The Nata Clinic is responsible for health care delivery to the 6,000 residents of Nata and the surrounding villages. More than 12,000 people rely on the services of the clinic. The clinic also oversees the three remote health outposts of Maposa, Manxotai, and Sepako. The outposts are reached by dirt/sand track and the farthest is 36 miles away. The clinic is so busy that it is often referred to as a hospital. The closest general hospital is 60 miles away and the closest surgical hospital is 120 miles away. The clinic consists of two main buildings. The 1st building has two consultation rooms, one room for wound dressing changes, pharmacy, and an office. The 2nd building consists of a 3 bed ward, 2 bed delivery room and a 4 bed post delivery/recovery room. There is also a trailer where the PMTCT (Prevention of Mother to Child Transmission) Lay Counselor performs pre and post test counseling for HIV/AIDS and the nurses collect blood for the CD4 (T-Cell) count of HIV infected patients. The compound also has four houses where some of the nurses live.
The clinic employs 25 full time staff. All are citizens of Botswana except where noted. The staff consist of :
Our Doctor recently arrived from the Democratic Republic of Congo. The clinic was without a Doctor for nearly 8 months.
6 Nurses (3 are midwives)
1 Pharmacy technician on contract from Zambia
2 of the Nurse Midwives are on contract from Zambia
3 Family Welfare Educators
2 Nurse Assistants
3 General Duty Attendants
1 PMTCT Lay Counselor
2 Nurse Orderlies
Numerous challenges are faced everyday at the Nata Clinic. We do not have enough consultation rooms and patients are forced to often wait hours to be seen by a Doctor or Nurse. When post-op is empty, we often use this room for consultation. The nurses advise expectant mothers to arrive early in their labor so they can be transported to the hospital. Many expectant mothers wait too long resulting in over 20 babies born every month at the clinic. The delivery room lacks even the basic equipment. There is no oxygen and we currently have no autoclave for sterilizing instruments. Instruments are being transported to the hospital for sterilization and then returned. Contamination is always a risk. We lack many medications that are needed in treating the most basic diseases. The General Duty Attendants must wash all the linens by hand as there is no washing machine.
Since nearly 40% of the population is HIV positive the staff are constantly at risk of contaminated body fluids. Since Nata Clinic is the only health facility in the area, victims of road accidents are often brought to the clinic for stabilization before being transported the 120 miles to the surgical hospital. There are often times when a lone nurse is caring for a patient that would have a trauma team in the developed world. Transportation is by far one of the greatest challenges the clinic faces. The patients on Anti-retroviral treatment must travel to Gweta (60 miles away) every three months for a review of their treatment. Many cannot afford to pay the $4 round trip fare. Patients squeeze into the back of ambulances (covered trucks) for the journey to receive their life saving medications. When the trucks break down, patients are unable to come into Nata from the outpost clinics. When emergency situations arise, patients are often transported in the back of police vehicles or other government vehicle to make the 120 mile trip to the surgical hospital. The high rate of Tuberculosis and Malaria are also adding to the stress of the HIV/AIDS pandemic. Unfortunately, nearly 50% of all expectant mothers are HIV positive. It is estimated that the rate of infection among the general population is between 30 and 40 percent. The patients also seek the advice and assistance from traditional healers. The healers are unable to combat HIV/AIDS and patients often wait too long before seeking help from the clinic.
The doctor treats a sick patient in the Nata clinic.
Despite all the challenges, the staff of the Nata Clinic continues to do the best they can with a difficult situation. Nearly all of the pregnant women are being tested for HIV and if they are positive are participating in the PMTCT program. Mothers that are enrolled in the program are reducing the rate of transmission from mother to child to only 5-7%. This is a huge success as without treatment the rate would be nearly 45%. Nata Clinic has access to the rapid HIV/AIDS test and a person can learn their status in 15 minutes. Due to a great deal of education, the stigma of HIV/AIDS is decreasing. Some patients are living openly with the disease and acting as peer counselors to convince others to test.
UPDATE - MAY 2008
There have been many changes at Nata Clinic over the past two years. We are grateful we are still led by our Sr. Nurse Oipokile Gaokwale. She is much loved by everyone and does a great job under difficult circumstances. Nata Clinic began rolling out their ARV program and we now serve 450 of the 550 people who need ARV's. This has taken a big strain off of our clinic ambulances but transport remains a problem. Your donations have been put to work at Nata Clinic. We have purchased a fetal heart monitor, 2 otoscopes (for checking ears, nose, and throat), benches, fans, digital blood pressure machine, protective gowns, protective eyewear, office furniture, cleaning supplies, medical supplies, medicine, and two proffessional scales. By June 2008 the clinic will have a copy machine and washing machine. All of the equipment has helped to boost the morale of the staff and in turn allowed them to serve the patients better. There is a new building being erected at Nata Clinic that will serve as our very own ARV clinic. We tried and tried to get an autoclave but could not find a supplier. We will keep trying. Another important development is than Nata Clinic now has internet. It's been wonderful for this technology to come to our clinic and has helped for the staff to be more involved in the website. Nata clinic staff wish to thank the donors for lightening their load.