2. DEDICATION
We dedicate this report and work to our parents, uncles, relatives, friends and our school
administration that guided and supported us throughout this internship. We want to say
thanks and express our heartfelt gratitude for their relentless efforts.
3. ACKNOWLEDGEMENT
We say thanks to God almighty for guiding and leading us throughout this internship. We want
to say thank you most especially to the Chief of Center, community representative, community
health workers and the entire staff of district hospital of Manjo for taking out time to teach,
correct, direct and supervise all the activities we carried out daily and for helping us to acquire
knowledge. We want to thank the entire staff for their relentless efforts in helping us acquire
4. the best and we say a big thanks to our parents and families for supporting both financially and
morally.
Moreover, we will like to thank ST LOUIS HIGHER INSTITUTE OF MEDICAL STUDIES
and their entire staffs for their relentless efforts in makes sure we gain knowledge out of classes
and also to make sure the internship was a success though with all the challenges they had
during these periods.
Finally, we acknowledge ourselves for the good work during the one month of internship at the
district hospital of Manjo.
TABLE OF CONTENT
Contents
DEDICATION.......................................................................................Error! Bookmark not defined.
ACKNOWLEDGEMENT ...................................................................................................................... 3
LIST OF ABBREVIATIONS................................................................................................................. 6
CHAPTER ONE..................................................................................................................................... 7
INTRODUCTION .............................................................................................................................. 7
5. INTERNSHIP OBJECTIVES............................................................Error! Bookmark not defined.
SPECIFIC OBJECTIVES..................................................................Error! Bookmark not defined.
DURATION AND SITE OF THE INTERNSHIP ............................Error! Bookmark not defined.
SIGNIFICANCE OF THE INTERNSHIP.........................................Error! Bookmark not defined.
CHAPTER TWO ...................................................................................Error! Bookmark not defined.
DESCRIPTION OF THE HEALTH FACILITY.............................................................................. 11
History of the hospital........................................................................Error! Bookmark not defined.
ORGANIZATIONAL CHART OF THE HOSPITAL ..........................Error! Bookmark not defined.
FUNCTIONAL DEPARTMENTS OF ST. PADRE PIO..................Error! Bookmark not defined.
CHAPTER THREE: ..............................................................................Error! Bookmark not defined.
DISCUSSION OF SPECIFIC OBJECTIVES .................................................................................. 19
DESCRIPTION OF THE ACTIVITIES OBSERVED AND PERFORMED UNDER
SUPERVISION AND INDEPENDENTLY......................................Error! Bookmark not defined.
CHAPTER FOUR..................................................................................Error! Bookmark not defined.
CONCLUSION................................................................................................................................. 40
SWOT ANALYSIS .......................................................................................................................... 41
RECOMMENDATION .....................................................................Error! Bookmark not defined.
REFERENCE.....................................................................................Error! Bookmark not defined.
6. LIST OF ABBREVIATIONS
COC: Chief of center
ANC: Antenatal clinic
OPD: Outpatient department
D/C: Dilation and Curettage
BP: Blood pressure
POP: Postoperative/preoperative
H2O2: Hydrogen peroxide
N/S: Normal saline
IV: Intravenous
IM: Intramuscular
ORS: Oral rehydration solution
DHM: District Hospital Manjo
7. CHAPTER ONE
1.1INTRODUCTION
An internship is a professional experience that offers meaningful, practical work related to a
student’s field of study or career of interest. Internship is all about giving students the
opportunity for career exploration, development and to learn new skills related to their field of
study, It is also all about building students capacity and ability and getting them ready for the
field of work. Internships help to broaden and add more to what we have learned in school, not
just the written but mostly the practical part of what we learned.
As interns, especially in the medical field, we need to be practical, assist and contribute to the
team and the community, learn and gain experience, practice patience, self-control and above
all learn to communicate with colleagues, community and patients.
Moreover, community internship is a type of internship that involve direct contact between
the interns and the community at large, in other words community internship is a full-time
commitment that requires a high level of dedication and interaction with the community and
interns.
1.2 BACKGROUND STUDY
Our internship was carried out at District Hospital Manjo for a period of one month, that is
from the 21st
of March to the 21rd
of April 2023. It was community base internship and our first
community internship.
For this period, we work in all the units in the hospital for both night and day shifts(maternity,
OPD, laboratory ,minor theatre and the medical ward) for the first week and the last week of
our internship and also went out to the community where we gave out health talks in schools,
bars ,meeting points, door to door visits in association with some organisation for which they
came out during this endemic(typhoid) to provide aid to the community of Manjo.
During this period of community internship, we acquired new knowledge on the basics of how
the health centers is link to the community and how the basic needs of the community are
managed at the district hospital level before further investigation are carried out if needed.
The internship was not an easy task for us as we had to managed the thinking and reasoning of
the people of the community, although it was a great experience in our site as we were given
opportunity to put in action what we studied in school in practices, especially when it comes to
certain procedures which requires rational. We learn many new things, and part-take in so many
aspects as well as asking questions and thus our doubts were clarified.
