WEBVTT

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[REGGAE MUSIC]

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MAVIS GILMOUR: This is
Jamaica, our Jamaica.

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We have got cool mountains
and hot music, green fields,

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blue waters, pretty beaches,
beautiful views everywhere

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you look.

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There's really no other place
that seems to have so much

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of what everybody
wants and needs.

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We have got new industries,
making new jobs.

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No wonder so many people
come to Jamaica as strangers

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and go away as friends.

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And no wonder so many of our
relatives who have gone abroad

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are so happy to come back home.

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Everywhere in the
island, you can

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see a friendly
wave, a happy smile,

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and see our folks walking good.

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But things are not quite as
rosy as we want them to be.

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Think about the children you
see who walk around half hungry

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all the time.

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They never get a
good start in life

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because there are too
many of them in the family

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and not enough food
or money to go around.

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Or how about the cultivator who
cuts his leg with his machete

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or mother who cuts
herself on the wash pan,

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and there is no one about
who knows how to take care

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of the wound, all the old
folks who just cannot make it

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to the nearest
clinic by themselves,

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and they have
nobody to help them?

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And every day, there are more
babies being born, more mouths

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to feed, more bodies to care
for, more schools to build,

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more jobs to find.

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In the country
parts, especially, it

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is awful hard to get medical
help when you need it.

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Clinics are far away
and difficult to get to

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over bad roads.

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The clinics are often crowded.

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Well, the plain
truth is we're still

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terribly short of
doctors and nurses,

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and it takes many
years to train them.

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Good health is
everybody's concern.

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Jamaica's future depends
on having a healthy people.

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Our greatest health
need in Jamaica

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today is the lack of
medical help and knowledge

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at the village level, in our
homes, and in our families.

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To help provide the
health care that

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is so badly needed, especially
in the country parts,

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the government has started
a new program, a program

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of community health aides.

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KENNETH STANDARD:
Well, our department

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of social and
preventive medicine

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has been working for some
time in the nearby village

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of Hermitage.

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And in recent years, we
extended our services

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to the neighboring
community of August Town.

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This we did with
limited resources.

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But in doing this, we involved
the community from the outset

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in helping to plan the program.

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And from the community,
we had volunteers who

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assisted us with the clinic.

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Then it occurred to
us that at some stage,

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it would be nice if
these volunteers who

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were helping in
various ways could

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be given some
organized training so

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that they would be able to
function more effectively.

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Our concept was
that this training

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should be valuable to
the aides in helping them

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to be the arms of the
health nurse working

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in the community, our
own public health nurse.

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The responsibilities of
the aides, we often stress,

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was that they would
work not alone

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but under the direct supervision
of some professional worker--

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in our case, the
public health nurse.

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But we saw them as
working as the arms,

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also, of community development
workers and, in fact,

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bridging the efforts
in the community.

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In fact, they could be
considered the first port

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of call for activities
related not only to health

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but community development.

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[MUSIC PLAYING]

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KENNETH MCNEILL:
We have recently

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introduced a new
system of health care

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delivery in Jamaica, which
involves the use of community

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health aides.

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We have, therefore, taken
the decision in government

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to implement it substantially
in the first place

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to cover the parishes
of Hanover and St. James

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and also to cover a substantial
portion of the city of Kingston

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in the areas of greatest need.

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And this is the manual
of the training program.

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You'll see it's quite a
comprehensive manual that

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covers a number of
what we describe

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as modular skills with which
these people will be equipped.

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And here is Nurse [INAUDIBLE],,
who is our senior public health

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nurse--

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in fact, the principal
nursing officer

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in charge of the
public health program,

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and who is, in fact, in
charge of this program.

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Now, I want you to understand
that this program falls

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under the professionals.

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It will fall under the
public health nurses

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so that the community
health aides will be trained

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by the public health nurses.

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They will be responsible
to the public health nurses

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so that we are not fragmenting
the general responsibilities.

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SPEAKER 1: I'm going
to do it for you today,

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but you must take
her to the clinic.

