Question

Scenario: An expatriate nurse has been given a mandate by an international medical NGO and the host country’s Ministry of Health to identify outbreaks of meningitis in rural areas. She visits numerous remote health clinics with a driver and translator in order to assess where the greatest needs are so as to optimize the allocation of scarce healthcare resources to address the outbreak.

In many locations, the clinics are understaffed and seem to be overwhelmed with many seriously ill patients and a crippling lack of medicines. However, the patient numbers at several of these sites do not meet the strict epidemiological criteria of a meningitis outbreak, as defined by the international NGO and Ministry of Health. As a result, these sites are unlikely to receive additional personnel or resources, despite the fact that the local clinic staff are barely able to cope with the present burden of disease. The overwhelmed clinic staff plead for more support and ask the expatriate nurse to stay and help treat patients. The nurse is deeply conflicted about what to do.

Questions:

What are three aspects of the case that consider new information or that offered deeper context.

What are two aspects of the case that can apply in practice healthcare field now or in the future.

What is one aspect of the case that found confusing, created question for further consideration, or which would to learning more.

Answer 1

Three aspects of the case that consider new information:

The above case scenario considers the information, that offered deeper context, are:

1. Outbreak of meningitis

Meningitis is the infection and inflammation of meninges, the coverings of brain. It is an infectious disease ( bacterial or viral meningitis) characterised by headache, neck stiffness and photophobia, fever, chills, myalgia and vomiting.

2. Epidemiological criteria of Meningitis

Epidemiological criteria if Meningitis dealing with the Agent, host and Environment interaction. The caustive agents of Meningitis may be Virus , bacteria ( Streptococcus Pneumonia, Heamophilus Influenza, Neisseria Meningitidis) or fungus.

Mode of transmission: Close contact between person to person may increase the spreading of infection as the infection spread through the mode of droplets of respiratory and throat secretions. In outbreak areas, the people should avoid close contact, sneezing and coughing in the public places. They should wear the masks and need to keep healthy distance to prevent cross infection.

3. Scarcity of healthcare workers : Inequalities in the health services are existing in between the rural and urban areas in most of the countries. Health care workers are more tend to be concentrated in the urban areas. An area of the health care sector that need more reformation and concentration by the Government is rural health sector, especially in the outbreak areas. Lack of knowledge and unhealthy practices may increase the susceptibility of the rural people to communicable diseases like meningitis. Many children may die or disabled due to Meningitis in developing and under developed countries due to poor health services and inadequate medications.

Two aspects, that can apply in practice:

1. Appointing an expatriate health professional to study the actual condition of rural areas ;

Appointing the experts from the health care field to study the outbreak of an area can help to study the actual situation. An expatriate person can study the situation without any objective bias and influence of local community. The report, they submit can be the result of actual study after hearing the local people and the health staff from the rural areas. She can focus on the health situation rather than the political situation of the country or the area.

2. Creating Awareness about the epidemiology of communicable diseases : Another aspect in the case , that can apply in the practice is creating the awareness among population and health workers about the epidemiology or the mode of transmission of the communicable diseases. By creating a public awareness on the prevention of Meningitis can help the population to prevent further spreading of the disease.

One aspect of the case that found confusing:

The aspect that found confusing in the case scenario, is the request of health care staff to the expatriate nurse to stay with them and help. Instead of requesting her to submit an actual and detailed  report about the situation and to recommend the Government officials to allott more staff and resources to the area, especially the out break areas, they were asking her to stay and help them even though she is an expatriate nurse appointed by the NGO and the Ministry of health.