First Week of Community Clinical in Iloilo

Week 1

January 11-17^th, 2011

Location: Janiuay, Iloilo

Students: Jill Peacock, Kristin Carmichael, Cara Burgess, Brianne Suderman, Cristina Santoro & Melanie Fontaine

We have officially completed week 1 of our community health nursing in Janiuay (phonetically- honey why). Our week began with courtesy calls to official members of the community such as the Minister of Health, the Mayor of Iloilo city, the Governer of Iloilo province and the Mayor of Janiuay. We were warmly welcomed to this new community and were introduced to the staff house. During our stay in the staff house, we are required to work together by cooking meals, washing dishes, gardening and housekeeping. By doing this, we have been able to quickly build relationships with the Filipino nursing students and our clinical instructors.

Our community experience began in the Rural Health Unit (RHU) a publicly funded facility. Implementing IMCI (Integrated Management of Childhood Illnesses), providing immunizations, and assisting in deliveries are among some nursing skills we have practiced so far. In our practice we have observed that the supplies are scarce and less than ideal. A reality very difficult to understand comparing to our rich supply of materials within our Canadian health care systems. Improvizing and or reusing supplies are common pratices in this facility due to lack of resources.

We have also nursed beyond the facility and set up clinics in remote communities such as those occuipied by the Atis. The Ati is a Negrito ethnic group which are identified as the Aboriginals or first inhabitants of the Philippines. We walked through small rivers, rice fields and mountainous terrain to set up a community assembly. Vital signs, wound dressings, health teaching, and discussions surrounding priority needs were identified by the community members.

In this culture, a common belief is seeking alternative treatments versus the modern biomedical models. We have come to understand the Filipino culture is very in touch with the super natural world. For example a young boy in the village had a substantial rash, identified later as scabies, on his feet. The mother of the child explained that they believed the child stepped on a dwarve`s house, hidden in small mounds of dirt, and crushed it. Doing this irritated the dwarves and they hexed his feet thus causing the severe rash. Many people in this tribe do not wear shoes which can cause further infections and delayed wound healing.

Not only do we have to understand the health concerns but we also need to embody the practice of cultural competency by respecting and including their beliefs and perceptions . In week 2, we will commence home visits to further assess and understand health priorities of this community group in order to plan and implement appropriate nursing interventions.