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tomorrow, must take
her up to the doctor.

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SPEAKER 2: Yes, all right.

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MAVIS GILMOUR: Community health
aides will work in the village

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where they live.

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They will bring
health care and advice

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to the families in
their own areas.

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SPEAKER 1: This thing
that I'm putting on here

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is acriflavine--

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acriflavine.

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Can you remember what you give
Angela for lunch yesterday?

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SPEAKER 2: Well, for
lunch, [INAUDIBLE]

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get the [INAUDIBLE] porridge.

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SPEAKER 1: Porridge?

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SPEAKER 2: Yes.

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SPEAKER 1: What
kind of porridge?

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SPEAKER 2: Cornmeal.

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SPEAKER 1: Cornmeal?

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SPEAKER 2: Yes.

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SPEAKER 1: Fine.

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What kind of milk did
you put in the porridge?

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SPEAKER 2: Dry milk.

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SPEAKER 1: Dried skim milk?

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SPEAKER 2: Yes, yes.

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SPEAKER 1: Oh, fine.

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Anything else that you can
remember for lunch yesterday

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that [INAUDIBLE]?

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SPEAKER 2: And some biscuit.

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SPEAKER 1: Biscuit?

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SPEAKER 2: Yes.

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SPEAKER 1: Fine.

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How many children have
you got, Mrs. Thompson?

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SPEAKER 2: I have
here eight children.

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SPEAKER 1: Eight children?

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SPEAKER 2: Yes.

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SPEAKER 1: Mrs. Thompson,
what are you doing about it?

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You want to go to Eldersley?

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SPEAKER 2: Yes, next month.

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I want to start it.

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SPEAKER 1: You didn't go there
since you have the last child?

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SPEAKER 2: No.

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SPEAKER 1: Why you didn't?

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Don't you know that
delay is dangerous?

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SPEAKER 2: Yes, that is true.

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SPEAKER 1: Well, Mrs. Thompson.

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SPEAKER 2: But you
have a sick baby.

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You know, that's why I
[INAUDIBLE] doing all the time.

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SPEAKER 1: Well, with
all the sick baby,

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Mrs. Thompson,
delay is dangerous.

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And what I'm advising
you, Mrs. Thompson,

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is that you go to the family
planning clinic in Eldersley.

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SPEAKER 2: Yes.

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SPEAKER 1: You will
meet with the officers

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there, the family
planning officers.

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And they will be able to
tell you much about it.

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SPEAKER 2: Yes.

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SPEAKER 1: Even more than what
I would be able to tell you.

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And you'll get all the
information that you need.

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Then Mrs. Thompson?

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SPEAKER 2: Yes?

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SPEAKER 1: What about
the baby's father?

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Is the baby's father
supporting the child?

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SPEAKER 2: No.

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SPEAKER 1: Oh.

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Imagine, the baby's father
is not supporting the child.

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And how you believe
that you will get along

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with so many children?

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SPEAKER 2: I don't know.

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I have to go and look work.

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SPEAKER 1: And if
you have a baby,

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you cannot look
work with a baby.

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SPEAKER 2: No, can't go.

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SPEAKER 1: Well,
you see the sense

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in what I am saying to you.

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You see the sense in
what I'm saying to you?

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SPEAKER 2: Yes, yes.

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SPEAKER 1: And you are
going to promise me?

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You are promising me that I'll
see you at the family planning

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clinic in Eldersley?

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SPEAKER 2: Yes, I hope
to go there next month.

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SPEAKER 1: Promise me
that I will see you there.

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SPEAKER 2: Yes.

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And leave something
up there good for me.

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SPEAKER 1: Oh, that's funny.

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SPEAKER 2: Very nice.

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[LAUGHS]

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SPEAKER 1: That you will get.

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That you will get.

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That you will get.

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MAVIS GILMOUR: The community
health aides will work closely

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with the public health
nurse and leading citizens

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who take an interest in
community health matters.

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SPEAKER 3: [INAUDIBLE] today
Mrs. [INAUDIBLE] Gordon.