8. These community internships was a great period in our carrier although the first one as we
mainly carried out activities under supervision and on our own. As this one help us to identify
some of the challenges the community face that is a major treated to their health and as it also
helps us to identified research topics as we climb our career ladder
1.3. INTERNSHIP OBJECTIVE;
1.3.1 GENERAL OBJECTIVE;
The aim of the internship was to permit and help students to observe clearly the practical
part of most or all what is being taught in school, to have an overview of how the
hospital and the community works and its administrative setup, acquire a basic notion
of team and group work, acquire good working attitudes and respect for hierarchy and
keep good records and statistics.
1.3.2 SPECIFIC OBJECTIVES
Utilise the primary health care concept in managing families in a community setting.
Apply principles of community mobilization to promote health.
Identify key players of health in the community.
Identify the health dialogue resources and inquire about their activities.
Give health talks to school, churches as well as other significant social groups in the
community.
Identify the activities of the health area and the priority programs implemented in the
health area and participate actively in their success including mobile vaccination
programmes, clean-up activities, distribution under supervision of essential drugs in
primary health care.
Identify the social behaviours and patterns of behaviour to which affect the health of
the community (market, slaughter house, water catchment, traditional birth attendances,
alternative medicine and school)
Help families or communities to make the link between selected nuisance factors and
identified health behaviours in order to find simple solutions together.
Bring family or the community to organize them in order to put into practice the chosen
solution.
Direct families to use other development sector (related sectors) to resolve specific
issues
Help members of the community to empower themselves on the health plan
9. Apply communication techniques as taught in any problem solving. This involves
taking active part in community health sensitization programmes
Evaluate the activities carried out with the community
Identify at least three health problems in the community and propose solution to these
problems
Writing a group report
1.4 SIGNIFICANCE OF INTERNSHIP
Community internship provide significant knowledge on how the primary sector
functions
Understanding on how the community interact with the district hospital.
Acts as a building block in one’s career.
Internship enhance student communication skills and how to withstand pressure
Provide a network between the community and the health center with base on health
talks.
For the student to have an intern opportunity to gain experience in an employment
situation in the health care setting.
Understanding of team work between the district hospital and community to fight
against diseases and prevent further reoccurrence of a disease.
Identification of health problems and provide solutions to these health problems.
To be able to collect data, analyse and interpret the data collected, improves on the body
of knowledge as medicine is dynamic and new ideas are brought into the field.
The internship provides the medical students the opportunity to experience realistic
working environment, situation and equip them as medical personnel.
It provides insight into the practice of a primary health care.
For the students to have an intern on opportunities to gain experience in an employment
situation in health care setting.
Provision of network between professionals in the field as students build contacts in
their field that is a stepping stone to additional opportunities within the same
organization.
Internship is significant in that; it allows the students to know their strengths and
weaknesses.
10. Provide students on how to conduct themselves in a professional manner thereby
respecting all ethical principles and follow the code of ethics.
Internships are a great way to apply the knowledge from the classroom to real world
experience practically.
Gain experience and increase marketability. Having an internship gives you experience
in the career field you want to pursue. Not only does this give individuals an edge over
other candidates when applying for jobs, it also prepares them for what to expect in
their field and increases confidence in their work.
Internships provide students with the soft skills needed in the work place; it also permits
students to learn how a professional work place functions.
s
11. CHAPTER TWO
DESCRIPTION OF THE DISTRICT FACILITY AND COMMUNITY OF
MANJO
The HDM is located on the heavy axis Douala-nkongsamba (the national No5), which falls
under the Litoral region of Cameroon precisely in the Moungo division. The city of manjo is a
rural commune of the Cameroon littoral region. Its area is 305km2 with a population estimated
at 34230 inhabitants, it is the capital of the district of manjo located north of the department of
moungo. The district hospital carries out activities such as minor surgery, antenatal,
vaccination, admission, and consultation. It’s also an OPEC center which provides
psychological support to patients with chronic diseases like HIV, HIGH BLOOD, and
DIABETIES by following them up. It provides help to the community especially the less
privilege to get cheap and up to standard medical help, trained intern and other medical
personnel such as nurses, Doctors, Pharmacists, laboratory technicians and Mid wives where
they boast their performance and minimize cost in order not to make little errors as possible in
the health of the community in which they are located so as to grant quality services to the
community.
HISTORY
The HDM was created in 1956 as an elementary health center, in 1979 it became an integrated
health center; from 1980 to 1996 it became the Mandjo district hospital and from 1996 to 1997
to the present day it became the district hospital of Manjo.
Etymologically, mandjo takes its name from muame Njo which means <<elephanteau> >
because of the large number of elephants encountered in the area, their ancestors come from
several localities such as: Eban, Emeng, Ekangte, Mantem, Kolla, and the languages spoken
are: Mboo, Pijin, and French.
