Every couple of weeks, Dr. Kubacki meets with the nurses who work at the Cavango clinic to improve the clinic and healthcare provided. The nurses take care of all patients without Dr. Kubacki when he is gone. To assure that the town is not dependent upon him, he has these meetings to “teach a man to fish” rather than do all the fishing for them.
To do this, Dr. Kubacki has created a booklet with treatment and diagnostic symptoms for the most common of illnesses for the region. Treatments are listed with the correct medicines and dosages for several patient weights (infants require different doses than adults, for example). At the meeting that I sat in on, Dr. Kubacki went over the symptoms and treatment of malaria, our most common presenting illness, and a very deadly one. The nurses were engaged and eager to learn.
It was interesting to realize that the nurses had never learned a thorough amount of simple math. A question came up as to what ¾ a pill meant. Did it mean you give three pills and then four? It was surprising that these very intelligent and hardworking people had never encountered fractions. With explaining that if you broke one pill into 4 pieces, you give only 3 pieces, the message was clear. A nurse said, “Oh I understand, then you can use the extra piece for another patient or another dose”. So smart! I am sure 2nd grade me did not pick it up that quickly when I first learned fractions.
Dr. Kubacki also uses this time to get feedback about the clinic from the nurses. Thoughts of this meeting were word that a doctor is now in the region is quickly spreading and more and more people are coming to get care. They reiterated how grateful they were to have a doctor here and that his work is making a difference. Some concerns were that one of the clinic doors had been destroyed by termites (such a love-hate relationship with these bugs… see termite pictures!) and it needed replaced. We would have to go into the city for a new one. The nurses also gave feedback on the solar lighting system that had been installed. They absolutely loved being able to see to take care of patients in the nighttime hours. One nurse chuckled about how they used to use only a flashlight to see, and that they often had to use the patient’s lamp because theirs would burn out. They were grateful for the new solar lighting installation and it helped them to do their jobs with greater ease. Another nurse mentioned that they continued to not have medications in syrup form for the children. Kids had to take the medicines crushed, or if they were old enough to eat, they would have to take a whole pill like the adults do.
Dr. Kubacki had a great way of leading the staff at the clinic. He touched on the subject of improvement very delicately because these nurses have been working at this clinic long before he came. He did not want to intrude on the great service they were already providing, and yet he wanted to tactfully share his knowledge with them so that patients could get the best care possible. His mentality of coming as a learner and asking the nurses questions about their opinions worked very well. He was a collaborator rather than a foreigner imposing ideas and practices onto a system that these Angolans had been using for years. Working alongside these people rather than above them has served him, and the Angolans, well. Teach a man to fish, by fishing alongside him!