Wound management

Submitted by Michaela Sholes

When discussing general wound management with the communities, we encourage the following actions to prevent infection and promote healing in a wound:

· Control any bleeding through elevating the limb and apply direct pressure with your fingers. Wear gloves and use a sterile dressing if possible, or ask the victim to apply pressure himself.

· Clean around the wound with soap and clean water or disinfectant (e.g., alcohol, peroxide). Clean all skin within 2 inches (50 mm) of wound, starting at the edges and spiraling away from the wound. Note: these liquids shouldn’t be poured into the wound, but instead are used to clean the outside of the wound.

· Flush the wound with clean, drinkable water (bottled, boiled, or cleaned by SODIS method). Use a Pure Water sachet or a small clean plastic bottle with a hole in the cap to squeeze water through the hole to create gentle pressure. Use at least ½ liter of water, or more for larger wounds.

· Do not remove large objects that are firmly embedded.

· Cover the wound with sterile gauze and a clean dressing.

·Change the dressings at least once every day or whenever the bandage becomes wet or visibly dirty.

Many of these steps are easier said than done…it IS a challenge to get clean water and to find items like sterile gauze. But it WILL make a difference between spending a little money/time now and spending much more money/time at the clinic later once an infection has set in.

Many of these steps are easier said than done…it IS a challenge to get clean water and to find items like sterile gauze. But it WILL make a difference between spending a little money/time now and spending much more money/time at the clinic later once an infection has set in.

Sourcing local first aid supplies

Submitted by Michaela Sholes

The MoM team worked on a plan for identifying locally available and cost-effective items to be included in a community first aid kit. Some things were easier than others to identify: for example, clean white cloth for slings/swathes/bandages are readily available in the local market, while sterile tweezers, gauze, and scissors are somewhat more difficult to locate at a cost-friendly rate! Although gauze is available fairly cheaply, it is not in sterile packaging. While visiting a local pharmacy, we discovered all kinds of things that were presented to us as "appropriate for putting on wounds," not all of which were actually useful. It's not as simple either, as the temptation to jump to judgement of the pharmacies and medicine sellers. If sterile gauze is hard for the seller to access, then that translates into a higher cost for those wanting to buy it. In relation to medication, the danger lays not necessarily in WHAT is sold, but HOW it is sold. I went in asking for a cream to keep my wound clean and was handed (without instructions regarding the differences of each) one described for burns, one for skin fungus, and one triple antibiotic ointment.

In more Westernized areas, these things tend to be much simpler and we don't think much about it. If you get a scratch or small wound, you put some neosporin on it and be about your business. If it's a larger wound, you make a quick trip perhaps to the 24-hour emergency room and get yourself fixed up. But I've realized through exploring these avenues, that many of us are perhaps more dependent than we think on our "band-aids and neosporin". If we found ourselves without our two easy fixes and no emergency room in reach, would we know what to do? How many of us know how to keep a wound clean without alcohol and antibacterial creams available?

Classes begin

Submitted by Michaela Sholes

MoM and the AvTech girls had a great first class together for this term and I'm looking forward to more sessions with them! The girls and I reviewed their First Aid curriculum, practicing taking vital signs on each other and Mavis, our cook, as well as going through each stage of the Patient Assessment System. I think my favorite part was definitely the discussion time towards the end of the session, where we had an insightful conversation about the role of a health worker, particularly when it comes to local cultures and beliefs and the interaction with modern medicine. Emanuella shared common beliefs from her area and seemed to grasp the need for balance between culture and modern medicine almost immediately. I have no doubts that these girls have the right stuff to bring insightful, caring, and dedicated health education to current and future communities.