12. ORGANISATIONAL STRUCTURE OF THE HEALTH CENTER
CHIEF OF CENTER
Figure 1.1ORGANISATIONAL STRUCTURE OF DISTRICT HOSPIAL
MANJO
MEDICAL OFFICERS
THE GENERAL SUPERVISOR
(GS)/REVENUE COLLECTOR
WARD CHARGES
LABORATORY TECHNICIANS AND NURSES
PHARMACY ATENDANT
AUXILIARY STAFFS
13. FUNCTIONING OF THE DISTRICT HOSPITAL AND THE COMMUNITY
The DHM provide services to the community with a program which run every day from
Monday to Sunday in all the units which are Medical ward, Surgical Ward, Maternity,
Pharmacy, Pediatric Ward, OPD, Pharmacy and the Laboratory have two shifts the day shift
that runs from 8:00 am to 3:30pm and the Night shift from 5:00pm to 8:00am and they are open
from Sunday till Monday.
The community have an estimated total population of about 25 thousand people and it is made
up of three set of people, business men and women, civil servants and farmers which makes up
75% of the total hand work of the people of these community.
PRODUCTS AND SERVICES OF THE ORGANISATION
Activities of the services include the following;
Consultation which may either be Admission and discharge of patients, monitoring
patients’ vital signsReferring of severe cases and monitoring of the health of the
community.
Laboratory, the laboratory is functional daily they carryout test for both in and out
patients
Dispensing of drugs to patients
Carrying out of minor surgeries, wound dressing, circumcision
Teaching patients and carers to promote good health, by given them health talks about
their health and how they can manage their health
The midwifery department is made of the ANC, family planning, maternity, labour
room and delivery room. The above listed are units on their own but they are connected
to and commonly requested for pregnant women. All these units are functional daily
except for the ANC which is not functional on Sundays. At the ANC, Mondays are
14. scheduled for first visits only. Thursdays are scheduled for pre-term mothers,
Wednesdays for postnatal visit for babies from 1-4 months, Thursdays for expectant
mothers (term pregnancies), Wednesday for postnatal visit for babies from 6-12
months. Saturdays are scheduled for check-up.
15. MAP OF MANJO COMMUNITY (VILLAGE)
Figure 2 : COMMUNITY MAP
16. ORGANIGRAM OF DISTRICT HOSPITAL MANJO
Recipe
logger
Econome Medical
supervisor
Chief of
service
Material
accountant
Nurse
Service
Agent
Babysitting
service
Medecine
Direction
General
supervisor
19. CHAPTER THERE
DISCUSSION OF SPECIFIC OBJECTIVES
We were expected to learn and practice. These include; knowing key players in the community,
activities of the people, traditional meal, the link between the health center and the community
(how information and work is related to the community), sensitization, health talks, assessing
and recording data from the community and reaction of the peoples concerning health, hygiene
and sanitation in relation to cholera and typhoid. Community monitoring and evaluation, bring
out possible problems and solutions to the problems in which the community face.
Our community internship was carried out both in the hospital and out in the community where
we were giving opportunity to have one on one talks with the families of the community and
also part take in some health related programs such immunization, clean-up activities,
distribution under supervision of essential products and drugs in primary health care, giving
health talks to schools, families, door to door visit, meeting points, quarter heads and area
where some youths come together to drink. Infection control was one of our main objectives
since we arrived when there was an outbreak of an epidemic disease that is typhoid outbreak
which was at its highest in the community and our district hospital being the main treatment
center of manjo. Disinfection and decontamination are various ways in which we carried out
in the community in other to stop the rate of infection in the environment are kept clean and
avoid any form of spread to avoid contamination or infection. It is practiced in all departments
in the hospital and the hospital environment and also in the community. Community monitory
brought us specific situation which required effective nursing assistance especially in disease
management and calculation of the rate of infection through data collection base on health
talks, sensitization and campaigns about health because they help us to know what quantity of
management should be given to a particular family and the reasons why it should be given.
Finally, management of health problems in the community of manjo district hospital is held by
the chief of center (director), quarter heads, community workers, hygiene and sanitation team
and population of manjo.
DESCRIPTION OF ACTIVITIES OF INTERN AND PLAN OF ACTION
OF EACH WEEKPLAN OF ACTION
GENERAL INTERNSHIP ACTIVITIES
20. During this period of internship, which lasted for 5 weeks, we were involved in the following
activities:
Involved in patient management under close supervision
Here each intern was giving the opportunity to manage their patients under the supervision of
one of the staff of the district hospital and after managing the patient he/she goes the person
who supervising and a remark on what each person did is made.
Involved in patient examination
During patient’s examination, each intern is giving the chance to give his or her own opinion
(the various clinical features and tests to identify what the patient is suffering from).
Community work
During this period, we meet with the community to assess their health status, assess factors that
can lead to health disorders, create awareness about infection, control and prevention.
SECTION ONE
DISTRICT HOSPITAL
ACTIVITIES OBSERVED, PERFORMED UNDER SUPERVISION AND PERFORMED
INDEPENDENTLY AT THE DISTRICT HOSPITAL
We arrival the clinic at 6:30, and started with general cleaning of the health centre,At about
8:00 AM meet with the Chief of Centre of the Manjo district hospital, the General Supervisor
presented us to the staff of the hospital and then we visited patients and then visited the entire
hospital.
