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Journals from HHPA/HESC 398 Island Health Care: Type 2 Diabetes in the Bahamas January Term 2012

2012-01-09 Day 3: culture and clinics

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Today we had the opportunity to visit health clinics around the island and talk to them about their diabetes education program and what they do to help their diabetics with managing their diseases. We were chauffeured around by our favorite bus driver, Rudy, who took us on a small tour before we started the visit. He drove us down the coast of the island and we were able to see some pretty fantastic homes along the coastline. When we got to the Ministry of Health we were suppose to meet up with the President of the Bahamian Diabetes Association, but there was an emergency and he was short staffed so Ms. Judith Scavella and Ms. Farrington joined us instead. Ms. Farrington was a nurse and Ms. Scavella had many titles including a nurse practitioner, a disaster management planner and a midwife. They had both worked at the clinics that we were going to visit, and I think that they were pretty excited to go back and visit. They got on the bus with us and we drove through some inner city areas with titles like Coconut Grove, which were founded by slaves after their emancipation.

The first center that we went to was called South Beach Health Center, which sees up to 200 patients a day. What was interesting on these tours is that they showed you every room of the building, down to the storage rooms and bathrooms. So we had a nice long tour of the first health center and talked to some of the staff members about their specialties and what some of their rules are for making sure that people are being compliant. We learned some pretty interesting facts at the first clinic: they put an announcement on the radio if a child has missed an appointment for an immunization; they have a rule against having baby bottles in the hospitals because they are trying to push for breast feeding; and a vision test must be completed by every child before starting school. We got to talk to their diabetic educator, and she gave us some handouts that will be really useful for Eleuthra. She also told us that most of their patients are compliant, but it is hard because they don’t want to stick themselves with needles and change their lifestyle- but honestly, who would?

The next clinic that we went to was the Gambier Clinic. It was very different from the first clinic that we visited. It was set up on a hill that was covered with garbage and run-down homes. The Gambier Clinic only sees 20-30 patients a day, but they do a lot of home visits to check up on their patients with chronic illnesses, especially diabetes. They want to be able to view them in their environment and see what some stressors are that may contribute to their non-compliance.

After this we got to stop at a deaf school where Erika spent some time talking to the students there. It was AMAZING to see them interact. You can read her blog post for more details about that. When we left the school we stopped to get some lunch at Good Fellow farm that was delicious- partly because we were all starving, and partly because it really was delicious!

The last clinic that we visited was a step-down clinic from the first one. We also got to talk to their diabetic educator there , and she echoed the same thing that the first two had said- people are willing to change if they see some complications arising, but it is a challenge to make them want to change their lifestyle, their eating habits, or their exercise routine, if they don’t have to. Sounds like we have a challenge waiting for us on Eleuthra!

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