Centro de salud xochimilco (Week 1 Feedback)

Dra. Morales – She serves as a filter. Quickly trying to figure out what the patients’ complication is and what specialists and/or tests are needed for such problem. Patients get referred to specialist and sent to labs for labwork.

• A lot of paperwork is involved with her position. Every piece of paper (referral, prescription, lab work) must have patient information (name, number, address, basic health facts, etc.).

• This results in more almost half the visit spent in silence while she writes the information down.
  
• Sees patients nonstop (around 15 by midday).

• Her efforts against intimate partner abuse:

• She gathered a group of nine government workers including a psychologist, doctors, social workers, and lawyers. Doctors at Xochimilco are trained to be able to identify victims of DV and patients are followed up with psychologists who go through a thorough questionnaire to idenfity level of intimate partner abuse and file a report with the police.
• Psychologistat the clinic gave presentation to patients sitting in the crowded waiting room about intimate partner abuse (among other topics).
• Nobody forces the victim to make any decisions. The police report is simply put on file as evidence to help the victim in the future if, and once, the victim decides to “denunciar” the perpetrator.
• Problems:

• Medical school curriculum does not include detecting intimate partner abuse
• “Mandatory reporting” is ONLY in cases in which firearm is used against victim or the damage to the victim’s body takes more than three days of hospital stays to heal (According to Dr. Victor Tenorio).
  

Consultation rooms are definitely not as equipped as they are in the USA

• Patient bed sheet not changed all day long (and possibly not washed overnight).
  
• Smallroom; uncomfortable chairs; also serves as storage room (people occasionally come in during patient visits to take out documents from cabinets); no airconditioning system.
  
• Limited medical equipment

Preventative care and community health is highly emphasized here.

• Presentation EACH day to waiting room (DV, raising teenagers, etc.
• Dengue prevention – community visit (one case from the area, send nurse and administrator to surrounding community to check people’s patios, hand out abate-grains that kill mosquito larava-)
• Diabetes weekly meeting – check blood glucose levels, weight, blood pressure, give words of encouragement and health tips. Patient community. Free amazing food!
• COMMUNITY FEEL – everyone knows each other (ex. nurse talked to someone on the street about why she had not shown up to her visit, neighbors informed others of dengue problem, etc.)

General patient health conditions

• Adults:

• Diabetes, overweight, pregnancy, depression (other psychological problems)
• Lack of insurance (seguro popular)

• Children:

• Accidents, underweigh (I only saw three or four children patients)

Overall, the Centro de salud xochimilco impressed me immensely. Their mixture of disease prevention, community health and primary care was not only thorough, but also very effective.