DAY 6 - School Health Programme and Antenatal/Postnatal Care!

Good morning…our day started of at 9.00am at Klinik Kesihatan Bandar where we all gathered before heading off to Sek Keb Saraswathy.

the Pejabat Kesihatan Van which carried all  the vaccines and the nurses...

When arrived we headed to the Bilik Sains where the nurses were already performing the physical examination on year 6 students which consist of :

Looking for lice in their hair

Measuring their BMI( where if BMI>3O, they will be referred to PZM for diet counseling)

Visual test

Look for previous BCG scar( whereby if it is absent the student will be re vaccinated again) –absent BCG scars are most commonly seen among the immigrants.

Their cleanliness observed and lastly systemic review is conducted noting for patients with Bronchial Asthma ( ask if they are using inhalers), heart diseases and ect.

All these will be recorded in the blue book ( Rekod Kesihatan Murid).

the Rekod Kesihatan Murid book

 

in the Bilik Sains listening to the briefing  by sister Busroh

The components of the examination

The consent signed by the parents

with Sister Busroh (lady in blue)

in front of the Bilik Sains

Year 6 children will not be vaccinated excluding the children with absent scar. They will be briefed on the HPV vaccination which will be given to them next year ( form 1). After  the briefing,  a consent form will be handed to them  to get the permission  from their parents allowing them to receive the vaccination.

The HPV vaccine was introduce in Kuala Muda early this year for form 1 students where it is divided into 3 doses which is at 0,1 and 6 months.

Students being examined by the nurses

The lice medication which was given to the students with lice..

The lice medicine!!

Furthermore, all the girls and boys who was having lice were given the lice medication and the children were advice not to eat the medicine, to store it in a safe place which is away from their younger siblings and to put it on their head without applying oil and to leave it on their head for only 4 minutes as longer than that will cause their hair to fall. 

After examination, we all took a break as the next session will be for the afternoon session students where we will be giving vaccination to the standard 1 students.

During our break time after the morning session at Sek Keb Saraswathy, all of us went back to MCH clinic at KKBandar for the antenatal and postnatal session.

Here we met with sister Mariam who was a real jovial person thou she was upset with us for interrupting her break time ( haha). While joking with us she advised us on all the important things for us to know during this session and its significance. She really stressed on the significance of each antenatal assessment stating that as a future doctor it is very important for us to really understand it.

Entrance to the MCH clinic...

Sister Mariam

She basically recapped on all the antenatal assessment which we studied during our Obs and Gyne posting in 3^rd year,including the history taking and obstetric examination for the mothers..

She said that  the history taking would be more reliable if it was taken from the patient's parents itself…as careful assessment of the previos history and family history of the patient would help to exclude inherited diseases like Diabetic mellitus,bronchial asthma,cardiac disorders and hypertension. After the briefing we were asked to observe the clinic. 

The registration counter

The antenatal record books..

A mother being examined during one of her antenatal visit...

The Obstetric calender used to determine the Expected Date of Delivery of the mother..

In the lab where the urine and blood sample is being investigated  by Encik Mazuki (the lab assistant)

The HbA1c level is measured using this device

The hemoglobin level is detected using this device..

Outside the lab where mothers put their urine sample into the basket  out there!

We left the MCH clinic around 12pm to have our lunch break....
After having a break in Old Town Kopitiam, we gathered back in the school at sharp 2pm. We were all very exited to meet these young kiddos who are extremely afraid of needles.

The nurses have just arrived at the Pusat Sumber in the school where the vaccine will be given to the students!

Preparation of the vaccines!

Getting the needles ready..

The yellow  bins where the needles will be disposed..

The children just arrived and they were given their RKM books..

The class teacher was explaining to the students about the vaccination and they were told to  swallow the oral polio vaccines and not to spit it out!!

These children will be given 3 types of vaccination on the same day:

DT( Diptheria Toxoid and Tetanus Toxoid ) ( 0.5ml i/m)

Measles vaccine( 0.5ml s/c)

Oral Polio vaccine (2 drops)

we were giving them 2 drops of polio vaccines each

The oral polio vaccine ( 1 bottle can be used for 10 students only)

The subcutaneous vaccine which is being given by the nurse!

ALL THE CRYING STUDENTS THAT WE HAD:

Consulting the crying students...

We were  holding the students so that they would not push the needles away!!

 ALL OF US WERE GIVEN THE CHANCE TO HELP VACCINATE THE STUDENTS!

Most of us were anxious to give the injection- as it was our 1st time!

giving the intramuscular injection..

1 of our grp member giving the i.m injection also...

The children were also given 1 tablet of panadol-to be taken at home!

Children without the rekod kesihatan book and without parents consent will not be given the vaccine on that day…all these children including the ones absent will be given the vaccines later on.

With the presence of the old BCG scar, the BCG vaccine will not be given...

The BCG vaccines are stored in a cold chain box 

DT vaccine- given i/m ( on the left hand as it is painful)

The Measles vaccine given s/c ( on the right hand as it was less painful)

Our day ended with great satisfaction at about 5.30pm. We gave vaccines to 5 classes of standard 1 students. Therefore it was extremely tiring yet we enjoyed it...!!!

by J.R.Ranjaylina and R.Karthiga....