At about 9:00 AM, the General supervisor then distributed us to various units in which we
spend in the various units of the hospital base on each student department of studies at school.
The district hospital is comprised of 5 units that is;OPD, laboratory, medicalunit, pharmacy,
surgical unit maternity/antenatal ward. We did carry out numerous activities and most of our
activities was done during our shifts, under strict supervision by our senior nurses, the doctors,
COC, laboratory technician for the different units found in the health center.
21. CONSUALTATION ROOM/ OUT PATIENT DEPARTMENT
Here we did observed how patients who came in to the hospital are welcome and how the senior
nurses get patients information and how vital signs are monitor and patients complain taken
down and prescription are done after the diagnosis are done with the help of laboratory result
to confirm
Vital signs monitoring
Materials
Thermometer, Pulse oximeter, Stethoscope, sphygmomanometer, scale, patient hospital
booklet alcohol and cotton
Activities observation
Here I did observed how a male of 35years of age came to the hospital with complain of chest
pain, dry cough, fatigue and headache and how he was welcome and how his condition was
managed from the monitoring of vital signs and also how to managed the range when someone
has high temperature and blood pressure, moreover how to record patients information on the
register and hospital booklet
Procedure
Welcome patient into the hospital, allow patient to rest
Prepared your materials for monitoring vital signs
if it’s an old patient, ask for the patient hospital booklet but if it’s a new patient get a
new booklet for the patient and open a file for the patient and write down the patient’s
information (name, sex, occupation, date of birth, marital status, phone number and
where the patient lives)
start by taken the patient temperature using the thermometer place under the armpit of
your patient and allowed for 3mins, after 3mins removed and read and record what you
read into patient’s booklet
Place your sphygmomanometer on the left arm and place your stethoscopes under your
cuff on the brachial artery
Pump the cuff and open it slowly and get your reading and record it into the patient
booklet
Use the pulse oximeter and get the reading of the patient pulse and record it and finally
get the weight of the patient using the scale and record it
Take the booklet to the doctor or the senior nurse
22. Activities done under supervision
Welcoming of patients at the hospital
Recording of patients’ information
Monitoring of patient’s vital sign
Blood collection
HIV test, Malaria test, typhoid test
Administration of patients medication
Taking of vital signs
Activities carried out independently
Welcoming of patients
Monitoring of vital signs
Carrying out a series of test in the lab Administration of patients medication
• Taking of vital signs
Recording of patients’ information
2) LABORATORY DEPARTMENT
The laboratory is small one, carrying out a series of test. The laboratory carried out tests of
different units such as Biochemistry, parasitology, microbiology, serology,
ACTIVITIES PERFOM INDEPENDENTLY AND UNDER SURPERVISION
Gram staining technique, MS test.
GRAM STAINING TECHNIC
Procedure
23. Prepare the slide to be viewed and allow it to dry
Put crystal violet on it and allow it to stain for 30sec and wash it off with clean water from the
tab
Putlugoliodine on the slide and allow it to stand for a period of 30sec to 1min and wash it with
clean water
Add alcohol and wash it immediately
Put carbon fruschen on the slide and allow it to stand for 30sec to 1min, wash it and then dry
it
Put immersion oil on it and view under the ×100 power objective
PERFORMED UNDER SUPERVISION
CRP test, WIDAL test, Chlam test, BG test, HBestimation and FBS,Urine albumin, urine
sugar, vaginal swap.
CRP test procedure
Collect a venous blood from the patient and centrifuge it to obtained plasma and serum
Take a white RPR Carbon board and put 50µl of the CRP sera on it.
Add 50µl of the serum on it
Stared it with a dry needle cork for 3min and then report the result
ACTIVITIES OBSERVED
Direct stool examination urinaly.
Direct stool examination procedure
A clean sterile stool container is handed to the patient to bring in a small amount of stool
24. When the stool is brought in, a wet mount is prepared to view wither there is any parasitic
organism inside
In case of suspected cholera stool, a dry mount is prepared to check in for Vibrio cholerae
MEDICAL WARD
The medical warded is divided in three parts which are made up of nursing station, female
and male ward. The male ward has been set as the main unit for handling cholera patients.
Here we observed several activities carry out such as cleaning of the clinic, consultation, drug
administration, report writing and handing over. All of these had a particular way its was
carried out and its was carried out for both shifts, Night shift drug administration, monitoring
of vital signs, report writing and handing over in the morning. Each, morning prayers are
done followed by night report reading and question ask and answer
Activities
Prayers and reading of last night report by nurses on duty for the night shift followed by rounds
with doctor and nurses to check if patients are responding to treatment.