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And she's a new
community health aide.

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You know, she will be
working in this area.

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She has undergone a period
of eight weeks' training,

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and she is expected to do
those duties that do not need

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the skill of a trained nurse.

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I know that you are a
person who is always

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very interested in the
health of the community

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and the whole well-being
of the community and that,

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especially, like
I've always come

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to talk to you
about these people,

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I have brought Mrs. Gordon.

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During her period of
eight weeks' training,

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she has covered a number of
subjects, important subjects,

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subjects that will
help her to really help

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the people in our community.

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And she's very interested
in this sort of thing.

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You know, she has
covered subjects

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like first aid and
bandaging, home nursing,

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knowing the common signs
and symptoms of disease,

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knowing about the
circulatory system

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and the digestive system.

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She has also covered things
about her community health

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and knowing her
community, knowing

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the people who live
in her community,

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and knowing the services
that are available.

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SPEAKER 4: That's nice.

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SPEAKER 3: I'm
sure you will find

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her a very interested person
in the community at large.

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And I am sure you
will always find work

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for her because you're
always having your sick list,

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and you're always wanting
us to come in and see

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to these people.

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SPEAKER 4: Let me hope so.

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SPEAKER 3: I'm sure she
will be a great help.

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SPEAKER 4: Well, I'm
delighted, Mrs. Gordon.

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MAVIS GILMOUR: Many old
people need special help.

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This old man is deaf and lives
far away from the clinic.

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He has a sore on his leg.

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The community health aide is
doing a dressing at his home

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until he can get
back to the clinic.

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SPEAKER 5: Mr. [INAUDIBLE]?

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SPEAKER 6: Mm-hmm?

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SPEAKER 5: When is
your appointment

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to go to the clinic?

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SPEAKER 6: Your what?

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SPEAKER 5: Your appointment
to go back to the hospital?

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SPEAKER 6: When am I
[INAUDIBLE] to go back there?

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SPEAKER 5: Mm-hmm.

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SPEAKER 6: [INAUDIBLE]
three weeks' time.

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SPEAKER 5: Three weeks' time.

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Please make sure that you
remember that three weeks'

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time, you are to go back
to see the doctor, OK?

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MAVIS GILMOUR: Good
health starts early.

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That is why we have
well baby clinics,

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to provide care for
mothers and babies

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to make sure they stay healthy.

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The community health aides
will help at these clinics.

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SPEAKER 7: So
you're breastfeeding

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Angela at the moment, yeah?

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Well, we don't have any
substitute for breastfeeding,

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and at the moment, Angela
can't take anything else now

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beside the breast.

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You don't give her anything
else beside breast?

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SPEAKER 8: No.

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Just leave [INAUDIBLE] she drink
the breast milk on [INAUDIBLE]..

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I give her some breast
milk [INAUDIBLE]..

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SPEAKER 7: [INAUDIBLE],,
yes, that's right.

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Vanessa, you have to take
all the balanced diet now.

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That's so your baby
can be properly fed.

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And you must get some rest.

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You must drink a
lot of milk that you

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can have plenty of breast
milk to feed your baby.

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You must eat a lot of
vegetables and a lot of meat.

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And you must get a lot of rest,
even half an hour rest each day

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that your baby can be
healthy and strong.

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MAVIS GILMOUR: The
real hope of Jamaica

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lies in the health
of our children.

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Even with a good start
in life, children

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need a lot to grow up
healthy and strong.

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Sometimes, though, people
don't know the right foods

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to feed their children.

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They need help in planning
the children's diet.

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The community health aide is
trained to give such help.

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SPEAKER 9: All these
things are sterilized now

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with boiled water,
the cold boiled water,

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and straining the
milk and everything.

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MAVIS GILMOUR: Of
course, healthy children

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are happy children.

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Too many children too
close together in a family

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can cause health problems
for mothers and for children

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and hardships for grandmothers.

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SPEAKER 9: OK, you
can just look at it--

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8 ounces.

