Secondary Health Care And Tertiary Health Care A Compulsory Program In Health Policy

Chapter One

1.1 Brief Introduction of Client.

Madam “N” is a wife of Mr. Selbar from the family of Selbar Nimlyat a 40 year old middle age woman.
She is about 6.5metres tall and slim she is black in complexion and was brought to the comprehensive health Jos University Teaching Hospital (JUTH) Zamko branch Langtang North LGA Plateau state. The woman was brought to the hospital with the history of snake bite by her husband Mr. Selbar on the 12th August 2017 at about 4.30 pm, with the following signs and symptoms:-blood from the site of the bite, Swollen legs, pains and tenderness, headache, fever and fangs mark of the snake (two punctured wounds).

1.2 Health Condition of the Client.

In the consulting room during history taking, the patient was made to understand that she was bitten by a snake, a carpet viper venomous snake (poisonous snake type.) while returning home from the farm at about 3.30pm.

1.3 Diagnosis

After the history taking she was admitted for observation and a laboratory investigation was conducted to determine whether the venom have been circulated to the blood or not. The lab test conducted is called” clotting time” which is usually observed for 20minutes.

1.4 First Contact with the Client.

My first contact with the client was when she was brought to the hospital’s emergency room with the history of snake bite on the 12th August 2017 that I picked interest in the case after the Doctors’ consultation and declaration of snake bite which the snake was killed and brought alongside with the patient.

1.5 Case Study Background.

Madam N’ was the first born of her family before gotten married to Mr. Selbar , she was borne grew up in Jimakwi village of Mikang LGA of plateau state Nigeria. She married in the same village

1.6 Immunization History.

The history of immunization of Mrs. N” was not certain at that time that she was borne, but she was vaccinated against cerebrospinal meningitis vaccine and measles vaccine during the measles out braked that time without any updated records.

1.7 History of Previous Illness.

According to madam N” explanation, she was once admitted in the General Hospital Langtang North sometime in 2014 for chronic typhoid and malaria fever after laboratory investigation.

1.8 History of the Present Health Condition.

The present medical history of madam N” is accorded to snake bite in the farm as the client was working in the farmland of maize and yam. She did not wear any protected farming gadget like rain and hand gloves. The history also shows that the client had finished working in the farm and was about to go home when incident occurred.
On Examination, there was swelling, fang mark seen at the right leg. (R)leg fever and headache was also present.

1.9 Family Social History.

The husband’s name is as follow:

Sure name: Nimlyat
Other names: Selbar Nanjing
Religion: Christianity
Occupation: Driver
Sex: Male
Address: Before Baptist church Jimakwi (Mikang LGA Plateau state)

Client Data:

Sure name: Selbar
Other names: Mrs. “N” Nanjing.
Occupation: Farming
Sex: Female.
Address: Before Baptist Church Jimakwi Mikang LGA

1.10 Family Graphic Table Showing the Family Paedagary.

..available in the complete material

1.11 Past Family History.

In the family of N”, there is no serious family health history ever known to both the family at the father’s house and also in the husband house (matrimonial home). However, they both had one time or the other experienced malaria and also typhoid attacks. These were treated accordingly.

1.12 Present Family History.

The present family history of madam N” is seen as the first wife of the family of Mr. S” who have two wives, but the second wife had just divorced the husband due to unknown caused. Madam N” could also be seen as the first child of mother. The families have no any serious ill health condition or medical challenge. However, madam N” is a mother of six children. There are four (4) boys and two (2) girls. The names of the family members and children and their age are as follows:

Mr. Selbar Nanjing Nimlyat —- 1971 = 46 years = Father
Mrs. “N” Selbar N. Nimlyat —- 1977 = 40 years = Mother
Patu Selbar —- 1997 = 20years =1st Child
Lohnim Selbar —- 2002 = 15years =2nd Child
Sunday Selbar —- 2008 = 9years =3rd Child
Sarnak Selbar —- 2010 = 7years =4th Child
Godsave Selbar —- 2013 = 4years =5th Child
Nanmwa Selbar —- 2016 = 1year =6th Child