Discussion with patients to get how the are feeling and if any problem also aid carer in making
of patient’s bed who are in the wards, Placing patient in bed
Act as carer to patients who don’t have anyone to take care of them
Drug administration
Consultation
Consultation is mostly done at night at the level of the medical ward but during the day it is
done at the outpatient department. There are certain criteria to be mindful of when carrying out
consultation like monitoring of vital signs, filling of consultation registrar
Taken of vital signs (monitoring of patients closely who just left the theatre)
Drawing of nursing care plan for patients who are to be admitted and treatment chart for each
patient for patients who are in the various wards
Wound dressing
Act as a sterile nurse during wound dressing
Cleaning of materials after being use
3.1) DRUG ADMINISTRATION
25. Here we did observed how drugs are administer and their various route of administration, we
observed drugs being administer intramuscular ,intravenous, rectally, orally and intradermal in
the case of BCG which is a vaccine given to children from birth.
Activities observed
Draw your nursing care plan (nurses’ assessment, nursing diagnosis, scientific explanation,
planning, intervention, rational, and evaluation) and treatment chart in the case of drugs
Arrangement of things needed for drug administration on a tray or trolley and oobservation on
how an IV cannula is place
Discussion with patients followed by drugs administration
Discarding of waste after usage and writing of report
Arrangement of materials needed for administration of a drug intravenous
Here we observed how a 29years old man was administer drugs intravenous, he came in with
complain of headache, join pain, generalised body weakness, high temperature and abdominal
discomfort, lab testes where run on him and his diagnosis was set to be malaria being
positive(rapid diagnostic test was done) and the first the nurse was to calm down the
temperature of the patient with a drug known as analgin and this drug is given intravenous.
Materials
Gloves, syringe, wet and dry swap, tourniquet, butterfly needle, cannula and plaster
Drugs needed to be administered are arrange in the form in which it can be easily served on a
tray
Waste bag
Procedure
Take your tray containing your medication and moved to where you want to served your
medication and before taken the drugs you check if the right drug and it’s the right dosage.
Arrange your medication by the help of another nurse, that is place e your ringer lactate solution
on the stand and flush the line of the solution
Put on your gloves
Ask the nurse helping you out to prepared the medications
Choose the patient vein you want to insert your cannula
Use your tourniquet and tie few inches above the vein you choose and allowed it to dry
26. Use wet swap and clean the vein and ask you nurse assessing you to remove the cannula from
its package and give you
Use the cannula and punctual the vein you choose
Place one plaster on the top of the cannula and one benefit the cannula in a butterfly shape
Discussed with your patient and explain to your patient the site effect of the drug you want to
administer (i.e. his system may refuse the drug)
Attached your ringer lactate line to the cannula and allowed the infusion to flow
Place your medications in your ringer solution comprising of vitament B first, thenanalgen and
follow by quinine
Record the time you put the quinine medication
Allowed it to flow for 4hours
Activities carried out under supervision
Drug administration of second line of quinine infusion
Prepared your medication on a tray and takes it to the ward in which the patients is there
Greeting of patient and discussed with the patient
Ask patient how he or she is feeling and if they had any discomfort and if any, you notified
your senior nurse or the Doctor
Materials
Gloves, Médication (quinine, vit B complexes, and ranger solution), Syringes, Waste bag
Procedure
Prepared your materials
Put on your gloves
Prepared your medication, which is place your ringer lactate solution on the stand and open the
channel for the solution to go through the channel and removed any air bubble
Pick your syringe and removed it from the package
Aspirate some of the solution and keep, removed the needle of the syringe
Place your left hand beneath the arm where the cannula was place and open the channel which
allowed you to get away to administer your drugs
Use your syringe containing the solution you aspirate to flushed the vein, this is to make the
vein passable
Connect your ringer solution channel to your cannula
Put your medication into your ringer solution and record the time when its start and when it
will stop
27. Collect all waste material and put them in their respective waist bag
Activities carried out independently
Drug administration of third line of quinine infusion, ORS, flushing for a cholera patient
3.2) CASE STUDY FOR A MALARIA PATIENT
MALARIA PATIENT
Patient of age 21 years was brought into the house with complain body weakness, join patient,
persistent frontal headache and fever for 3days.upon diagnosis and laboratory test it was
confirm that she had severe malaria
MANAGEMENT PROCEDURE
Analgin should be saved to calm down her temperature.
Care for patient by standing for patient when there is no career.
Setting of quinine infusion which comprises of quinine, vitamin B, Ringer lactate
Monitoring of vital signs every 4 hours before start of infusion and end of infusion
SURGICAL UNIT;
It’s a small block in the hospital where minor operations are carried.Here we observed
several operations only took part in the cleaning of the theatre and surgical team material.