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See the measuring cup?

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8 ounces.

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MAVIS GILMOUR: With
fewer children,

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there will be more food
and clothes, more love

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and attention, more
education, more of everything

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for every member of the family.

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SPEAKER 9: So give
this to Carla, OK?

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You're the
grandmother for Carla?

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You're the
grandmother for Carla?

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SPEAKER 10: Yes, yes,
the grandmother, yes.

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SPEAKER 9: And
where's the mother?

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SPEAKER 10: Mother [INAUDIBLE].

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SPEAKER 9: Is she married?

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SPEAKER 10: No, she not
married, not [INAUDIBLE]..

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MAVIS GILMOUR: When
community health aides

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come on their
regular visits, they

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will also give you advice
about family planning

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to help you better your life.

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SPEAKER 9: Advise
her, the mother.

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SPEAKER 10: Oh, yes, yes.

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SPEAKER 9: You know, because--

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you can tell her that
if you are living--

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if you are having children in
now, you wouldn't have so many

16:08.918 --> 16:11.210
and your children are here,
and your children are there

16:11.210 --> 16:14.090
and you ask somebody
to take care of them.

16:14.090 --> 16:17.600
And you'll put them at the
streetside, abandoned there.

16:17.600 --> 16:19.820
You know, it's not looking good.

16:19.820 --> 16:23.510
MAVIS GILMOUR: Life
doesn't always go smoothly.

16:23.510 --> 16:27.470
When you're old or
sick or can't work,

16:27.470 --> 16:32.930
sometimes you need a helping
hand to get back on your feet.

16:32.930 --> 16:37.040
Community health aides are
trained to help old folks

16:37.040 --> 16:39.530
like this old man.

16:39.530 --> 16:42.980
He recently came home
from the hospital.

16:42.980 --> 16:44.980
He had a stroke.

16:44.980 --> 16:47.230
And the community
health aide is helping

16:47.230 --> 16:52.270
him to exercise his arms
and legs every day so he

16:52.270 --> 16:53.624
may get back his strength.

16:53.624 --> 16:54.832
SPEAKER 11: Open the fingers.

16:57.385 --> 16:57.980
Open them.

16:57.980 --> 16:58.480
Open them.

16:58.480 --> 16:59.830
Open them.

16:59.830 --> 17:01.720
SPEAKER 12: [INAUDIBLE]

17:01.720 --> 17:03.670
MAVIS GILMOUR:
Community health aides

17:03.670 --> 17:07.950
know where and when to go
for the right medical help.

17:07.950 --> 17:09.700
SPEAKER 13: You see,
I was looking for you

17:09.700 --> 17:11.800
to come to the
clinic with Jerrell.

17:11.800 --> 17:12.880
And I don't see him come.

17:12.880 --> 17:15.920
And you've been complaining that
Jerrell has a cold in his head.

17:15.920 --> 17:17.079
So I come this morning.

17:17.079 --> 17:18.010
I'm not leaving you.

17:18.010 --> 17:21.940
You are going to the clinic to
see the doctor this morning.

17:21.940 --> 17:25.630
Yes, you see, in
your condition, I

17:25.630 --> 17:28.180
was wondering if he
wasn't feeling well that I

17:28.180 --> 17:29.450
could take him up for you.

17:29.450 --> 17:33.620
But since you are coming, we
will go along to the clinic.

17:33.620 --> 17:36.550
So you must remember to
give Jerrell his medicine.

17:36.550 --> 17:40.840
And it's important now for you
to have all the rest you can.

17:40.840 --> 17:42.960
With this baby
coming, you probably

17:42.960 --> 17:44.680
will have to neglect Jerrell.

17:44.680 --> 17:48.075
So you must see to it that he
get his feeding, properly, see

17:48.075 --> 17:49.840
him like the new-coming baby.

17:49.840 --> 17:52.060
Give him hugs when you can.

17:52.060 --> 17:54.610
Give him things from the
family pot, as usual.

17:54.610 --> 17:58.510
Give him his milk, cheese,
even sole fish if him want.

