I arrived five minutes late for the 8am meeting today and missed prayers. Impressively, one nurse who had been on nights and another who had started her holiday both turned up for the meeting. One staff member came in 10 minutes after me, and then we had a full complement. I was sitting next to Nurse Zulu who was cold. She was wearing red woolly Christmas socks, with flip flops.
The first item on the agenda was community work. Mr Chulu, the public health inspector, encouraged staff to meet and engage with the community. Everyone thought this was a good idea, especially as community work attracts a financial bonus, but our clinics are extremely busy and no staff can be spared. We discussed how we might do this, but came to no decision.
After the meeting, I asked Mr Chulu to list the specific campaigns with which he needed support. The date for the mass dosing of people with DEC to counter filariasis has not been fixed. Neither has the date for the administration of vitamin A and de-worming tablets to children. He plans to visit the villages which have a greater incidence of malaria, to ask about the use of impregnated bed nets and to look for mosquito breeding sites. He wants to do some health education sessions in schools on HIV and sexually transmitted diseases. He said he would be grateful for my help.
The next item was the complaint about health workers “chit-chatting while the queue of sick patients grows longer on Monday mornings”. Everyone agreed that it was necessary to have a meeting on Monday as this was what all civil servants do. One health worker said, “If I go to the Ministry of Agriculture offices on Monday mornings, I have to wait.” Another countered this, saying, “But they don’t do any work. We have to see all these patients.”
One nurse spoke about changing the day of the meeting, only to say it was not possible. Then something rather strange happened. “We could start work earlier, have the meeting from 7:15 till 8am, then begin seeing patients,” said a senior nurse. This would be a shorter meeting, so there should be a timed agenda, to avoid overrunning. “But what if staff come late? What do we do then?” “We send a volunteer to find out why that person is tardy.” Everyone agreed. I was shocked.
There were two official data collection meetings at Crystal Springs Hotel in Chipata, each lasting two days, with a generous per diem of $55. The letters specified who was to attend, so there was no discussion. We welcomed a new staff member who had been posted to Kakumbi as a punishment.
Finally, there was a disciplinary matter which took up 25 minutes. Someone was not doing their job and the new nurse in charge confronted the person at the meeting. This was not the first time the staff member had failed to do their duties. The “in charge” asked other people for their observations, and then asked the staff member to respond. Unfortunately, the response was in Nyanja so I didn’t understand it.
The nurse in charge replied by saying, “To deny is to disrespect your supervisors. Coming on pompous will make you lose out. Humble yourself and work.” The threat of disciplinary action was raised (a transfer to a less popular health post) if there was no improvement. It was rather intimidating, but someone spoke out in mitigation, “We are all human, we all make mistakes.” The written warning was entered into the minutes.
At “any other business”, someone raised the issue of poor communication when patients with tuberculosis were transferred from Kamoto Hospital to the health centre. Apparently this is because the officer who used to do this job has left and not been replaced. Another problem was the lack of laboratory cover at the weekend, because the two workers had both been given leave at the same time. This was the busiest time of the year for the lab, with all the malaria tests being required. No one knew how this could have occurred.
There were no questions about the week’s rota (the main reason for having the meeting on Monday mornings). I asked about the public holiday, African Heroes Day, which falls on May 25th; we will just open for the morning on that day.
We kept to time and we made some decisions. All in all, more effective and efficient than many NHS meetings I have attended. I will have to get up earlier next Monday to see what happens.