3-‐month period 12 cases were provided with
immediate emergency care of which 5 were referred to tertiary care hospitals for advanced treatment mainly
open reduction of broken bones. The total number of referrals, minus those made for RTA during these three
months were 30 patients.
Pathology Lab Statistics: The pathology lab conducted a total of 443 routine investigative tests in this
three month period. The table below shows the breakdown
Lab Test Performed from 1st April to June 30th 2014 Pregnancy Urine Test 82
Urine Routine Examination 33 Blood Grouping 43 Blood Hb 117 Blood Glucose 44 Vidal Test 67 Blood Malarial Parasite (MP) 26 RA factor 5 Toxoplasma 9 SGPT 17
Total Test 443
For additional details please find attached the Morbidity Matrix as Annex 1
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CASE STUDY
“Baby girl born in the centre”.
That was the good news that we got on
the first week after Eid Holidays in
August. Nineteen year old Shaista Bibi
is a new entrant to the IDP community
in Tarru Jabba. She is basically from
North Waziristan and at 7 months
pregnant she became a widow in June
2014 when the Pakistan military
launched an offensive against the
Taliban titled Zarb-‐e-‐Azb. Her young
21-‐year old husband. Ali Haider, was on
his way back from their fields ready to
reap the crop for the year when a
sudden military onslaught put him in
the line of fire. He sustained an injury to this chest which he succumbed to within a day. Not even given a chance
to mourn him, the rest of the family was evacuated by the military and herded off with large group of fellow
victims and unceremoniously dropped to an IDP camp in Bannu 4 days later. Shaista’s mother lives in Nowshera
and having lost all, she chose to return to her natal home.
The strenuous journey and the tremulous events that shattered her life were too much for her to bear and she
collapsed, unable or unwilling to get out of bed. She complained that her baby has not moved since that terrible
day when young Ali Haider died. Worried , her mother brought her to the RMF Health Center and her ante-‐natal
visit showed the foetus to be in perfect health and all looked on the spot. Uplifted with this news, Shaista Bibi
began to experience the first flicker of hope and anticipation after the death of her beloved. The unborn life
within her demanded that she be strong and able.
On August 12th, Shaista Bibi gave birth to a lovely baby girl who she immediately named Mashal, meaning “a ray of
light” as this child gave this young mother the first ray of light and hope that life is meant to be lived with love and
peace. Delivered safely and with ease, Shaista left the clinic the same day. She came for her first post-‐natal visit 4
weeks later. Breast fed and well clothed, baby Mashal was the epitome of health and what was more important,
Shaista Bibi, totally immersed in new motherhood is coping well with the loss of her husband.
Baby Mashal in the arms of her mother in the first
post-‐natal visit to the center
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Conclusion
Interaction with the KPK government has yielded results. The EPI program has given us the nod that they can set
up an EPI desk in our center. This means that a government EPI technician will be posted to our clinic with the
vaccines. Our contribution will be to ensure an effective maintenance of the cold chain. Naturally the EPI will
include polio drops that will contribute in a small way to the alarming situation in Pakistan
Annex 1. Morbidity Matrix
RMF Health Centre Nowshehra from Jul to September 2014 Months Jul-‐14 Aug-‐14 Sep-‐14 Total Total Patients for the month 911 947 1036 2894
1 Female 789 814 929 2532 Male 0 0 0 0 Total Adults 2532
2 Children (Male) 69 85 73 227 Children (Female) 53 48 34 135 Total children 122 133 107 362 MCH Details
1 Antenatal Care 72 95 99 266 2 Postnatal Care 41 54 60 155 3 Family Planning 22 32 42 96 4 Infertility 7 12 7 26 5 Amonrrhea 38 40 46 124 6 Dysmenorrhea 45 48 60 153 7 Leukoria 56 62 68 186 8 P/V Discharge 20 15 24 59 9 P/V Bleeding 17 22 12 51
10 Ovarian Cyst 25 10 32 67 11 Irregular Period 32 35 46 113 12 Polymenorrhgia 12 20 26 58 13 PID Pelvic Inflamatory Disease 30 38 42 110 14 Fibroid 3 4 6 13
Total MCH 1477 Primary Health Details 15 Anemia 68 42 48 158 16 Abdominal Pain 35 40 28 103 17 Resprtory Infection 42 45 38 125 18 Enteric Fever (Typhoid) 29 22 30 81 19 Dyspepsia 42 34 25 101 20 Vomiting 32 28 22 82
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21 Scabies 26 40 32 98 22 Food Poisoning 3 2 1 6 23 Urinary Tract Infections 40 38 45 123 24 Hypertension 12 18 32 62 25 suspected Meningitis 6 0 1 7 26 Burn 2 4 3 9 27 Acute appendicitis 0 0 1 0 28 Jaundice 25 12 15 52 29 General body aches & Weakness 28 62 71 161 30 Diarrhea 45 58 62 165
Total Primary Health 1333 31 Non-‐RTA Injuries 3 7 5 15 32 RTA road traffic accident 9 0 3 12 33 Referral 17 8 10 35
884 947 1042
Lab Test Performed from April to Jul 2014
Tests Jul-‐14 Aug-‐14 Sep-‐14 Total Pregnancy Urine Test 31 27 24 82 Urine Routine Examination 7 10 16 33 Blood Grouping 10 17 16 43 Blood Hb 32 38 47 117 Blood Glucose 7 17 20 44 Vidal Test 17 29 21 67 Blood Malarial Parasite (MP) 10 8 8 26 RA factor 1 0 4 5 Toxoplasma 3 3 3 9 SGPT 0 5 12 17