17:58.510 --> 18:01.653
You have a lot of
protein in sole fish.

18:01.653 --> 18:03.570
OWEN MINOTT: Even though
our training out here

18:03.570 --> 18:06.800
is so good in
medical school, we're

18:06.800 --> 18:12.005
quite incapable of communicating
adequately with the patient.

18:15.210 --> 18:21.360
As an example of how the aide
can be an extension of the work

18:21.360 --> 18:25.980
that a doctor or nurse
can do, let us just focus

18:25.980 --> 18:29.160
for a minute on a problem
like I had this morning

18:29.160 --> 18:30.980
right here in the clinic.

18:30.980 --> 18:32.730
We have a malnourished
child, somebody who

18:32.730 --> 18:35.220
is vomiting, having diarrhea.

18:35.220 --> 18:37.680
And the mother is doing the
best she can to feed the child.

18:37.680 --> 18:39.690
But her best consists
of giving the child

18:39.690 --> 18:42.450
glucose water, which,
when a child is vomiting,

18:42.450 --> 18:44.460
is a good thing to do.

18:44.460 --> 18:47.400
But the stage is
now reached where

18:47.400 --> 18:50.280
the mother has had this
child on glucose water

18:50.280 --> 18:52.433
for about two weeks.

18:52.433 --> 18:54.850
The thing is that she was told
to put the child on glucose

18:54.850 --> 18:56.460
water when it was
vomiting, but she

18:56.460 --> 18:59.820
didn't understand to take it off
when the vomiting had stopped.

18:59.820 --> 19:03.090
So we now have a
mother with a problem

19:03.090 --> 19:04.890
of a child who is
no longer vomiting

19:04.890 --> 19:07.410
but who is heading for
protein malnutrition.

19:07.410 --> 19:09.090
And this is where
the aide comes in.

19:09.090 --> 19:12.720
Because she could have explained
to the mother what is going on.

19:12.720 --> 19:14.680
In the follow-up with
regard to the patient,

19:14.680 --> 19:16.080
she would have gone unseen.

19:16.080 --> 19:17.430
[REGGAE MUSIC]

19:17.430 --> 19:20.070
MAVIS GILMOUR: This
community health aid program,

19:20.070 --> 19:23.460
which has started in
St. Elizabeth, Hanover,

19:23.460 --> 19:29.970
and St. James, will bring basic
health care to your homes.

19:29.970 --> 19:34.110
It will make it possible to
bring to the local village

19:34.110 --> 19:41.880
level on a regular basis modern
medical care and knowledge, not

19:41.880 --> 19:46.390
only about the growth and
development of the child

19:46.390 --> 19:50.580
but also the everyday
care of minor ailments

19:50.580 --> 19:53.760
for both young and old.

19:53.760 --> 19:57.450
As we have seen, the
community health aid

19:57.450 --> 20:01.710
has been well trained
in such health areas

20:01.710 --> 20:05.880
as first aid, family
planning, counseling,

20:05.880 --> 20:10.290
the feeding and care of
infants and old people,

20:10.290 --> 20:13.710
and maternal and child care.

20:13.710 --> 20:17.310
They will work directly
under the supervision

20:17.310 --> 20:20.100
of the public health nurse.

20:20.100 --> 20:23.880
They are accepted by the
whole medical profession

20:23.880 --> 20:29.160
and are recognized as a valuable
addition to the health team.

20:29.160 --> 20:31.830
Your community
health aid will be

20:31.830 --> 20:36.630
your neighbor and your
friend, someone near at hand

20:36.630 --> 20:40.200
you can turn to
when you need help.

20:40.200 --> 20:45.600
She will be your first port
of call for health problems

20:45.600 --> 20:48.210
and health information.

20:48.210 --> 20:50.530
Look out for her.

20:50.530 --> 20:53.700
She will be wearing this badge.

20:53.700 --> 20:56.010
She will be your helper.

20:56.010 --> 21:00.704
[MUSIC PLAYING]