Last week our focus was on school health. We started off our school nursing experience with courtesy calls to the Assistant Superintendant and the supervisors of the Antipolo School Division. We learned that the main health concerns for the students within the division are the presence of head lice, dental carries, and skin conditions. Next we visited two Barangay Bagong Nayon Elementary Schools, numbers II and IV, which are the schools we were placed at for the week. The elementary schools here go from kindergarten to grade six and they are generally designed with a large outdoor gymnasium/auditorium in the center and classrooms around the perimeter. They serve a very large student population; for example, Bagong Nayon Elementary School II has a shocking 5000 pupils. We introduced ourselves to all the grade one classrooms that we were to assess the next day. We also met the nurse of the school division. He teaches for two hours every day and must visit each of the division’s 60 elementary schools every week. We felt some disbelief upon learning of his extremely large workload. In the evening of Monday January 24th, we met up with the other six Canadian students that came over from Iloilo to join us in Antipolo for the week.
On Tuesday January 25th, we spent the day conducting physical assessments on grade one students. The assessments included vital signs, height, weight, heart, lungs, eyes, ears, nose, throat, mouth, neck, skin, scalp, and extremities. At Bagong Nayon Elementary School II, the number of assessments reached well over 500 in one day. Some common findings were head lice, dental carries, impacted ear wax, poor vision, low weight, and nasal discharge. The amount of lice was alarming to us, as more children had it than not.
The following day we spent the morning administering childhood immunizations in the barangay health clinics as we did in the first week. Then we proceeded to the schools to attend an open meeting with parents in the afternoon. At the meeting we presented the results from the previous day’s assessments and gave health teachings for some of the common findings. The floor was also opened up for parents to ask questions and express their thoughts. It was really positive to see the high number of parents in attendance.
We returned to the barangay health clinic the next day to assist with prenatal assessments, as in the first week. Then we went back to St. Michael’s for an early lunch and to change into some nicer clothes for the afternoon. We drove down to the UERM campus to attend the 5th Dean Emeritus Evangelina M. Dumlao Lecture Series. Our Canadian clinical instructor, Susan Fowler-Kerry, was the keynote speaker with a presentation about pediatric pain. We were reminded of the need for nurses worldwide to join forces with one another to advocate on behalf of children. After the presentation, we were treated to a catered merienda (snack) that was large enough to be a meal, in what we are learning is typical Filipino hospitality.
On Friday January 28th, we did a postpartum home visit in the community. The mother was a mute teenager, with no father in the picture. At birth the baby weighed 2.5 kg, and on Friday at nearly four weeks of age she weighed only 2.7 kg. She had sunken fontanels and decreased skin turgor – her skin was loose, wrinkly, and “old” looking. She was very lethargic and difficult to awaken with either touch or sound. The home visit consisted of a lot of teaching with the mother. She was shown how to use a needleless syringe as an improvised breast pump. We asked her to try to feed the baby more often even if it means waking the baby for feedings. We tried to offer lots of encouragement to the struggling mother. It was a very difficult situation to see. It made us appreciate the children’s rights and social services back home in Canada. It is heartbreaking to say that at the end of the visit every single one of us walked away wondering how much longer the baby would be alive.
The above pictures were taken with consent.