What a day! We had gone to bed feeling we were well prepared and ready to go the following morning. Boy, were we in for a surprise! After gathering our Tumutumu partners we arrived at the site to discover over 100 people awaiting us!
We quickly separated, with the clinicians, graduate students, and our exercise physiologist, Heather, going into the back of the building to set up, while the undergraduate students and peer mentors began setting up registration, anthropometrics, and screening stations in the front of the building. We worked with local community members and clinic workers to rearrange furniture and set up the rooms in a way that was conducive to an easy flow of patients through each station.
Darren was working with the nurse practitioners and graduate students and helped to set up their “pharmacy” and patient rooms while Annya and I made sure every station had what they needed before we began. We handed out paperwork and patient educational materials, and did our best to answer last minute questions. Once the registration desk and anthropometric stations were ready, we opened the doors and let the first patients in.
The beginning is always quite slow as we’re waiting for the first ten patients to make it through registration and anthropometric measurements and get to the patiently-awaiting screeners. It then takes even longer for them to be screened and to assess whether or not they need to see the nurse practitioners, or if they need to be referred to the local health care facility. Despite the clinics being an effort to screen, diagnose, treat, and ultimately better understand cardiovascular and metabolic disease, people come in with a wide variety of other ailments in addition to wanting their blood sugar and blood pressure checked.
Chaos ensued, despite our best efforts at organization. The first clinic of the trip is always a bit hectic since all the new team members are still getting used to the protocol, and trying to figure out what works best for them and their partners. Add to that a line of over 400 patients waiting to be seen, and it’s easy to see how crazy/busy things became. We had to assign an extra 2 people to the anthropometrics station to help get people through the first part of the process more quickly. I realized that we were running out of all of our paperwork, including the card we were using to gather research data and record patient results, as well as our patient education materials. Jacob ran off to have more copies made.
In the meantime, we decided to set up an 11th screening station in an effort to help move things along more quickly. My partner, David, and I screened patients for over 3 hours while running around to check on everyone in between patients. Annya and I eventually switched, and she took over screening patients.
The lines backed up everywhere. People were crowding into the anthropometrics area, so it was difficult for our team to measure peoples’ waist circumference. We had to keep moving people back towards the door, but then they would eventually crowd back in and we’d have to do it all over again. The lines lengthened. Everywhere. Lines to be registered, lines to fill out the questionnaire, lines for anthropometrics, lines for screeners, lines for clinicians. Lines everywhere! We were rapidly running out of paperwork again, and had to resort to creative measures.
Eventually, we had to cut off the lines and prevent more people from entering. We shut down anthropometrics and were just checking people’s blood pressures and blood sugars, and sending those to the clinicians we knew we could help. Despite this “fast-tracking” we still didn’t finish until after dark. People were exhausted, hungry, and probably a little shell-shocked. The team helped clean up the room, return furniture, and pick up trash. We loaded up the practitioners and got on the bus.
We owe a HUGE thank you to the community members that sacrificed their time and energy to help us out. Joyce at the registration desk was SO helpful and so positive, I don’t think I saw her without a smile on her face once. And there was a former teacher from the primary school we visited the day before helping to usher patients through everything and helping manage the lines. Not to mention the faculty at Tumutumu (especially James and Vincent!) and their AMAZING students.
The guest house attendants were gracious enough to leave dinner waiting for us, and we devoured a cold meal. Our Tumutumu partners arrived and asked us to pack meds for the next clinic in the morning. None of us were very interested. We had originally planned to pack meds the next morning before the clinic since we were within walking distance and everyone was so exhausted already. However, they were quite persistent and got their way!
Despite it being around 11 pm, we busted out the medications and sorted, divided, and packaged them for the next morning. Those Tumutumu students surprised all of us with their tenacity and dedication.
Finally, very late at night, we made it to our rooms and to our beds, knowing we were going to do it all over again tomorrow. Very early tomorrow.