MARY NELLE REEANNE R.
ETCOBAÑEZ
RTRMF – MEDICAL CLERK
CLERKSHIP ROTATION: PUBLIC HEALTH AND COMMUNITY MEDICINE – CHO TACLOBAN
COORDINATOR: DR. GLORIA ENRIQUEZ-FABRIGAS, MD, MPH, MPA
DISTRICT HEALTH CENTER DATE
SAN JOSE DISTRICT HEALTH CENTER JANUARY 2-6, 2023
TACLOBAN CITY HEALTH OFFICE (MAIN) JANUARY 9-13, 2023
SAGKAHAN DISTRICT HEALTH CENTER JANUARY 16-20, 2023
DIIT DISTRICT HEALTH CENTER JANUARY 23-27, 2023
SUMMARY OF ACCOMPLISHMENTS
CONSULTATIONS
PEDIATRIC 53
ADULT 52
TOTAL 105
TOP 3 CASES SEEN
● SYSTEMIC VIRAL INFECTION
● HYPERTENSION
● ACUTE ASTHMA/PNEUMONIA
TOP 3 CHIEF COMPLAINT
● COUGH AND COLDS
● FEVER
● HYPERTENSION
TOP 3 MEDICATIONS GIVEN TO COMMON
COUGH AND COLDS
● CARBOCISTEINE
● LAGUNDI LEAF
● CETIRIZINE
VACCINATION
● EPI VACCINE 47
● COVID-19 VACCINE 2
● FLU VACCINE 1
OTHERS
LABOR ASSIST ✓
DIDACTICS (PCAP) ✓
MCCOD ✓
PROBLEMS ENCOUNTERED:
Bad weather condition
Heavy traffic
Flooded areas
Shorter amount of time spent on some health centers due to work suspension cause by
heavy rains.
Rude patient
ALTERNATIVE COURSE OF ACTION:
Bad weather condition can cause heavy traffic because vehicles are being driven slowly due to
some flooded areas and these are my top three reasons why I am sometimes late. But to avoid
these, I would allot longer times for travelling to arrive on time at the area where I was assigned.
Some days for work were suspended due to heavy rains and these affected some of our targets
to meet our goal but for us to achieve this we would sometimes extend and use our spare time
for lunch.
Be professional. Remain calm and explain well to the patient what is the procedure to be done.
REFLECTION:
In my 4 weeks of Community Medicine rotation at the Tacloban Local Government Unit, I
learned a lot of things that cannot be learned in the hospital. In the community, I was able to
meet different kind of people with different stories. I realized that we are not just doing physical
exam or merely giving them medicines to get treated but sometimes these people just need our
encouragement for them to have a proper health. I also learned a lot from the physicians who
were guiding us in everything that we do in the health, and although some of them already
aged, they are still continuing their service to the people and it is such an amazing thing that
they are still dedicated to their profession regardless of their age and all of their achievements. I
also appreciate the nurses, midwives and barangay health workers, we may have a higher
education but there are a lot of things that you can learn from them out of their experiences. I
learn how to properly talk to patients at the community, their techniques on giving vaccines to
children and even how to assist calmly on a mother who is giving birth. These are just some
ordinary things to others but for me, not only knowledge was gained but also skills in this
rotation.
FINAL REPORT:
WEEK 1: SAN JOSE DISTRICT HEALTH CENTER
We had our orientation with Dr. Fabrigas at the CHO and we were designated to different
district health centers. I was assigned at San Jose District Health Center. At first, I have no idea on how
to diagnose, manage and treat pediatric patients since we haven’t rotated on Pedia department yet.
Thankfully Dr. Fabrigas conducted a short review to us on how to get the Weight for Age, Height for Age,
Height for Weight and the MUAC of pedia patients. This is really important as it will also help us identify
if a child suffers from acute or chronic malnutrition. Getting the age and weight of the child will also help
us to give the proper dosage of medications. This is very helpful to us as most of our patients where we
are assigned on our first week belonged to the pediatric group. Dr. Ciacho who is the assigned physician
at San Jose District Health Center also help us in assessing our patients, taught us on how to give proper
diagnosis and treatment. The healthcare workers as well as the other staffs were also helpful to us.
WEEK 2: CITY HEALTH OFFICE (MAIN)
We were assigned at the main office which is Tacloban City Health Office. I assisted on Dr.
Salinas and Dr. Fabrigas. In this assignment, i learn how to quickly compute for the dosage of the
medicines to be prescribed to pediatric patients. Since there are a lot of patients, we have to be fast but
sure of what we are doing to accommodate more patients. I also had my first experience of vaccinating
pediatric and adult patients. I was nervous at first but the nurses were kind and helpful in guiding us in
vaccinating every patient, And although we only had a shorter amount of time spent due to the bad
weather condition which requires suspension in the government offices in this assignment, I was able to
learn a lot, gain some skills and become more concern on preventing some diseases by giving health
advises.
WEEK 3: SAGKAHAN DISTRICT HEALTH CENTER
I was assigned at Sagkahan District Health Center. It was a bit challenging for us since there was
no physician assigned on the health center where we can nearly ask and refer to our patients, but the
cases were somehow manageable and those that we have encountered on our previous weeks. we had
our consultations where most of the chief complaints were cough and colds among pediatric patients.
The health center also had its scheduled immunization where we vaccinate 110 pediatric patients. We
first screen the patients for contraindications and precautions even if they already had that vaccine
previously. Before we administer the vaccine, we make it sure that we know what vaccine are we giving
to our patients by asking the nurse who is in charge of dispensing vaccines before she hand it over to us
to avoid errors and health complications to our patients. We also assisted on a teenage mother who was
about to give birth to his 2nd baby, a few hours later she delivered a healthy baby girl.
WEEK 4: DIIT DISTRICT HEALTH CENTER
We were assigned at Diit District Health Center where Dr. Escape is the physician in-charge. It
was also an advantage to me since it is just near our house. Just like with our previous assignments, we
also had our daily consultations where most of our patients were children and there were some adults.
Dr. Escape guided us in every patient and after we examine the patient, we would tell him our findings
then he also checks them if our findings are accurate. And although the patients are not that many as
we have on our previous assignments, there is no time wasted because while waiting for patients Dr.
Escape has so much to share about his past experiences and we learned a lot from him not only with
regards to clinical skills and his techniques on handling patients but also with some important lessons in
life.