JMAP 2022 - Hiteen: A Day in Pictures
My clinic room for the day.
Normally used for paediatric clinics - made for a pleasant working environment.
My capacious room from last week was being used by the dermatologist who benefited from the space to perform procedures.
All the clinic rooms and facilities are nicely configured across one floor.
X-ray capabilities across the corridor.
Allowing for rapid diagnostics.
Patients are given the physical (old-style) x-ray film to be viewed on our film viewers if computer facilities aren’t available.
Laboratory.
Able to process all routine blood work - including a blood gas machine - basic immunological tests and urine cultures.
Phlebotomist in the adjacent room.
Blood samples handed straight to the lab technician, hot out of the oven.
Emergency room.
A small area with three bays, one of which is a paediatric bay.
Initial assessment and treatment can be provided to sicker patients.
Nine hours a day, seven days a week.
Those requiring further stabilisation and management are referred to the local government hospital, 15 minutes away, and sent by ambulance.
The absence of a defibrillator surprised me - stimulated an interesting debate with colleagues.
A peaceful environment today.
It didn’t feel like your usual emergency department resuscitation area.
Only one bay was occupied by a patient when I explored the unit.
She was receiving a bag of fluids.
She is going to be followed up by our general practitioner.
The paediatric bay in the emergency room.
This bay doubles up as a breastfeeding area.
For those who wish for privacy.
I found a patient praying in there later in day.
Pharmacy.
Supply of basic outpatient medications.
The pharmacist issues me with a list of available stock prior to starting my clinic.
I exhausted Depo-Medrone supplies last week and we are waiting for these to be replenished.
I have scheduled all joint injections for next week.
Kitchen.
The mint leaves were especially brought in to satisfy my new-found taste in mint-infused hot water.
Generic hospital biscuits not found here.
Cleared the list.
Much to the surprise of the clinic manager, Yaseen, I had cleared the 35-patient list by 1pm.
My efficiency has improved, without compromising on patient care.
I think I’m beginning to meet expectations.
‘Walk-in’ patients trickled in until I finished at 4:30pm.
I’m expecting a 50- to 60- patient list next week!
Lunch.
Fast food is not my usual style.
But when offered in the absence of a substantial breakfast, it’s hard to say no!
I promise there is shawarma hiding underneath the thick layer of fries!
Yaseen is going to cook us bamya (okra stew) for lunch next week. He used to run a successful restaurant before turning his hand to healthcare management.
People here are impressively multi-talented.
Not yet paperless.
Clinical notes, investigation requests, prescription pads and referral requests.
Once a patient has a blood test, they bring the results for me to review next time they see me.
In the absence of an IT system to store this data, patients are responsible for keeping a physical record of all their test results.
Speciality clinics.
Patients can either book or walk in to see a particular specialist, depending on their symptoms, without referral from a general practitioner.
I receive many on-the-day referrals from orthopaedics because often patients are unaware their symptoms are rheumatic in nature.
To the left (read top to bottom): Pharmacy, Radiology, Cardiology, Orthopaedics, ENT, Ophthalmology.
To the right (read top to bottom): Dentist, Paediatrics, Dermatology, Laboratory, Obstetrics & Gynaecology.
Do you think I could convince them to fill the final box with ‘ الروماتيزم ’ ?
That translates to Rheumatology.
Primary school.
Offering education and hope to Hiteen’s many children.
Situated adjacent to the JMAP clinic.
Funded by UNRWA.
Playing field.
Located next to the primary school, also funded by UNRWA.
I was thrown on as a last minute substitute by the camp’s children.
Got a few touches on the ball, no goals though.
I also couldn’t draw in a capacity crowd to the game.
Two of the children were exceptionally talented.
There’s no harm in dreaming.
A neighbourhood growing in size.
A neighbourhood sinking in deprivation.
As the population rises, the living conditions worsen.
Zinc roofing sheets.
Over many years these have been mostly replaced by solid and permanent roofing, except for a handful of homes.
Conversely, the Jerash/Gaza camp homes are predominantly covered by zinc roofs.
Homes with zinc roofing are essentially uninhabitable during colder and wetter months.
Some have no choice.
A typical Hiteen alleyway.
Imagine this at night.
There is no street lighting here.
Balancing the books.
Those fortunate enough to work or build local business struggle to stay afloat.
This place sells hummus, ful medames and falafel.
I will taste some on my next visit to the Hiteen/Schneller refugee camp next week.
