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From Outreaches to Inreaches, TLC Expands Patient Care

(Some stories go untold. This one is three years in the making.)
While TLC regularly goes to wherever people live in rural and underserved areas of Eswatini, now patients also come to The Miracle Campus seeking treatment. In great numbers. Every day.

Urgent cases. Emergencies. Hospitalization. Routine ART (AntiRetroviral Therapy) refills and counseling.

The same systems, the same dedication, and the same compassion that make possible more than 120 mobile outreaches annually spill over into “inreaches” every day of the year. 

It’s a busy place these days, the Miracle Campus in Sidvokodvo. It’s a learning center for prospective staff. It’s a hub for supply chain logistics. It’s the workplace for more than 600 people.

Patient registration is important, as is patient satisfaction.

But mostly, the Miracle Campus has become an “inreach” for patients. The word is out in Eswatini: “If you are hurting, find a way to get to The Luke Commission’s base of operations, and you will receive help.”

“I like the name ‘inreach,’” said Dr. Fletcher, who has been at TLC for three years, and along with Dr. Harry, heads up a team of nine doctors. 

This hospital patient knows where to draw strength for this day.

TLC’s ‘reach’ means anyone can come ‘in’ too.

The Specialized Care and Surgical Center, TLC's hospital, is still under construction inside. However, the building is enclosed and usable. And in use it is! 

SCSC patients know their turns will come.

More than 100 patients come through SCSC daily. They are patients who arrive for the first time with common medical conditions. SCSC is set up like a typical outreach with 10 departments, including pharmacy, cancer screening, counseling, vision and hearing care, and prayer.

Patients are registered and triaged beginning at 7 am. Often the line at the gate is long. Patients are given chairs to sit in while they wait by the guardhouse.

Pharmacy staff members at SCSC entertain a patient’s baby while her mother consults with a doctor.

Meanwhile, Vehicle Warehouse Number 1 (the sixth warehouse is currently under construction) is no longer used as a warehouse for vehicles. It’s the main on-campus medical center for patients who need a full assessment, for return patients, and for patients with complex conditions. Normally, three doctors and eight nurses serve the 75 to 150 patients a day in V1.

The big vehicle warehouse door is opened for fresh air, as many patients are being attended in this Miracle Campus medical center.

Always-smiling Phumaphi is one of the lead nurses at V1. She loves her job. 

“I always try to put myself in someone else’s shoes, from the patients to the doctors. I like to be a life-saver,” she laughs. “I like to be called to help and relieve stress for someone else, especially a new patient or staff member.”

Phumaphi checks another nurse’s patient information. iPhones and iPads keep everyone connected at TLC.

Phumaphi’s exuberance even does her own heart good.  “I’m learning from everyone,” she said. “There’s no need to be grumbly. We just show love. God is love. Love makes everything else flow, even for patients who are receiving hard news about their health. That way you represent Jesus.”

Dr. Fletcher said he often meets patients for the first time in SCSC. Then he may see them for followup care in V1. “God is always part of that care,” he noted.

Dr. Fletcher (left) is assisted by translator Sifiso to understand a patient’s medical concerns for her children. From Zimbabwe, Dr. Fletcher says he understands about half of spoken Siswati.

Some patients are admitted to the hospital. It currently can house about 50 patients. Another wing is being constructed, which will more than double the hospital’s size.

One morning recently, Dr. Simon was doing rounds at the hospital with a new nurse. “How has patient care changed in the two years you have been here?” he was asked.

Simon (left) discusses patient care in TLC’s hospital.

“The capacity has grown from managing ART patients to seeking intricate answers for complicated medical cases,” Dr. Simon explained. “We have extended to pediatrics, palliative care, mental health, and so much more. We’ve started to offer physical therapy, consulting with a group in the US. We even offer music to the patients.”

“Do you like you your job?” Considering whether or not this was a trick question, Dr. Simon hesitated for a moment and then answered: “You know I do.”

Prayer is given in station 3 of SCSC with Sifiso (left) and Jabulane. Vision care is offered in station 9.

Graduating in medicine in 2012, Dr. Simon said he particularly likes the patient-centered care and the addition of more nurses.

The Luke Commission currently employs about 55 nurses whose jobs include participating in outreaches, community health visits, and, of course, the hospital, V1, and SCSC inreaches. They are on call for emergencies.

Hospital patients catch the warmth of the morning sun. Notice the new hospital wing being constructed by TLC’s asset team.

Medical care at The Luke Commission is available 24 hours a day. People approach to the gate at all times day and night. “We have a team on duty at all times,” noted Dr. Fletcher, who has been a doctor since 2005. He is from Zimbabwe and moved his family to Eswatini with him.

When asked what changes he has seen since coming to The Luke Commission, Dr. Fletcher answered with his own question: “Besides me?” he said, only half-kidding.

Counselors and nurses catch up on iPad entries at one end of the hospital ward.

Then came his observations. Dr. Fletcher said he has seen the number of employees “multiplied I don’t know how many times, patient numbers up significantly, personal growth in the team, and a very efficient team at outreaches.”

“The character of the team, and me personally, has changed. They’re on another level,” he noted. “Now I think before taking a step, is this the good or right thing to do?”

Dr. Fletcher teaches and trains in V1. Always teaching…

Continued Dr. Fletcher: “My definition of humble has changed. Doctors often send up with an element of pride that can affect the cohesiveness of the team. However, you are always learning in medicine. In complex cases, you think and then rely on the team. I’ve learned that working as a team is better for the patients.”

And more: “Harry has made me look at things differently. It’s okay to admit to a patient that I don’t know what’s going on with him, but I will try to find out.”

Patients leave campus, thankful for their care. Staff leave campus, thankful for being part of TLC team.

With nine doctors on staff, Dr. Fletcher said, “Harry is my go-to guy.”

Dr. Fletcher followed with an African story. “Teamwork throughout TLC is like a puzzle. Each piece has its own place, and if some pieces are missing, we might not see the giraffe that all the pieces make.”

“It’s another day’s journey, and we’re so glad about it…” the old song says.

In other words, every member of the TLC team plays a part in patient care. Doctors and nurses and medical assistants, for sure, but also cleaners and counselors and cooks, builders and business people, donors and doers, whoever they (and you) are. 

May the inreaches continue…

(Janet Tuinstra)

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