CASE STUDY;
Operation for a girl of 28years of age who came to the clinic with complain of side pain
although Some of us were not allowed to take part in any procedure since it was not the first
surgery they have seen and part take in, some of us part take in the cleaning and watch of the
materials use after the operation, Doctor theatre wear clean and pack for sterilization
materials
Activities observed
Preparation of materials and equipment needed for the theatre
Prepared patient who has to undergo operation
Take the patient file to the doctor
Preparation of theatre room by placing sterilized material and equipment on their own side and
all this is done by a nurse which is sterile
Preparation of medications needed in the theater in a tray
Monitoring of vital signs of the patient
28. Drug administration intravenous
Preparation of the theater bed
Preparation of sterilized equipment on the theatre table by a sterile nurse
Put on the theatre gown for the Doctor. After the operation clean your equipment with hydrogen
peroxide and wash your materials and dry.
5; ANC (ANTANATAL CARE)
Its focuses on care and follow up for pregnant women to when they put to birth,
Activities carried out under supervision
Weighing babies
Taking vital signs of pregnant women
Checking their glucose, protein and WBC concentration in urine
Calculating gestational period
Filling of vaccination cards and forms
Distributing mosquito nets
Health talks
We observed how gestational period is calculated using an obstetric wheel and also done
manually. From what we had observed, we noticed that gestational period can be calculated
using two different ways which are;
You could calculate gestational period from the woman’s last day of menstruation.
You can calculate it following the result of the Echography. This is used if the woman has
forgotten when the last day of her menses was.
We observed and we were taught how to test for the presence of glucose, protein and leukocytes
in the urine of a pregnant woman using a machine. To do this test, a cup is given to each
pregnant woman where she urinates and a demarcated strip is deep into the urine up until the
lines on the strip don’t show then you dry up with a tissue then you place it on the machine and
it gives the readings
5.1 Maternity
Activities carried out
Checking if the uterus is fully dilated
Educating mothers on how to care for their babies and themselves
Delivery
Circumcision
Activities observed
29. We observed how deliveries are done. Before every delivery, a delivery trolley is prepared. A
delivery trolley comprises of; Sterile gloves, A small sized towel, Umbilical clamp, 1ampoule
of vitamin k, 2 ampoule of oxytocin, Gauze, Tissue, Betadine, A bowl of water with cyteal in
it, Half a bowl of water with sodium hypochlorite solution in it.
After the baby has been delivered, an umbilical clamp is used to hold the umbilical cord of the
baby. The baby is given an ampoule of vitamin k IM to enhance blood clotting and to prevent
haemorrhagic disease of the newborn. The baby is oiled with olive oil and wiped gently. The
baby is dressed first by covering the chest, feet, head and then the rest of the body. 2ampoules
of oxytocin are given to the mother IM after delivery of the placenta to help in uterine
contraction in order to prevent postpartum haemorrhage.
After observing a number of deliveries, we were allowed to part take in some of the delivery
processes.
Procedure for vaginal delivery
Stage one: Dilation
Check if the cervix is fully dilated that’s if it is greater than 8cm. there are a few numbers of
people who give at 7cm or less
Stage two: Birth
At birth, there is first the presentation of the head.
Rotation and delivery of the shoulders
Delivery of the body and umbilical cord
Stage three which is delivery of the placenta.
We observed a circumcision. The circumcision table was set. The materials for this procedure
are;
Sterile circumcision set containing forceps, Gauze, Spirit lamp, Vaseline, Betadine, Glove
An artery forceps was used to cut part of the foreskin of the penis. Gauze was used to send
back the foreskin to expose the head of the penis. A small iron rod was used to burn the cut
part to prevent blood flow. After stopping the bleeding, betadine was used with gauze to clean
the penis.
After that, Vaseline gauze was tied round the child’s penis and covered half way with a diaper.
30. SECTION TWO
COMMUNITY INTERNSHIP
THE STUDY AREA
MANJO DISTRICT HOSPITAL
The study was carried out in the Manjo village, which is a farm settlement area where people
leaving are mostly farmers. Due to the highly nature of the land, most of the concentrate on
food crops rather than cash crops. Originally, the village have 10 quarters that is headed by
different quarter heads.
Concerning the health aspect, most of the indigence attend hospitals at Manjo district hospital
and a few goes up to the nkongsamba hospital unless referred. For the social aspect, one can
say the inhabitants so united and help each other out but they are very tribalistic.
Concerning the economic aspect, the people where at first friendly, one can get plantain,
banana, and palm wine at a cheaper price when compared to the market.
The study was done in this area in order to assess a number of variables such as the awareness
of the population on hygiene and sanitation, their awareness of the presence of vaccination and
the provision of mosquito nets in their community and also to do a brief health assessment of
the members of the community.
Study Design
Considering this work was an internship work and not a project or a research document, we
used a cross-sectional study design. This study was used because it is ideal to give us the
knowledge we need on the knowledge and awareness of the population on infection control
31. and prevention of diseases. Also, because the results which were gotten from the sample
population will be a representation of the entire Manjo district hospital.
Study population
The study population of the inhabitants of the Manjo community with our host Center being
quarter 1 to 8. The study was carried out from the 21st
of March to the21st
of April.
Inclusion Criteria
All participants within the quarters mentioned above.
