<%BANNER%>

DLOC



Joining hands for health: caring and sharing at school time
CITATION PDF VIEWER
Full Citation
STANDARD VIEW MARC VIEW
Permanent Link: http://ufdc.ufl.edu/AA00013241/00001
 Material Information
Title: Joining hands for health: caring and sharing at school time
Abbreviated Title: Joining hands for health
Physical Description: 35 p.; 28 cm.
Language: English
Creator: Public Hospital Authority
Publisher: Public Hospital Authority
Place of Publication: Nassau, Bahamas
Publication Date: 1985
 Subjects
Subjects / Keywords: Health care--Bahamas.   ( lcsh )
Health education--Bahamas.   ( lcsh )
Spatial Coverage: Caribbean Area
 Record Information
Source Institution: College of The Bahamas
Holding Location: College of The Bahamas
Rights Management: All rights reserved by the source institution.
System ID: AA00013241:00001

Downloads

This item is only available as the following downloads:

Joining hands for health 3_4 ( PDF )


Full Text

PAGE 1

Volume 3No. 4 1985/86,.

PAGE 2

TABLE OF CONTENTSPage1.Immunisation ProtectstheNation12.Life Abroad Kayla Musgrove. 23.Employment OpportunitieswithinthePublic Analyst Laboratory Donald Cooper 24.Editorial................................................................................................ 35.GowithAgriculture Cecil Dorsett 46.RadiographyJane Treco.......................... 67.Career LifePlanningPortiaJordan68.CommunityHealthNursingAn ExcitingCareerPhilaberthaCarter............ 99.A very Special Visitor 1010.Overview oftheMedical Records Department.. BrendaIngraham1311. Up-Date Felicity Aymer1412.WhatNursesareMade For (Poem) Enid Ruddock.....................2213.Dietetics -ACaringProfession Rosalie Foulkes..................2314.Physiotherapy Velma Burrows2515. The Field of Social Work LoreneClarke26 More on Immunisation......... 2816.On Becoming aPharmacistByPierre2717.Health Education in Motion Felicity Aymer3118.A Brief ontheHealthInspectorate Melony McKenzie....... 3319.Editorial Committee 3520.Evaluation...........3521. About the Contributors .Inside Back Cover

PAGE 3

IMMUNISATIONPROTECfSTHENATION.MinisterGayaddressingthegroupattheAwardsCeremony,AnnsTownClinic.TheMinisterisexpecting100%coveragebyyear'send!!Theweek ofJune1st -7thwas observedinNew ProvidenceasImmunisation Week. The focus was to create agreaterpublic awareness oftheimportance of basic immunisation coverage forthenation's children. The media, radioanddaily newspaper focused on va rious aspects of immunisationandcontributors tothemedia effort weredrawnfrom alltheclinicsaswellasthe CommunityNursingServices, ClarenceA.BainBuilding. Althoughthethrustfortheactivities occurred dur ingthatweek, all children completingtheirbasic cover age on schedule triple DPTandpolio by age seven months and DPTlPolioandMMR by age twelve months in the month ofJune,were awarded certificatesandgifts.Light refreshments toparents(predominantly mothers) were served after each ceremony heldattheBlue Hill Road Clinic on Monday,30thJuneat1pmAudiencewaitingforthestartoftheAwardCeremony,Blue HillRoadClinic.Certificates were awarded by Mr.L.Emerson Smith,PermanentSecretary, Ministry of Health. Fox Hill Clinic on Wednesday, 2ndJuly4pm Cer tificates were awarded by Dr.KenBarko, PublicHealthDepartment. Ann's Town Clinic on Thursday,3rdJuly3pm Certificates were awarded bytheMinister ofHealthHonourable Dr. Norman Gay. Coconut Grove Clinic on Thursday, 3rd July at4:30pm Certificates were awarded by Mr.L.Emerson Smith,PermanentSecretary, Ministry of Health. The Number of children qualifying forCertificates:-Blue Hill Road Clinic 78 DPTlPolio 78MMR Fox Hill Clinic 7 DPTlPolio 5 MMR Ann's Town Clinic 33 DPI'lPolio 33 MMR Coconut Grove 43 DPI'lPolio 44 MMRDr.F.Mahmood,ActingMedicalOfficerofHealthIN.P.awardingcerficatesandgiftsattheBlueHillRoadClin ic.

