UNIVERSIDAD NACIONAL “PEDRO RUIZ GALLO” FACULTAD DE MEDICINA HUMANA MEDICAL ENGLISHTEACHER:Dra. ROSA GONZÁLES LLONTOP. GROUP 08STUDENTS: AGIP ALARCON WALTER ARBOLEDA DIAZ OSCAR BECERRA SILVA FRANK CAMPOS TAPIA ALEXANDER CARRASCO HERRERA DENIS PISCOYA TENORIO JORGE PLASENCIA DUEÑAS ESTEBAN RIVERA PAICO MAYRA ROJAS RUIZ ROMMEL SALAZAR SALAZAR EDUARDO TINEO TINEO DENNY LAMBAYEQUE, DICIEMBRE DE 2011.
INTRODUCTIONIn Health Center ToribiaCastro of Lambayeque UNPRG studentsthe second year of medical school we made a humancommunity work in public health based on health care to thepopulation in the areas of protection, promotion, recovery andrehabilitation, finding a significant relationship at the beginning ofthe basic actions of public health relations between infectiousdiseases and low living standards. Thus began the rise ofcommunicable disease control and some sanitation activities. Italso is working on actions to promote health for different agegroups and occupational health and mental health. In thisprocess the health institutions are organized through the creationof Ministries of Health and Social Security institutions as in the caseof the health center Toribia Castro. The research group toconduct several research and observation and pregnant patients,the drug discovery and natural medicines that people use asusual in their daily lives, change the way you see the perspectiveof health is well that ends in that health must necessarily beunderstood, analyzed and interpreted within the overall contextof economic and social development. It should be noted that thehealth conditions the process. Development is conditioned by thedifferent variables involved in this process. By virtue of this healtheffect is a phenomenon resulting mainly from the interaction ofpolitical, economic and cultural factors
SCHEDULEWEEK ACTIVITIES1 week Reconnaissance of zone and health center Toribia Castro2 week Situacional Diagnostic of “February 18”3 week Identification of health care providers and health determinants in Lambayeque4week Inquiry about medicinal plants in the Model market of Chiclayo5 and 6 weeks Intramural description of the work in the health center Toribia Castro7 week Situacional Diagnostic of “Old Mocce”8 week Elaboration of “Old Mocce” map9 week Familiar name in every home of “Old Mocce”10 and 11 week Family Records in “Old Mocce”13 week Training of vaccination
HEALTH CENTER TORIBIA CASTRO CHIRINOSDESCRIPTION OF THE FUNCTIONS OF STRUCTURAL UNITS A. SITUATION ROOM The young village is inhabited by a large number of people who are in poverty and extreme poverty.
B. LEADERSHIP AND MANAGEMENT FUNCTIONS Manage the activities of health maintenance and meeting the health care needs. Efficiently manage human, financial and material resources to the health center according to the parameters of productivity.C. MEDICAL RECORDS The health center collects the information needed to provide proper care for such care, preventive and social development.D. ADMISSION The unit that coordinates and integrates care movements and contacts of all patients in the hospital complex and specialized care in your area.E. TRIAGE Try to avoid delay of patient care would worsen the prognosis for the delay in their care.F. CHECK UP ROOM The health center provides personal attention to each patient taking into account the socioeconomic, cultural and environmental comprising this jurisdiction.
G. SENIOR OPERATIONAL UNIT Its purpose is to promote healthy aging through the implementation of family support programs.H. DENTISTRY The goal is to maintain oral health of the population, providing basic preventive dental care in order to promote self-care oral hygiene and healthy habits of non-cariogenic food, intervening on risk factors.I. NURSING The hospital has the function of primary health care in a society which provides human resources prepared to strengthen the health plans.J. MATERNITY WARD We found: • Bed where delivery is made. • Surgical Light Source. • Warmer to receive the newborn.
K. STERILIZATION ROOM Is the service you receive, conditions, processes, controls and distributes textiles, biomedical equipment and instruments to all sectors of the hospital, to provide an input safe for use with the patient.L. PUERPERIUM This environment is for mothers after childbirth, is for the recovery of the breastfeeding mother and the newborn.M. OBSTETRICS The specialist controls the pregnant woman regularly to monitor possible problems during pregnancy that may be detectable.
