Secondary Health Care And Tertiary Health Care, A Compulsory Program In Health Policy

1.1 BRIEF INTRODUCTION OF CLIENT.

Madam “N” is a wife of Mr. Selbar from the family of Selbar Nimlyat a 40 year old middle age woman.

She is about 6.5metres tall and slim she is black in complexion and was brought to the comprehensive health Jos University Teaching Hospital (JUTH) Zamko branch Langtang North LGA Plateau state. The woman was brought to the hospital with the history of snake bite by her husband Mr. Selbar on the 12^th August 2017 at about 4.30 pm, with the following signs and symptoms:-blood from the site of the bite,

Swollen legs, pains and tenderness, headache, fever and fangs mark of the snake (two punctured wounds).

1.2 HEALTH CONDITION OF THE CLIENT.

In the consulting room during history taking, the patient was made to understand that she was bitten by a snake, a carpet viper venomous snake (poisonous snake type.) while returning home from the farm at about 3.30pm.

1.3 DIAGNOSIS

After the history taking she was admitted for observation and a laboratory investigation was conducted to determine whether the venom have been circulated to the blood or not. The lab test conducted is called” clotting time” which is usually observed for 20minutes.

1.4 FIRST CONTACT WITH THE CLIENT.

My first contact with the client was when she was brought to the hospital’s emergency room with the history of snake bite on the 12^th August 2017 that I picked interest in the case after the Doctors’ consultation and declaration of snake bite which the snake was killed and brought alongside with the patient.

1.5 CASE STUDY BACKGROUND.

Madam N’ was the first born of her family before gotten married to Mr. Selbar , she was borne grew up in Jimakwi village of Mikang LGA of plateau state Nigeria. She married in the same village

1.6 IMMUNIZATION HISTORY.

The history of immunization of Mrs. N” was not certain at that time that she was borne, but she was vaccinated against cerebrospinal meningitis vaccine and measles vaccine during the measles out braked that time without any updated records.

1.7 HISTORY OF PREVIOUS ILLNESS.

According to madam N” explanation, she was once admitted in the General Hospital Langtang North sometime in 2014 for chronic typhoid and malaria fever after laboratory investigation.

1.8 HISTORY OF THE PRESENT HEALTH CONDITION.

The present medical history of madam N” is accorded to snake bite in the farm as the client was working in the farmland of maize and yam. She did not wear any protected farming gadget like rain and hand gloves. The history also shows that the client had finished working in the farm and was about to go home when incident occurred.

On Examination, there was swelling, fang mark seen at the right leg. (R)leg fever and headache was also present.

1.9 FAMILY SOCIAL HISTORY.

The husband’s name is as follow:

Sure name:               Nimlyat

Other names:          Selbar Nanjing

Religion:                    Christianity

Occupation:             Driver

Sex:                            Male

Address:                   Before Baptist church Jimakwi (Mikang LGA

Plateau state)

CLIENT DATA:

Sure name:              Selbar

Other names:          Mrs. “N” Nanjing.

Occupation:             Farming

Sex:                            Female.

Address:                    Before Baptist Church Jimakwi Mikang LGA

1.10 FAMILY GRAPHIC TABLE SHOWING THE FAMILY PAEDAGARY.

  46yrs   40yrs   20yrs    15yrs    9yrs    7yrs   4yrs   1yr

                 KEY

46 Years               F (Father)

40 Years               M (Mother) Mrs. “N”

20 Years               1^st Child

15 Years               2^nd Child

9 Years                 3^rd Child

7 Years                 4^th Child

4 Years                 5^th Child

1 year                  6^th Child

1.11 PAST FAMILY HISTORY.

In the family of N”, there is no serious family health history ever known to both the family at the father’s house and also in the husband house (matrimonial home). However, they both had one time or the other experienced malaria and also typhoid attacks. These were treated accordingly.

1.12 PRESENT FAMILY HISTORY.

The present family history of madam N” is seen as the first wife of the family of Mr. S” who have two wives, but the second wife had just divorced the husband due to unknown caused. Madam N” could also be seen as the first child of mother. The families have no any serious ill health condition or medical challenge. However, madam N” is a mother of six children. There are four (4) boys and two (2) girls. The names of the family members and children and their age are as follows:

1. Selbar Nanjing Nimlyat —-      1971  =         46 years        = Father
2. “N” Selbar N. Nimlyat        —-      1977 =          40 years        = Mother
3. Patu Selbar                                     —-      1997  =          20years         =1^st Child
4. Lohnim Selbar                         —-      2002  =          15years         =2^nd Child
5. Sunday Selbar                         —-      2008 =          9years           =3^rd Child
6. Sarnak Selbar                         —-      2010  =          7years           =4^th Child
7. Godsave Selbar                         —-      2013 =          4years           =5^th Child
8. Nanmwa Selbar                         —-      2016 =          1year             =6^th Child

1.13 PRESENT MEDICAL HISTORY.

As been explained before, the present medical condition of Madam N” is snake bite from the due to unprotected farming gadget like rain boot, hand gloves and rain coat.etc. The above mentioned equipment serves as protected gadgets against external reptile bite or insect sting like snake bite or scorpion sting. In respect to the above, I was able to provide the rain boot and the hand gloves to the client to prevent further occurrences. I also advised her on environmental sanitation and bush clearing to avoid harboring of reptiles malaria vectors, also to provide toilets facility to avoid opened defecation which almost resulted to second episode of snake attack but God almighty intervened.

1.14 OBJECTIVES OF THE STUDY.

1. The main objective of this study is to establish a friendly and lasting relationship with the family for the purpose of supporting and promoting health.
2. To create awareness and health educate the peasant farmers on the use of protective gadget when farming or rearing animals.
3. To assessed the health status of madam N”.
4. To visit the families at home in order to make direct observation of their mental, physical, social and economic status within the content of their environment.
5. To create awareness about snake as a poisonous and deadly reptiles to human being.
6. To identify complications of snake to human being, animals and environment at large.
7. To produce report at the end of interaction with Madam N” and family.
8. To proffer solution to government for assistance on snake bite or government intervention on snake bite.
9. To know that snake bite is deadly.
10. To identify and know the classification of snakes and their types.