PAGE 4

LIFE ABROADKA YLA MUSGROVEStudying abroad can be bothanenrichinganden lightening experience. On myarrivalinNova Scotia, Canada, where Ipursueda Bachelor of Science degree, I was greeted by veryunpleasantweather.Noamountof reading about a far away country could have preparedme for such a drastic changeinclimate. Acclimi tisation though, which wasatfirst difficult, was quickly surmountedasI developed a new lifestyle, especiallyintheway I dressedandI soonbeganto appreciatetheweatherasI got involvedina variety ofwintersports. These included suchthingsascross-country skiing, ice skating, tobogganingandsleigh riding.Makingsnow men wastheparamountfeature. Studying abroad, one obtains a multifaceted educa tion. One doesnotonly obtain book knowledgebutalso livesinandisexposed to a different culture; onelearnsto acceptandrespectotherpeople's beliefsandvaluesandtheylearnto respect yours. The Nova Scotiansarea friendly, mild-spiritedandeasy going people, there foreadjustmentwas effortless.Infact, to help foreignstudentsadjust,theInternationalStudentAdvisor im plemented a programme whereby eachstudentwas given a 'host parent'. Theseparentsfunctionedinas sisting students, where possible, byhavingthemattheirhomesduringweek-endsandinvitingthemto nu merous social gatherings. The hostparentsrepresented'ahome away from home'.Therewas alsoanInternational Students' Club wherefurtherculturalexchange took place. I was a very active member. The university consisted ofabout 3,000studentswhichisquite small. This is advantageousasrapportcanbe more easily de veloped betweenstudentsandprofessors. Acadia Unilight refreshmentsbeingservedonahotafternoonfollowingtheawardceremony.versityanditsenvironsarevery picturesque, especiallyduringwinterwhenthesurroundingmountainsare snow-capped.Tobe successfulinstudying abroad,theindividualmustnever forget hislher purposeinbeing there. Youmustrealizethatyour firstdutyis to yourselfandyour familyandthatyouareanambassador for your coun try. Toattainsetgoals requires prayers, discipline and perseverance. Youmustbe very carefulnotto become side trackedwiththeseemingly easy lifeandvarious choices afforded by campus life such asdrugsandother immoralities.Studyingandliving abroadhasbeen ben eficial -ithasnotonly madememore "learned"inmy fieldofstudy,butalsoithashelpedinmy development of self, exposedmeto a countryatfirst-handandithas helped me to appreciate home, especiallythesun,thatmanyof us so oftentakefor granted.EMPLOYMENTOPPORTUNITIESWITHINTHEPUBLICANALYSTLABORATORYDONALDCOOPERWithinthepasttwoyearstheportfolio ofthePub licAnalystLaboratory (PAL)hasbeen expanded to in corporate environmental monitoring,riskassessmentandwaste disposal evaluation.Inaddition,thePublicHealthcomponents of water,foodanddairy products analysishadbeen moretightlystructed to allow foranincrease inthemonitoringrate.Thishasresultedina 75% increase inthework load.Tomeetthese increased commitments,thesectionhashadto be restructured. Most senioradministrativepositionshavebeen filledandnew techniciansandjunior technicians hired. TheDepartmentof EnvironmentalHealthhasalso revisedthehierarchicalstructurewithintheLabdelineatinga clear promotion ladder whichmakesthepost of technician acareerorientated one. At presenttherearevacancieswithinthePALforjunior technicians (trainee), technicians (usuallywithaB.Sc.degree)andtechnologists (technician who has acquired a speciality area).Plansalso envisagethehir ing of senior technologists (to coordinate technicians inanarea)andanAssistantAnalyst (to supervise a sec-