SITUATIONAL DIAGNOSIS OF 18 FEBRUARY1. GEOPOLITICAL SITUATION:A. REGION:SKETCH: 18 FEBRUARYDREN Huaca LosChinos church A E B Children’svillage s C Wáter distribuidor church F D G Soccer field wells FARMSUPIS: Urbanización Popular de Interés Social
GENERAL INFORMATIONFounded 9 yearsService light 5 years agoProgram "Water for All" (for Mz. A, B and half of E)Sale of water: 0.40 x 1 or 3 buckets sun.B. ORGANIZATIONS, AND MEDIA SERVICES According consulted the residents themselves. PUBLIC SERVICES: Families of young people 18 FEBRUARY do have the basic services of public lighting and electricity in their homes. But so you do not have it with water and drain. Families are provided with water through a tank of the Regional Government of Lambayeque, which carries water 2 or 3 times a week, but currently under repair.For this reason the people are forced to buy at 60 cents a bucket of water sun for human consumption, this purchase makes you a man of his community, which is not known as it gets. They also have some grounds to remove the water but this is not suitable for human consumption, so only use it to wash your clothes or other complementary actions.C. MAIN PROBLEMS AND NEEDS OF THE COMMUNITY: ENVIRONMENTAL ISSUES SOURCES OF CONTAMINATION In human settlement "February 18" sources of pollution that cause the most common diseases in the locality are: a) Within the household Water: The lack of water and sanitation services have become the main problem affecting the area. So hopefully digestive disease outbreaks. Housing: Housing made of materials such as adobe, mats, thatch, among others are the habitat of various
microorganisms that cause disease. The floor being of earth, is a strong focus on respiratory diseases, bronchitis, etc. Food: That washed with water unfit for consumption or undercooked foods may be causing digestive diseases. Animal husbandry: Inside the house is dangerous, as the hair of attending these places also frequented by people and cause massive contagion of disease. Centers of work, school, meeting: it is inevitable that every day and establish social relationships with people. b) Outside the home: Landfills, which accumulate in the corners of houses, or in the ditches represent foci of infection that are the haunt of scavengers and insects that carry disease. Food stalls, canteens: People who suffer from diseases due to ignorance or irresponsiblySOCIO ECONOMIC PROBLEM After the recognition of the area we have an overview of the critical situation being experienced by the community. That issummarized as follows: The level of education of its residents is quite low, since not everyone can access it. Apparently there are no neighborhood organizations to expose their problems to authorities. Total disregard of the authorities to solve the basic problems affecting the community. Poverty, frustration and exclusion, and social deviance models to which they are exposed most of these residents make this community can be fertile ground for crime.2. EPIDEMIOLOGY OF POPULATION: After making home visits, we learned about the major diseases afflictingthe population. Digestive System Diseases. Diarrhoeal diseases. Respiratory Diseases.
HEALTH CARE PROVIDERS IN LAMBAYEQUEWalking throughthe streetsof the district ofLambayeque, we observesome places wherehealth servicesareofferedboth conventionalandalternative.We willdiscusstheseestablishments: 1. FORMAL HEALTH SERVICES: PUBLICHEALTH SERVICES HOSPITAL "TEACHING HOSPITALBELEN-LAMBAYEQUE PROVINCIAL" HEALTH CENTER"TORIBIACASTRO" HEALTH CENTER"SANMARTIN"
2. EMPIRICAL MEDICINE PROVIDERS:On the streets ofLambayequeand inthe marginal zoneofOldMoxeefindsome people whoare dedicated to providinga typeofhealth carepracticesbased onempiricalandhighlightingtraditionalmidwives,bone settersand shamans.Lets lookateach:a) MIDWIVES.Midwife isaperson (usuallya woman)whoassists the motherduringchildbirthandinitially acquiredherskillsattendingtheirbirthsorherselfworking with otherTBAs. EmelinaMs.PerezGonzalez domiciled in theMzGLt 24 told usasis that fromliving inMoxeoldbegan providingservicestopregnantandpostpartum womenprimarily.b) BONERS.They aretraditionalmedicine specialistswho master the techniquesaimedattreating various disordersof the musculoskeletal system, using themassage ordog-earedin therapy.c) SHAMANS.It is an individual who is creditedwith the ability to heal, tocommunicate with spirits and
presenting visionary and divinatory skills. Moxeareaarereferences to thefamousMr.Chicomasobadorwhose jobit wasinherited from his fatherwho wasconsidered the bestsobadorofLambayeque. DETERMINING FACTORS OF THE HEALTH IN LAMBAYEQUEs DISTRICT 1. PROTECTIVE FACTORS: The accessibility to services of health and the community activity of these (specially the realized one for the center of health Toribia Castro) is the principal protective factor that reaches to this sector of the population. Sector possesses the basic services of water, outlet and light. The streets asfaltadas also constitute a protective factor. Many educational centers that they find are important also for the information role.
The parks and gardens that not only act supporting the local ecology, but they serve as elements of distraction and anti stress. Also we possess Lambayeques fire brigade. The Center of the major adult, located in A. B. Leguía 269- Lambayeque, orientated to improving the process of the aging, by means of the development of programs, sociocultural, recreative, productive of familiar, intergenerational integration and of ways of life for an active aging. In the intersection of the streets Augusto B. Leguía and SebastiánOnetto we find to the CEDIF-Lambayeque (Center of Integral Development of the Family) of the INABIF, which offers food help to children in extreme poverty.