All participants of sound mental capacity
Both genders
Exclusion Criteria
Participants of age 18 years and above
Sample size Determination
Our sample size was a population of 140 inhabitants
Data collection tools and procedure
The tools used in collection of data from this study included; questionnaires, consultation
registrar and health talks in which the participants were asked to answer, physical examination
of the community in order to identify problems and come out with solutions to these problems.
Data collection procedure
The first step was a visit to the SG to inform them of our presence within the community and
to obtain from him a brief history of the community together with the geographical distribution
of the inhabitants within the community. The next step involved a physical assessment of the
entire Manjo district hospital in search for nuisance factors. A questionnaire was formulated,
which contained various questions to help us obtain the required data from the population. We
used jotters as well to write down the findings we got from the physical observation of the
community as we moved around.
32. Data management
After the data was collected, the data of interest was extracted from the questionnaire unto a
data extraction form and kept for further analysis.
Data representation
The data collected was represented in charts and tables
Ethical consideration
The approval of the questionnaire used for this study was approved
COMMUNITY INTERNSHIP PLAN
Upon arrival into the community did inquiries on the population distribution and composition
of the area of interest (Manjo quarter 1, 2, 4, 5, and 8), putting lesser consent on other quarters
present. With information gotten, have a monographic map drawn if one doesn’t exist.
Do an observation of the physical environment with emphasis on physical, human and social
spheres with the aim of identifying nuisance factors which might be present.
Develop a questionnaire in order to obtain data on the risk factors that affect health in the
community from physical, social or human spheres. The questionnaire was focused on getting
information on; Population awareness on infection control and prevention, occurrence of
vaccination programs/hygiene and sanitation program or other health problems, demographic
data of the subject, their use of the district hospital of Manjo services as well as other health
facilities. Finally, educate the population on hygiene and sanitation through health talks and
also give them tips on how to live a healthy life
33. WEEKS/DAYS Activities to be carried
21rd to 26st of
march 2022
orientation by the chief of center
Clinical work
DAY SHIFT
NIGHT SHIFT
Community workers
Visiting quarter heads
Visiting youth president
President in charge of hygiene and sanitation
Visiting community chairman
Visiting the hospital site
28 to 29th
of
march 2022
Cleaning of the hospital.
ANC, VACCINATION, DELIVERY
NIGHT SHIFT
30st
to 2rd of
April 2022
Health talks at meeting points.
SENSITIZATION
3th
to4th April
2022
Health talks at meeting points, door to door and area
where youths smoke weed.
Visiting of the head of quarter 3 and carrying sensitisation
NIGHT SHIFT
34. 5th
to 8th
April
2022
Vaccination campaign
Visiting hospital for health talks and vaccination
Clean up campaign
Sensitization to the public
10TH
to 15 TH
APRIL 2022
CLINICAL ACTIVITIES AND CLEAN UP
CONTIUNATION OF CLINICAL ACTIVITIES
17th TO
18th
APRIL 2022
CONTIUNATION OF CLINICAL ACTIVITIES FOR
BOTH SHIFTS
19th
to 21rd
CONTINATION OF CLINICAL ACTIVITIES FOR
BOTH DAY AND NIGHT SHIFTS
WEEK TWO
Met with the quarter heads and got information on the community from the head of that quarter
of the village council.
We got into the community to do an observation of the physical, social and human factors in
the community. An understanding of all this sector will prove to be very useful in creating the
relation which could exist between this various factors and health of the population.
The observation will also help us to know the various quarters and which of the quarters pose
the greatest health risk.
An understanding of all the quarters will as well help us in carrying out our sample
Development of and review of the topics was done on this week as well.
WEEK THREE
Health talks at schools and meeting houses, cleaning of the hospital, sensitization and data
collection from sample population. The aim of the data collecting this data was to aid us find
out the problems the people face according to health and so as to bring out possible solutions
to these problems.
35. Health talks at meeting points, door to door, visiting of the waterfall within the
community as well as other hospitals which they members of the community do visit when
they are sick.
Our data was comprised of social aspects of the community as per hygiene and sanitation with
respect to the epidemic (typhoid outbreak) which attack the community and finally how they
interact with the availability of their health center and how offend the use their health center.
WEEK FOUR
Our third week was most base on immunization and health
RESULT OF DATA COLLECTED IN THE COMMUNITY OF MANJO
A presentation on the awareness of the sample population on Typhoid medication
36. Fig 2: Percentage of population aware of typhoid.
The above shows that a greater proportion of 60% our sample population (89 participants)
had no awareness of the disease, with only a small minority of 40 participants which
represented 39% of the sample population were aware of the disease.
Presentation of the population that is aware of DHM as well as what is done there
40%
60%
0%
0%
TYPHOID AWARENESS AMONG MANJO COMMUNITY
% of population not
awareness of typhoid
37. Fig 3: Awareness of the population on the presence of DHM within their community as
well as what is done there.
From the above data, a greater number of the inhabitants of the Manjo community are well
aware of the DHM and have an idea as well 87% of the people which represents 122
participants of our sample population were aware of DHM, Whereas a smaller portion of13%
of the population representing 18 of our participants had no idea of DHM or what was being
done.