1.13 Present Medical History.

As been explained before, the present medical condition of Madam N” is snake bite from the due to unprotected farming gadget like rain boot, hand gloves and rain coat.etc. The above mentioned equipment serves as protected gadgets against external reptile bite or insect sting like snake bite or scorpion sting. In respect to the above, I was able to provide the rain boot and the hand gloves to the client to prevent further occurrences. I also advised her on environmental sanitation and bush clearing to avoid harboring of reptiles malaria vectors, also to provide toilets facility to avoid opened defecation which almost resulted to second episode of snake attack but God almighty intervened.

1.14 Objectives of the Study.

The main objective of this study is to establish a friendly and lasting relationship with the family for the purpose of supporting and promoting health.
To create awareness and health educate the peasant farmers on the use of protective gadget when farming or rearing animals.
To assessed the health status of madam N”.
To visit the families at home in order to make direct observation of their mental, physical, social and economic status within the content of their environment.
To create awareness about snake as a poisonous and deadly reptiles to human being.
To identify complications of snake to human being, animals and environment at large.
To produce report at the end of interaction with Madam N” and family.
To proffer solution to government for assistance on snake bite or government intervention on snake bite.
To know that snake bite is deadly.
To identify and know the classification of snakes and their types.

Chapter Four

Summary, Conclusion and Recommendations

4.1 Summary

Mrs. “N” received a prompt attention and adequate care from the snake bite which is an emergency case. She recovered fully and was discharged after 5 days of admission in the hospital on drugs and subsequent medical review.

My visits were all successful; I was given a good reception by members of the family and the entire community. The families were happy with the knowledge they got from me through the health talk and education by observation.
I succeeded in educating the family and the entire community about environmental sanitations and personal hygiene, and provision of toilet facility to avoid snake bite attack.

They were also advised to give prompt attention to victims of snake bite and visit the nearby clinic or hospital for medical attention.

4.2 Conclusion

Conclusively, with this family care study of Mrs. “N”, I gained and benefited from it seriously as I was able to interact with people, know their health behavioral practices and correct them where necessary.
I established a very strong and cordial relationship with the family and became a family friend to them.
The care also improved and promoted my communication skills on inter-personal relationship, communicating, counseling and interviewing skills

The family of Mrs. “N” and the entire community of Jimakwi village benefited from my visits as they were able to clear their surroundings make pit toilet, and control dumping of refuse (proper refuse disposal) their behaviors towards health and personal hygiene were positively affected.

If these clients care study will be a continuous program, most of the community members would have benefited from it so as to positively touch their life style toward improving health of the nation.

The knowledge of the snake bite and the management was a thing of great concern to many peasant communities/farmers.

4.3 Recommendations:

Since it has been known that snake bite had killed or causes the death of people irrespective of the age estimated 17 million worldwide every year, I am urging the Federal Government of Nigeria through the Federal Ministry of Health to complement the efforts of peasant farmers by providing the following items:

Farming gadgets e.g Rain boot, rain coat, and
Hand gloves
Collaborate and provide anti snake venom to farmers for free.
Build more standard hospitals/clinics that specializes in the treatment of snake bite.
Federal Government should also provide soft loans for farmers to purchase more mechanized farming equipments to curtail the snake bite cases.

The Federal Government should include home visit in Primary Health Care, Secondary Health Care and Tertiary Health Care a compulsory program in Health policy. This will also provide mobile services to enable the less privilege benefit from the Health Care services.

The government should also sponsor researches on anti snake venom so that it should be produced here in original.

The Department of Community Health Kwara State University (KWASU) should ensure adequate time for this family/client care study so that student will have sufficient time to study and provide necessary information needed.

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