The workers union of civil construction, which also is a protective factor of health for the worker. Also there exist services of recycling, which favor the decontamination of Lambayeques sectors.2. FACTORS OF RISK: One of the principal factors that put in danger the health of the population is the irrigation ditch that runs along the north margin of the zone. In her they find important centers of infection as heaps of garbage. The upbringing animal, especially cattle, which can predispose some zoonosis. The terrible condition of the network of outlets is really worrying since the places are different where there are situated collapses and exhibition of the served waters.
As well as there exist zones of considerable urban development, they think also, adjacent, different very poor, that they are not asfaltadas with housings adobes, in precarious condition, with accumulation. Garbage in not suitable places: Part of the street SebastiánOneto. LAMBAYEQUE MEDICINAL PLANTSDEFINITIONAre those plants with several active substances are used in curative orpalliative treatment of certain diseases.IMPORTANCEKnowledge of the use of medicinal plants for our health is of vitalimportance due to easy availability and low cost they have.The use of medicinal plants must be very responsible, taking therecommended doses. If discomfort persists, it is important to consultpeople with more experience in the use of medicinal plants and doctors.What are medicinal plants that have the greatest demand?Depends on the season:Summer: DesinflamanteWinter: Respiratory diseases: chamomile, peppermint, anise, lemonverbena.
HERBALISM "MIRACLE CHILD" SINCE 80Mercado.Model - Position. 80 - "B" (Cradle Sector) - Chiclayo, PeruRepresentative: Segundo Elmer Cruz Aldaz: specialist in medicinal plants,treat diseases: epilepsy, kidney, prostate and spills.Mr.ElmerCruzgave usto know theherbsthat healevery diseaseor serveas adietary supplementto preventdiseasein particular:
Blood:Moradillo, canchalagua.Stress:Valerian, marjoram, rosemary.Cholesterol:dandelion, pasuchaca.Constipation: sin with orange,honeyland (cleanse the digestive tract).Nerves:burnet, marjoram.Asthma:chilco,pulmonaria.Cancer:cats claw.Diabetes:blackberry.Inflammation:annattoAllergy:NorbaCirrhosis:extract,dandelionsaladserved withhoneyor juiceof land.Gall:Chancapiedra, ponytail.Muscle pain: analgesicherbs, welded withwelding,bloodsucker.Acne:bloodroot,Moradillo.Laxative-Antiparasitic:sen.Epilepsy:preparing aMasssteeped inwine, and mixed: Heart of theCondor, peak toucan,turkeyblood, 7 seedsmountain,beargall, gall of thehandle.7 herbsalsoare mixeddepending on thetype of disease.The treatmentiscomplemented bybathroomsevery 15days.Prostate:achiote, sour sop, calahuala, horsetail, shepherds purse.
INTRAMURAL ACTIVITIES AT THE HEALTH CENTER1. THE MEDICAL CONSULTANT The medical consultation is the main opportunity for the doctor to explore the patient’s problems and concerns and to start to identify the reasons for their ill health. Now let’s see its structure: Initiating the session gathering information physical examination explanation and planning closing the session2. OBSTTRICS AND GYNECOLOGY Obstetrics is the medical specialty dealing with the care of all womens reproductive tracts and their children during pregnancy (prenatal period), childbirth and the postnatal period.
Uterine Measurements During Pregnancy The fundal height--measured from the top of the pubic bone to the top of the uterus--is generally measured in centimeters, and its a measurement, as you might suspect, that should increase as the pregnancy continues toward your due date. Even though the fundal height is generally a diagnostic tool held over from the days before ultrasound, it is still useful in large clinics where the same patient may not get the same doctor twice in a row for her prenatal visits.
Naegeles Rule: It is a standard way of calculating the due date for a pregnancy. The rule estimates the expected date of delivery (EDD) by adding one year, subtracting three months, and adding seven days to the first day of a womans last menstrual period (LMP). Theresultisapproximately 280 days (40 weeks) fromthe LMP.3. NURSING-CHILD CARE CHILDREN’S IMMUNIZATION SHEDULE Vaccinations are some of the most important tools available for preventing disease, according to the U.S. Centers for Disease Control and Prevention (CDC). Vaccinations not only protect children from developing a potentially serious disease but also protect the community by reducing the spread of infectious
PHYSICAL THERAPY AND REHABILITATION MEDICINE Physical therapy (or physiotherapy), often abbreviated PT, is a health care profession. Physical therapy is concerned with identifying and maximizing quality of life and movement potential within the spheres of promotion, prevention, diagnosis, treatment/intervention, and rehabilitation. Thisencompassesphysical, psychological, emotional, and social wellbeing. Physical medicine and rehabilitation (PM&R), physiatry or rehabilitation medicine, is a branch of medicine that aims to enhance and restore functional ability and quality of life to those with physical impairments or disabilities. A physician having completed training in this field is referred to as a physiatrist or rehab medicine specialist. Physiatrists specialize in restoring optimal function to people with injuries to the muscles, bones, tissues, and nervous system (such as stroke patients).PSYCHOLOGYBENDER-GESTALT TESTThe Bender Visual Motor Gestalt Test, or simply the Bender-Gestalt test, isa psychological test first developed by child neuropsychiatristLaurettaBender. The test is used to evaluate "visual-motor maturity", to screen fordevelopmental disorders, or to assess neurological function or braindamage.
