Practical Issues

Practical Issues

The simple things are really important
Observing hand hygiene, safe practice with sharps, Infection control, privacy and dignity.

Take with you:
At least two pairs of scrubs and wash them every day. Take sufficient gloves for yourself (5 pairs per day) 

Mosquito spray (50% Deet), comfortable shoes, a watch with a second hand for observations, a thermometer  (these are always in short supply) and a head-torch.

In the event of ....
Needle stick injury.
IMMEDIATELY FOLLOWING EXPOSURE

  • APPLY FIRST AID :
  • Encourage local bleeding of accidental puncture wounds by squeezing, rinse under running water.
  • Flush splashes to nose and mouth, or skin with running water
  • Irrigate eyes with clean water, or saline.
  • DO NOT SUCK THE AREA Wash the affected area with soap and warm water.
  • DO NOT SCRUB THE AREA Treat mucosal surfaces such as mouth or conjunctiva by rinsing with warm water or saline. Water used for rinsing the mouth must not be swallowed.
  • DO NOT USE BLEACH ON THE INJURY

 Kilimatinde based students Report the injury to:
 Dr Bertha           0755435293   1st contact or if unavailable 
 Dr Chihoma
      0767225353    2nd contact 
Manyoni Based Students  Report the injury to:
Dr Kitundu  Manyoni         0783848413                                                                                                   
Who will arrange blood tests, Assess High or low risk according to source, type of fluid HIV status and supply PEP. If Status is not known or unobtainable assume yes.
Both Hospitals have a Central testing centre for HIV on site and are confident in HIV PEP .It will be helpful if you find out the location on your first day .
TAKE CARE WITH SHARPS.
PEP needs to be given as soon as possible and preferably within an hour. 
PEP is generally not recommended beyond 72 hours. 
In The event of.....
Animal scratch or bite

  • Acton following a bite irrespective of rabies risk
  • Scrub with soap and water preferably running water for at least 5 min
  • Remove foreign material (e.g. dirt, broken teeth)
  • Rinse with Plain Water.
  • Irrigate with Betadine, povidone- Iodine, or 40% alcohol such as Gin or Whisky.
  • Present urgently to the hospital.
  • If animal is suspected to have Rabies .Treatment is available in Manyoni
  • Snake bites urgent medical attention and anti-venom needed.
    Risk Reduction
  • Avoid close contact with domestic or wild Animals.
  • Especially avoid contact with wild animals that appear unusually tame.
  • Report any suspicious animal behaviour, e.g. rabid dog.
     
    In The event of .......

Malaria
If you are feeling unwell, headache nausea, Temperature and have been bitten and forgotten to take anti- malarial Tablets
Report to: Dr in charge at respective sites who can arrange Rapid diagnostic test (you may be able to do this yourself!)
Risk reduction

  • Bite avoidance
  • Long sleeves , socks .Especially in the wet season
  • Use Deet on skin and spray nets
  • Remember to take your Anti-Malarials
  • Prompt Diagnosis and treatment

 
In The event of .......
Diarrhea
Diarrhoea Self Treatment

  • < >< >Bismuth subsalicylate
  • Ciprifloxcacin or rifamixin
  • Protocol if not improving .blood mucous.
  • Self treat if prescribed and seek reputable medical attention.

You should be at least 24 free before you go back into the clinical area.
Diarrhoea Risk reduction

  • Drink safe
  • Boil kills everything
  • Filter kills protozoa /some bacteria (does not kill viruses.
  • Disinfect _kills bacteria/Viruses ,does not kill protozoa.
    Eat safe go with the locals boil it eat it forget it.
     
    In The event of.....Getting Lost : 
    Telephone  Laurent  Hospital administrator  0753368998   Kilimatinde

 Daudi Mannasha  0657015494 and  0752316215  or Manyoni
 Deogratiuos    Manyoni Guest house manager   0687072372
Or David  Taxi in Dar 0752378688 
Risk  Reduction 
See useful phone numbers and keep them in your Pocket /and phone.
Please Report any other accident or incident to your supervisor. 

First Aid
There is a small supply of first aid supplies in Kilimatinde bungalow, we are trying to build up a supply for Manyoni .If you bring any items you don’t use please leave for other students. Check dates
There is a pharmacy on both sites where you can buy supplies cheaply.
There is a first aid book on each site.
Remember 
Avoid dehydration
Look after your skin
Eat safe
Enjoy
Personal well being Stress, anxiety, homesickness

  • Culture shock
  • Working outside personal boundaries
  • Working with reduced resources
  • Little opportunity to communicate
  • Being different

Coping strategy Personal support system

  • Colleague network (Kili facebook page )
  • Communication with home links (phone systems are difficult .Don’t forget your passwords.
  • Join in things eg Masada Choir Practice : Kilimatinde Church Tues 6.30 pm.  Craft group for children: St Johns s School Saturday 2-4  Mishkaki and chip shop - Kilimatinde village each evening and lunch time.
  • TALK ABOUT IT - Enjoy your experience