THINGS CHANGE

Heading into the trip Tomi, Tosin, and Idris solely focused on implementing an electronic medical record system. However, due to the needs of the community and hospital alike, their projects were altered where they are now taking a systematic approach on improving the efficiency of health services. Likewise, Greg, who envisioned tracking the prevelance of HIV and malaria amongst the individual villages the hospital serves, has found that there are inadequate statistical measures in place to do so. Therefore, his project has shifted into helping the medical record department to track common diseases' incidence and prevelance per respective village through developing an excel statistical modeling platform. Lauren has been working primarily with the public health officers trekking team, assisting with immunization record keeping and birth registrations for children under 5.  Originally she planned to focus on maternal mental health and the factors influencing that, as well as its implications on childhood development.  However, since then her focus has shifted to a general assessment of maternal and child health services offered by the hospital with regards to efficiency, quality, and satisfaction.  Additionally, she has been working to promote health education among village women on a number of MCH topics and exploring the cultural factors in the Gambia that influence maternal and child health.

While working on our respective projects, we have also delved into other pressing issues that impact the hospital.  Approached by Hassan, a nursing student with Junkung, we learned that the hospital is inadequately disposing  both clinical and non-clinical waste. In Hassan's situational analysis, he specifically noted the lack of waste bins,inefficient dumping/ incineration site, and poor cohesiveness amongst environmental safety staff to collect waste from respective wards. After our meeting, we visited the make-shift dumping site behind the hospital which resembled a messy graveyard scattered with smold-ering used syringes, broken glass vials, and other indiscernible garbage. In the days to follow, as requested by Hassan,we brainstormed ideas on how to address this important issue.