Penny Wong

Community Nurse
APN
Primary Health Care
In rural area
Content:
1. Introduction of Primary Health Care
2. MSF experiences – community nurse role in
rural area
3. Nurse roles in disaster situation
4. General criteria for working in the field (MSF)
Primary Health Care
 A main strategy for achieving WHO’s goal of
“Better health for all”
 The values of primary health care to be
considered for health systems, as include equity,
social justice, universality, people-centredness,
community protection, participation, scientific
soundness, personal responsibility, self-
determination, and self-reliance.

(WHO)
Primary Health Care
Covers a wide range of services… including: (2)
 Health promotion
 Health education
 Diseases prevention
 Health risk assessment and disease
identification
 Treatment and care for acute and chronic
diseases
 Health maintenance
 香港

南蘇丹
Mission in Africa: South Sudan
(7 months) Outreach nurse
Primary Health Care Centre
(PHCC) &
Therapeutic Feeding centre (TFC)
South Sudan (independence since 2011)

 Estimated life expectancy of 62 years

Health care:
 Accessibility, sustainability and quality
 Lack of quality primary health care services
 Ministry of Health (MoH)
 THE CHALLENGE OF CONTINUITY OF CARE IN A
CONFLICT AREA:
War is part of life of many people in
South Sudan, a militaritsed society,
where the military men run politics

People are being exposed to

continual violence, increased
displacement, fear of attacks, disease
outbreaks and the risk of starvation.
 Armed conflict

Natural disasters

Endemic & epidemic

Sexual Violence

Healthcare exclusion

Sources from MSF international

Voices from South Sudan…..
前線的一天︰無國界醫生
https://www.youtube.com/watch?v=u5X6pxRYuyo&feat
ure=youtu.be
The Role of Community
Nurse in rural area
1.) Assessor and Advocator
Bearing witness and speaking out

Photo from MSF

Prepare for rainy season……

Photo from MSF

 Therapeutic feeding programme for
malnourished children (moderate and severe)

•Acute respiratory infection

•Diarrhea
•Dehydration
Screening (secondary health intervention) for
malnourished children
(Mid Upper Arm Circumference MUAC, weight for
height)

Severe
malnourished
2) Direct care provider
Wound care at hospital and clinic
Burn/abscess wound

What kind of infectious

disease?

Gunshot wound
Surgical procedures/Obstetric
3) Educator
 Out-patient clinic
Health consultation at out-patient clinic

Waiting hall

Health screening
 Training for community health worker
- Malaria, kala azar (visceral leishmaniasis), TB, HIV/AIDS, Leprosy,,

Elephantiasis (Elephant Leg Disease) …..Vector-borne diseases

Multi drugs
resistance TB

Kala azar
Disease prevention

Rapid Diagnostic
Test (RDT)
What is it use for?
4) Health Promoter
Infant Mortality rate

Extremely high at 79 per 1,000 live births,

one of the highest
(2,054 per 100,000 live births)

rates of maternal deaths in the world

(WHO 2015)

1.7 registered infant deaths per

1,000 registered live births in
2013
(DH 2014)
Health education and health promotion
for Traditional Birth Attendant

Promote women and

child health in rural area

Reproductive healthcare
 Health talk of Scabies outbreak
for villagers and health care
workers
Infectious diseases outbreak
and neglected diseases in
rural area ….
Guinea worms outbreak- health surveillance and health
promotion
- Home visit by outreach team at different villages
 5) Evaluator
Control and prevention
of disease outbreak
 Vaccination program
(Primary health intervention)

What kind of disease the

baby suffering from?
1. Supervise of community
health worker and
monitor of disease
outbreak

2. Laboratory investigation
Cross-cultural experiences……
 Custom, Traditional belief, Religion, Languages, Politics,
Value…..
 Taboo…..e.g. Female Genital Circumcision
 Spirit doctor
Guess…..?
Natural Toothbrush-chewing stick
Mission in Indonesia – Banda Aceh
印尼班達亞齊- Tsunami
Earthquake response in Sichuan
2008
As a nurse,
what can we can
do to the victims?
Here are different roles/duties
of
a nurse during disaster ….
In settlements/camps

Basic health care

Basic needs: water and sanitation
 7) Coordinator and collaborator
facilitate the work within different parties
(multi-disciplinary approach)
Prepare of medical materials and stock
checking
Training session- measles vaccination
campaign/Cholera vaccination
Mobile clinic – at remote villages
In patient ward ………. ward nurse
Wound care– screening and referral
for infected wound

Surgical procedures –
OT nurses
Do you know what is it?

Flexibility….
Lodgings, food & Team life…..
 General criteria for a field volunteer
 At least 2 years professional experience in your field of expertise
 Availability (minimum of 12 months)
 Ability to live and work as a team
 Experience in developing countries
 Ability to manage stress
 Willingness to work in high security contexts
 Flexibility
 Language skills (English, French)
 Tropical medicine courses
MSF expatiates in Yemen
https://www.youtube.com/watch?v=4GvePKpnBnY
Thank you
References
1. Primary health care: report of the International Conference o 1.
n Primary Health Care, Alma-Ata, USSR, 6–12 September,
1978, jointly sponsored by the World Health Organization and
the United Nations Children’s Fund. Geneva, World Health
Organization, 1978 (Health for All Series No. 1)
2. Definition: Primary Care. American Association of Family
Physicians;2010. Available from:
http://www.aafp.org/online/en/home/policy/policies/p/pr
imarycare.html#Parsys0002
 How to start to be a MSF
volunteer…
 Self assessment test & interview ……
Fluent English/French speaking/spanish
 Training or experience in tropical
medicine, infectious diseases (TB and
HIV/AIDS) or public health
(except Midwife & OT nurse)
 Pre-Departure Preparation course in
Europe for 2 weeks
 Stand-by period… & ready to go…
 Peer support