Le CSPS

In a recent letter from my grandma she asked if the village health care clinic was an actual building, which made me realize that I often use acronyms or French words that don’t translate well and might not fully explain them.  Yes, there is an actual building for the clinic, 3 in fact.  Let me introduce you to the Centre de Sante et Promotion Sociale, or CSPS for short. 

I’ll start with the pharmacy, since it is the easiest.  The pharmacy is a small, one room building a short walking distance from the rest of the CSPS buildings.  It’s an open room with long countertop splitting the room in half, and sitting on the other side behind a desk you will find Roger, book keeping or playing on his new fancy blackberry-type phone.  There are 3 large shelving units behind the counter with stacks of medicines lining them and then several boxes full of meds on the floor around Roger’s desk.  The pharmacy keeps stocked in the most common medicines, but anything too strong or not as common has to be purchased at the district medical center, 18 KM away.  Also, the stoop of the pharmacy seems to be the only place in village that I can sometimes get a bar of cell phone service, sometimes, on a good day. 

Next there is le dispensaire.  This is where I spend most of my mornings. The design of the building is 7 rooms and the waiting area that form a square with an open-air area in the middle.  I have no idea what the point of the open part is, but there is a tree and it’s not used for anything.  Once you walk into the building you enter the waiting area, naturally, where the walls are lined with built-in cement benches.  The building is supposedly cleaned, there is a janitor lady, but I’ve never seen her there.  It’s not overly dirty, but I wouldn’t call it clean either.  Cob webs cover the walls and bugs are everywhere.  Since there are so many flies and ants and little flying things, you can almost always find at least one toad hopping about in and out of rooms.  And there are probably so many flies because babies aren’t diapered and pee at will.  Sometimes mothers will wipe up the pee if it’s on the bench, but not likely and never off the floor.  Baby pee is viewed as nothing unusual here or something to fret over, I’ve even seen mothers let their babies play in/with their pee.  Also, it is not uncommon for a chicken to wander in and about.   

To the left of the waiting room is the consultation room.  There are two filing cabinets that hold all the CSPS documents, and examination table, and a desk.  Generally, the malade will come in and sit in front of he desk and tell the infirmier their symptoms.  Their temperature will be taken, if it’s a baby the nurse will feel its’ belly, once in a great while they will be weighed or blood pressure will be taken, and then a script will be written for something.  I have seen a few malaria tests betaken on toddlers, but I’m not sure how often this is done, certainly not all 100 something cases a month.  

To the right of the waiting room is the petite surgery room, where injections are given or wounds are bandaged.  However, if an IV is being put in (for malaria, usually) then that has to be done outside where there is more light, since there is no electricity in the CSPS.  This is usually done out back, where people can’t watch.  There is a room with beds in it where people with IVs or that are really sick can lay down, most often used by mothers with sick children.  This is the room where the “come lady” and her grandson, “Little man”, lived with her husband for well over a month while he recovered from a head injury. (They have since left the CSPS, much to my dismay as I enjoyed playing with Little Man, but the husband came in today to get his would checked on.  He gave me a big hello and Fulfulde greeting.  It feels good to be recognized warmly.)  There are also several other beat up mattresses that get laid out on the floor wherever there is space on a busy day.  There is a room that seems to only be used to house the car battery that is hooked up to the solar panel and for sick overflow, a storage room, and then 2 rooms that aren’t used at all for anything. 

Down the path from the dispensaire is la maternite.  I’ve only been in the maternite a handful of times, so I don’t know it as well but it seems to be almost the exact set-up as the dispensaire.  There is the consultation room for consults pre-natal, which has no other equipment besides an examination table, a filing cabinet, and a desk for the accoucheuse. I’ve helped with CPNs twice- the women are weighed, height is taken, sometimes blood pressure is taken, then they lay on the table and their bellies are felt up (a stethoscope may be used, I can’t remember), and then a bunch of stuff is recorded in a notebook for the CSPS and in a booklet the women keep, tests that may or may not have been taken.  Other rooms of the maternite include a birthing room, a recovery room which just has a few beds in it, and a storage room that has the CSPS vaccination fridge in it.  The fridge is hooked up to a gas tank, but I don’t know how that works.  The other rooms of the maternite remain a mystery to me, and I’d like to keep it that way (there are lots of stories of volunteers assisting with births, no thanks!).             

If you keep going down the path you will find the CSPS staff houses, and I have to say they are the nicest houses in village.  They were build by the same NGO that built the CSPS, so they are real, legitimate houses made out of real building materials.  Not too shabby. 

And so this is the CSPS, where my work is based out of.  Every morning is spent in the waiting room, where I sit and greet people and take temperatures.  I make babies cry.  Daily.  But I’ve seen them cry at the infirmier when he takes temperatures as well, so I like to think they are just afraid of being poked at, even though I know some are afraid of me because I’m white. Recently I’ve been passing the time by looking over old CSPS documents and gathering information for my “Etude de milieu” report.  We’ll see how I spend my days once I start doing projects.