Sankalp Hosts a AJWS Volunteer Nurse from Israel

July 15, 2010 11:35 am

by Vered Kater, RN, BsN, MsN, Newsletter April 2006

When the American Jewish World Service (AJWS) asked me to come to Mumbai and volunteer for SANKALP, I was not sure what to expect. I am a nurse and normally work in Jerusalem where I teach nurses at the Hebrew University in the School of Nursing.

I was asked to work with the nurses and give a first aid course for the outreach and Drop in Centers (DIC) workers. In theory this sounded fine but in reality the needs here are rather specific. At the first meeting with the learners I asked what they would like to be taught. Requests ranged from understanding hepatitis, coping with blood spills, treating bedsores and bandaging fractures and abscesses and treatment of convulsions.

Before beginning the training sessions I worked in the DIC’s and in the city with the outreach workers, observing needle exchanges and the communications of the staff with the addicts. In addition I spent some time at the shelter I learned to differentiate between the different users, chasers, smokers, snuffers and intravenous users. This opened a whole new world for me. I also assessed the difficulties of the nurses while treating abscesses and dispensing medications and the gaps in safety awareness when treating patients.

For instance, the nurses managed to infect all the utensils in the treatment box while treating a patient with maggots. In addition the gloves were thrown away in an open wastepaper basket, after which the nurse returned to the task of dispensing medicines without washing her hands.

On the streets of the city the SANKALP staff while exchanging needles, were also endangering themselves by carrying the used needles in a plastic bag. Jumping on crowded trains and busses increased the dangers of getting pricked by needles. With these observed needs together with staff requests, the training sessions were designed. My goal was to help the staff of Sankalp to help themselves and to teach them how to prevent getting infected while providing care. First Aid, First Us became a slogan, at all interventions, the implementation of universal precautions was practiced.

Staff training took place in the office and the attendance was very good. Each theoretical discussion was immediately followed by a practical session. The first topic was maggot care. A head was made from newspapers around a pot, medicine bottles were wrapped in white toilet paper and filled with food-colored water (3 different colors representing peroxide, setavlon and bethadine). One of the learners volunteered to demonstrate how to treat the “patient”. The end result was as expected, each bottle had 3 colors, as well as the anti-septic ointment (a plastic tube). Small basins are now used to pour the medications in before starting the treatment. By visualizing the effect of non-clean working practices the message was clearly understood by everybody.

Another session was dedicated on dressing and undressing a patient. This decision was taken after I had assisted with this task when we hospitalized one of the SANKALP clients. With a lot of laughter the staff discovered that pushing a floppy arm or leg in a sleeve is not the best way. Bedsores, massage and changing sheets with a patient in the bed were also practiced. One might argue that none of these subjects were related to first aid, according to my philosophy first aid is what is needed first and these were the identified needs.

I decided to work also directly with the clients that are on the replacement treatment and that stay in the DIC during the day. I taught them relaxation, positive imagery, affirmations and laughing meditations. These activities were appreciated and several clients are continuing these practices by themselves. The sessions took place every day and were frequently led by one of the learners who was tutored by me.

Small first aid kits were put together for the outreach staff, after a session on wound care they can now put to practice their newly learned skills.

Being with SANKALP workers not only gave me the opportunity to share my knowledge. I learned much from my learners, I admire their courage to work with the addicted clients in spite of or perhaps because of the fact that many have been on this road themselves. Their strength to continue to stay clean with all the temptations around them every day is amazing. SANKALP has apparently found the magic formula to help people to rehabilitate themselves.