Here is one of 19 pages of reports that we do each month in the clinic. Most are for the health department, but this one is for an organization that donates a monthly distribution of medications and supplies which is why there is some English in it.

Temperature and symptom screens for COVID were done for 3015 people as they entered the property. There were 524 people that were flagged with COVID symptoms that were directed to an additional screening area where they were interviewed and screened by a nurse. Of those, 9 were suspected cases of COVID. Due to the health department not performing mass testing, unfortunately none were confirmed. We distributed 96 masks to patients without one to protect others inside the property. As of June 2021, there has been no vaccine distribution in the country.

There were 45 emergencies. Two were referred, one died (while transporting to the hospital), and the others we cared for here at the clinic. Dressing changes totaled 458 and there were 11 people that needed sutures. Injections of all types (insulin, antibiotics, pain) totaled 399. There were 406 blood glucose tests done for our diabetics and malnourished children. Four people needed IV lines places for fluid or medication. There were 4 people that were burned and required daily wound care.

For the pregnant ladies, 18 came during their first trimester, 108 during their second, and 90 during their third. First visit 62, 2nd visit 68, 3rd visit 42, 4th time 25, 5 or more times 19 making a total of 216 pregnant ladies consulted and receiving care. There were 46 ladies that were considered at-risk pregnancies. There was a spike in STDs this month and many were detected from the screening process for these ladies. Treatment helped them, spouse, and baby. There were 17 women that delivered babies – 3 in a hospital and 14 at home. The age breakdown is <15yrs=0, 15-19yrs=3, 20-24yrs=3, 25-29yrs=2, >30yrs=9. There was one set of twins, making the total babies born 18. All were over 5 pounds and 17 babies are being breastfed. According to all past consults, there were suppose to be 41 women delivering babies this month. There is usually a big discrepancy like this and we suspect that women that live far away don’t want to travel far with their newborn. Baby layettes give during the first postnatal visit, before the baby is 15 days old, have increased the return rate, but we are usually can’t keep them in stock. Mosquito nets were distributed to 14 pregnant ladies for malaria prevention.

Malnutrition can be measured in many different ways: arm circumference (6m-5y), weight-to-age (acute malnutrition), and weight-to-height (chronic malnutrition). We screen and track all of these measurements for each child coming to the clinic. The stat that gives us the best overall view of how malnutrition is trending the the total number of weight-to-age. When measuring this the results are given in standard deviations from the average, which is considered 0. Overweight cases might be +1, +2, +3, etc, while malnourished cases are classified as -1, -2, -3, -4 (the more malnourished they are the higher the number). When we first started working in this area in 1998, 75% of the children coming through the clinic were malnourished. Of those, many fell in the -3 or -4 range. For June, 58% were normal weight, 42% were -1 or worse, 16% were -2 or worse, 2% were -3 or worse, and 1% (14 cases) were -4 or worse. The overall rate of malnutrition has slowly decreased over the years as well as the number of severe cases. Our lowest month was 34% in Jan 2019 and Mar 2020. Over the past 12 months, our lowest was 36% and our highest was 46% so the 42% for June was within range. We would love to see these numbers continue to drop. Slow change is lasting change. Please pray that doors would open for more education outside the clinic walls and for open ears and hearts for the caregivers to make solid, lasting behavior changes while raising their families that would promote healthy living and child development.

PlumpyNut (Medika Mamba) and PlumpySup/PlumpyDoz (Medika Djanm) are specially formulated ready-to-use therapeutic food (RUTF) used in our three malnutrition program: 1) USN-inpatient care for severe malnutrition, 2) PTA-outpatient care for severe malnutrition, 3) PNS-outpatient care for moderate malnutrition (also includes malnourished pregnant and breastfeeding women). We also have other programs that distributed food like the food boxes, protein supplements, and infant formula. For the 3 main feeding programs, there were a total of 156 people that received free care through these programs. There were 33 admissions, 0 deaths, 16 abandoned /no shows, 16 graduated/completed the program and arrived at goal weight. The total sacks of mamba distributed were 2718.

We served 23 people with disabilities. There were 26 patients that we referred to other facilities and 4 that were referred to us. Birth control (pills and depo shots) were helping 69 women this month. Birth plans were made for 33 women.

There were 8 people accepted Jesus and 1 that returned to Christ. The 3 chaplains did devotions with 1949 people under the open-air shelter in front of the clinic as patients waited to be seen. They had special individual prayer with 325 patients and gave life/spiritual advise to 700. They distributed 277 pieces of Christian literature.