MATERIALSTHE MACHOVER TESTThis test is often used today in connection with psycho dynamicevaluations and diagnostic assessments of children. The evolution ofdevelopmental theory and the way in which childrens psychologicaldifficulties are assessed has changed during the years. When interpretingthe Machover material an integration of theories from drive psychology,ego psychology, object relation theory and the theories concerning theselfs development is recommended.
MOCCE ANTIGUO MAPIn order to support a research project with Dr. Patazca, went to theLambayeque sector: MocceAntiguo, for to do a sector map, toinvestigate the chiefs of the area, to assess whether the services sectoraccounts for water, sewer and electric lighting, to examine whether theconditions of life are apt to have a good health and to recognizing andliving quarters uninhabitable.The map was prepared as follows: we form groups of two to ask thename of each family block by block, and one of us separately inquiredwho the authorities of the sector.
FAMILY RECORDSHealth Center: _______________________ House Nº___________I. GENERAL DATES DATE: ___________ Day: _____ Month: ______ Year: ________ II. RISKSector: _________________ Locality: ________________ Familiar Last name: ___________________ Nº Members: ____________Address: ________________ Benchmark: _______________Nº Families: ____ Nº Contributors: ____ Religion: __________ Language: _______ HIGH MEDIUM LOWIII. FAMILIAR COMPOSITION
GENOGRAMA genogram is a format for drawing a family tree that recordsinformation about family members and their relationships, of over at leastthree generations. The genogram is an excellent way to represent thecomposition of family data in a concise and readable. Data can beadded as they are collected.The family genograms display information in a way that provides a quickoverview of complex family patterns and a rich source of hypothesesabout how a clinical problem may be connected to the familycontext and the evolution of the problem and context over time.Genograms show three levels: The structure of a family: explains how family members are linked together, either biologically or legally. Recording family information: demographic information on the operation and critical family events. The relationships between family members: using different types of lines to symbolize different relationships between family members.Utility: Management of serious illness or death, symptoms shared by other family members. Assessed and management of common symptoms. Identifying the cause of symptoms rather than focusing on the patient presents. Anticipate or prevent medical problems. Considering and managing acute and chronic biomedical problems induced by stress. Recognize, diagnose, perform counseling or genetic problems registering. Diagnose and manage emotional and behavioral problems influenced by familystructure and function. In abuse and drug use.Genogramcontent data: Three or more generations. The names of all family members. Age or date of birth of all family members. Death, including age or date and cause.
Significant diseases or problems with family members. Demarcation of the family members living under one roof. Dates of marriages and divorces. The member who was born first must go to the left and right siblings, in descending order. Description of the symbols used. Symbols selected for simplicity and maximum visibility.Some symbols used in the genogram: members living in thehome evaluated, are contained in an en closed space within thegenogram.
ECOMAPThe eco-map is a supplement to familiograma and a great visual aid forthe family health team in understanding the environment in which lifeunfolds headed households. Its routine use is intended to represent thefamily and their contacts with their supra, the environment around them:the extended family, work, recreation, education, health services,educational institutions, the religion, etc.DESIGN AND PERFORMANCE OF ECOMAPASThe eco-map consists of a central circle containing the familiograma of thefamily, living under the same roof, around the center circle are locatedother circles representing friends, health facilities and education, work, theextended family, etc., in the context of the nuclear family.The size of the circles surrounding the familiograma can be variable andmust conform to the requirements of the design. Lines are drawn betweenthe family and the outer circles to it to indicate the nature of theconnections. The dotted lines indicate connections tenuous. Dashed linesindicate relationships stressful. The wider lines indicate greater union. Thearrows that are used can be drawn along the lines indicating the flow ofenergy and resources. Additional circles can be drawn if needed;depending on the number of significant contacts you have family.UTILITY He points out the interactions of the family and each of its members with the systems that surround and summarized in graphical form. Allows you to identify potential sources of stress or conflict. Suggests resources to mobilize in times of crisis. Indicates whether some people have good relationships with elements outside the family.