Fig 2: Percentage of population aware of typhoid.
13%
87%
0%
% of population not aware of
DHM and what is done there
% of population aware of DHM
and what is done there
90%
10%0%
0%
TYPHOID WARENESS AMONG THE MANJO
COMMUNITY
% of the population with an
awareness of DHM
% of population not aware of DHM
38. The above shows that a greater majority of 10% our sample population (12 participants) had
no awareness of DHM, with a large majority of 128 participants which represented 90% of
the sample population being aware of the DHM
Presentation of Hospitals most people in the community visit when they are
sick
Distribution of hospitals attended by most participants
The above data indicates that a greater majority of people visit the nkongsamba , followed by
District hospital with 14% of attendance, the penja health area (CMA) is next with 18%,
mbanga follows next with 5% of participants
34
40
5 3
0
5
10
15
20
25
30
35
40
45
DHM NKONGSAMBA Penja mbanga
Axis
Title
Axis Title
HOSPITAL
39. DATA BASE ON THE HYGIENIC CONDITION OF THE COMMUNITY
HOUSE HOLED H1 H2 H3 H4 H5 H6 H7 H8 H9 H1O H11
Number of persons in
the house
5 4 6 5 5 6 3 5 3 7 3
Number of houses in
the compound
1 1 4 17 5 5 2 10 20 5 11
Bushes around YES
NO
Standing water YES
NO
Sleeping under
mosquito nets
YES
NO
Source of drinking
water
=SPRING
=WELL
=TAP
S
W
T
Treatment water YES
NO
Number of toilets
2 2 3 6 1 2 3 1 2 2 3
Toilets with doors
YES
NO
40. Toilets with cover YES
Typhoid victims
YES
NO
Typhoid awareness
YES
NO
Those vaccinated
YES
NO
Awareness of
vaccine
YES
NO
Willingness to take
vaccine
YES
NO
Why not willing
=GOD
=NO REASON
=SCARED
G
N
S
CHAPTER FOUR
41. CONCLUSION
The FIVE WEEKS community internship carried out at the DISTRICT HOSPITAL OF
MANJO which was successful and educative, the support and collaboration from the entire
staff and especially the GS which help us in carrying out our day to day activities without any
complication, community workers, Quarter heads and also the community which help us in
answering most of our questions as well as given us a listening ear to hear us talk to them .
This case study internship was a success because our community, the nurses and chief of center
worked in collaboration to helped us achieve our goals at the end.
It was an interesting internship because we met students from other schools and we share ideas.
The case study was a good learning experience as theory was related to practice
SWOT ANALYSIS
Strengths
The community was really encouraging as they were ready to listen to what we were to give
out to them
Competent workers which are willing to sacrifice their all for their community.
Team work and relation between health center and the community was really encouraging and
good.
Proper time management and waste disposal
The presence of few and organized staff at the health center
Answer all question at their level according to primary health care
Weaknesses
42. We were not able to meet up with some of our objectives because we were not granted the
permission to go into certain parts of the community to learn more for instance at the slaughter
house.
Lack of knowledge about health of the community and a compound of 20 people using the
same toilet.
Houses build around the main supply of water in the community (amen water supply).
People connecting their toilets to main stream which people drink, watch dresses and food
stuffs to sale at the market.
Some quarters of the community lack areas where they can dump their dirt and as a result leads
to accumulation makes the area smelling.
No running taps at specific junctions of the community for the washing of hands to maintain
perfect hygiene.
Most people in the community lack knowledge about the possible solution to maintain perfect
hygiene and sanitation.
Consequences
Poor maintenance of hygiene and sanitation will result to poor health condition which can lead
to poor financial support which can help the community and individuals to grow as one
Possible solutions
Poor health can we resolved by creating health talks through media and social media to educate
the community on basic roles to maintain good hygiene and also by providing clean up
campaigns to help people keep their environments clean.
Creating of a pit where the community can dump their dirt in other its can be recycle if require
When people want to build, they should build 200meters away from the main water supply to
avoid cross contamination.
Provision of more mosquito nets to keep them off malaria
43. OPPORTUNITIES
The hospital’s location is just perfect, the area looks secure and calm.
Equipment and materials are available for learning not forgetting the improvisions made by
the practitioners at the hospital.
The departments are well equipped and functional.
We were opportune to gain more knowledge and experiences
We were able to create new relationships with other interns of different schools, the nurses,
cleaner and with some community members
Proper communication was made or established with the reasoning of the community, trying
to understand their believes
The community provided us with so many opportunities to know how primary health care is
managed at the level of the district hospital and the community, and also how certain procedure
is carried like health talks to the community and data collection is carried out and interpreted
at the district hospital.
Provided us with knowledge on how the hospital and community function together and also
the understanding of the culture and believes of the people.
THREATS
Due to the lack of specialist in the hospital and equipment in our district hospital there were
some cases in the community that the district hospital could not handle, so require further
assistance from the Nkongsamba regional hospital.
