Outreach in Kamacupa

A day in the MSF health post in Aifena

It is eight o'clock in the morning when the MSF team gets into the jeep and leaves the office in Kamacupa, Bie province. Their destination is Aifena, a camp for “ internally displaced persons”  who settled in the area during 2001 or shortly afterwards when the civil war ended. MSF runs a health post in Aifena to give basic health care to the displaced people as well to the local “host”  community. The national supervisor for MSF activities in Aifena and six other health posts in the area is Adelino Camato, an experienced Angolan tecnico medio, who is joining his team today. He supervises and supports the work and when consultations stop in the afternoon he summarizes the events of the last hours:

"Today, we gave consultations and treated about 70 people in Aifena. When we arrived people were already waiting. Some had walked for two or three hours to reach us, as the health post is the only option for medical attention in the area and treatment and drugs are free. The post is nothing more than a small house, where we can store our medical material. Water comes from a nearby pump.

As usual, we did triage in the entrance area of the health post - in other words, we had a preliminary look at the patients to identify severe cases. At this time of year, during the rainy season, most of our patients suffer from malaria, respiratory tract infections and diarrhoea. In the consultation room my colleagues checked lung and heart activities, took temperatures and used a rapid test to trace malaria. There is also a small pharmacy where we hand out drugs. We gave a short health education lesson to the patients waiting in the entrance area to inform them about medical issues: this morning, my colleague Paolino spoke about malaria and also about contraception, explaining the correct use of a condom.

We also carried out pre-natal consultations - a service that we offer every week. We try to motivate pregnant women to come and visit once a month. That way, we can follow the pregnancy to see if there are any problems and if a referral to the hospital might be necessary for delivery. We vaccinate the women against tetanus and give out drugs to prevent malaria since the disease can endanger the pregnancy. We also hand out iron tablets since most of the women are anaemic. This morning, a woman came with her five day old baby for a consultation. The child had breathing problems and its heartbeat was very fast. We had to take the mother and child with us to the hospital to find out what exactly was wrong.

At present, MSF runs or supports seven health posts in the area and has several teams on duty during the week. Often they are accompanied by Marie Duquenne, the Belgium outreach nurse, or Austrian midwife Judith Eberlein, both of whom I work with in close cooperation. I also join the teams most days, supervising the work, training my colleagues on the job and assisting with the consultations. The rest of the time there is administrative work for me to do, mainly setting up working plans and recording statistics on the number of consultations and the consumption of drugs. I like both sides of my work which is interesting and satisfying. It is only hard when there are patients who we are not able to help. I have worked with MSF since 1999, but I don’t think I will ever get used to these experiences."

MSF in Kamacupa

MSF supports Kamacupa hospital where we also offer surgical and laboratory activities. In addition, the team is expanding a tuberculosis treatment program which was established in June 2003. Seven health posts, run or supported by MSF, serve the surrounding villages as well as an IDP population of about 28,000 people located in several camps. At present, the team in Kamacupa consists of seven international and - only for the medical work - about 100 national colleagues. For almost all programs a national supervisor is in charge of leading the activities.