PAGE 5

tion). The picture thereforeappearsvery favourable for skilled people contemplating acareerinscience. WiththerestructuringoftheLab, techniciansarenowbeing soughttofillparticularneeds. Thismeansthata person with a degreeinBiology maynotfind a position,butonewitha B.ScinChemistrywill. Techni cians inthefollowingareasarecurrentlyindemandatthe PAL: Chemistry,EnvironmentalChemistry, Microbiology, Biochemistry, Food Science.Ofthedisciplines named, Chemistry isthemost re quired oneandthistrendis likely to continue forthenextthreeto five years. .Insummary,thefutureappearsbrightfor techni CIansatthePAL. Thepresentemphasis, however is basedprimarilyaroundChemistry. 'EDITORIALFor many teenagers, choosingacareer is not easy. Veryfewofus know fromanearly age in what areawewishtospend our lives. Additionally, the choices aresomany andsovaried that, rather than making it easier, career choices seemtobegetting more difficultandwhat many school leavers really are interested in is finding paid employment. Criticaltoemploymentandliving a reasonablyre-warding existence for the individualandhis family though, is a basic sound education the abilitytoread, write, express oneself,tounderstand,beunder stoodandreact appropriately.Inanattempttoshed more light on the health in dustry, CaringandSharingatSchooltime has at temptedtoprovide some insights into some careers in healthandhealth related professions.DirectorGeneralWHODr.HalfdanMahlerinconferencewithlocalPAHOstaff.3-

PAGE 6

GOWITHAGRICULTURECECIL DORSETTThecolonial system, coupledwithpastexperiences of slavery, povertyandhardshipsthatBlacks experi enced,maybeblamedfortheattitudeofmanyof to day'syoungpeople towardsagricultureasa profession.Whenagricultureis suggested,mostoftheresponsesarenegative. "Brother, Ihavebeentryingtogetaneducation togetasfarawayfromthefarmasIcangetandhereyouwantmeto go touniversitytogeta de greeinfarming?" or"That'shardworkbeingoutthereinthesundoingmenialtasks!" or, "I don't need a de gree to grow tomatoes!". Today, however,theseclichesareoutdated. Toequatethecollege profession of agriculturetofarmingislikesayingthataftergraduationmost electricalengineerswillendupwiringhouses. Why should you consider acareerinagricultureandrelatedareas?Amongthemodernsciences,agricultureanditsap pliedareasaresome ofthemostchallengingareasofstudy.ItisascomplexandasinterdisciplinaryasEngi neering, Medicine,LaworBusiness.Onthesurfaceitmaynot soundasglamorous tobea professionalworkerin"Ag."(agriculture)asitis to be a medical doctor, den tist,lawyeror a "space engineer",butthinkaboutit,thechallengesofproducingenoughfoodandeliminat-inghungerandmalnutritionarefargreaterandwillrequiremuch moreingenuityto solvethanthoseofgoing tothemoon, piggy-backorotherwise.Ifitwerenotso, we wouldhaveeliminatedhungerlong ago!Agricultureasa disciplineofstudyis diverse.Whateveryourinterests,youcanfindparallelsforspecializationinagriculture.Ifchemistryisyourbag,youcanbe a FoodChemistor Soil Chemist;ifengineering excites you,thereisAgriculturalEngineering;ifSocial Sciencesinterestyou,thereisRuralSociology or AgriculturalEconomicsandto a loverofBotanythere Horticulture.Ifyou wish to teach, you candoitas a Vo-Ag (Vocational Agriculture)teacherinahighschoo!orattheCollege ofTheBahamas.Irrespective ofethnicandculturalongms, fe" young peopletakeupfarmingasanoccupation otheJthanthroughinheritance,becauseitrequiresvery higr capital outlay.Thereisthecost oflandandfarmrnachinery.Thisisnottosuggestthatit is impossible,bwsimplythatunlessyouhaveplannedwellwhereyowlabourandcapitalresources will come from, full tim. farmingasanoccupation will bequitedifficult to breal into. Today, lessthantwopercentofthepopulation it TheBahamaslive onthefarm.Thereis alsothematte:

PAGE 7

of possessing a farm background to bean'lAg Major". Whileitis helpful tohavesome familiarity,itisnota prerequisite for mostcareersinagriculture.Although the actualnumbersvary, approximately 40% to 60% of studentscurrentlyenrolled inagriculturalandrelatedprogramsintheUSdonothavea farm background,infact they come from allwalksof life -urban,suburbanandrural communities. Whataretheopportunities for young women who majorinagriculture? Iventuretosaytheyrangefromgoodtoexcellentandarecertainlynot affected by sex, becauseagricultureencompasses such a widevarietyof job opportunitiesanddisciplines.WHATISAGRICULTURE?Agriculture is avastinterdisciplinarysciencewithmanyareasof specialization.Itisanapplied science which is shaped bythethreebasic sciences: physics, chemistryandbiologyandis supported bymathematics.Add tothesebasic sciences somehumanaspects, some commerceandsome technologyandyou have ag riculture! I doubtthata complete description of agricul ture can be accurately done,butitisimportantthatwelookatsome ofthemajorareasthatagricultureencom passes or with whichitis closely affiliated.CAREERCHOICESINAGRICULTUREThe choice of acareerisone ofthemostimportantdecisions onemakesinlife, so devote time, effortandstudy tothistask.Whatprofession would you like to have?Toooften acareeris chosen foritsglamouror someothervaguely defined reason. Youmustanalyseyourinterestsandtalentsthenexaminethosecareersthatappear tomeshwiththesecharacteristics. Infor mation onagriculturemaybe obtained fromtheDepartmentofAgricultureandFisheries,EastBayStreet,telephone 21277,Ministryof Education, oruniversitiesin the West Indies ortheUnitedStateswhich offers programsinagricultureandwhich will be willing to assist you.Inaddition,therearesomegovernmentpub licationsthatwould be most useful. CAREER LISTINGSinagricultureinclude chemical salesperson,brokerstatistics,management,business, farm realtor,farmmachinedealer,nurseryowner/ope rator, florist, feed lotmanager,qualitycontrol specialist and total abouttwentythree.COMMUNICATIONSIn view oftheemphasistheGovernmenthasplaced onagricultureandthesteadygrowthinthisarea,I foreseemanyopportunitiesinagriculturefor young menandwomenwithaninterestinandatalentfor communicating. Theyrangefromreportingfor adailynewspaper, radio or television, to technicalwritingandputtingtogethersalesliterature.You willdoresearch, consultwithagriculturalaffairs,interiorfarmers,businessmenandscientists. Youmustbe able to deal effectivelywitha widevarietyof personalities, be capableofunderstandingcomplexthingsandtranslatingtheminto layman'sterms.SCIENCEIf inquiry,sensitivitytodetailandabilityto solve problems interestyouandifyouarethor oughlytrained,thereareunparalleledopportunities for you inagriculturalscience.Herearesomeexamplesofareasofstudy:-agriculturalchemistry, engineering, agronomy,animalbreeding,entomology,foodscience,foodanalysis, ecolo gy, fish biology,horticulture,poultryscience, taxonomy, biochemistry, bacteriology,laboratorytechnology,parasitology,ruralsociology, soil chemistry, forestry, wild life science.PRODUCTIONAGRICULTUREIftheindependence of being your own boss, enjoymentof work, ability tomanagecapital,naturalre sources of soil,waterandlabourstrikeyour fancy,thereis no reason why acareerin production agriculturemaynotbe acareerfor you.Donotunderestimatethedemandonyourintelligenceinsuch a job and/orintoday's technologicalfarmingwhich is steadily becominga wayoflife inTheBahamas.Althoughphysicalstrengthandhardworkarenecessary,itis no way compares totheold days ofbackbreakinglabour. I know of several successfulhighschoolandcollege graduateswhoarereally"makingit"inagriculturalproduc tion. They all usetheirown special skillsandareenjoyingthefruits ofbeingsuccessful business people. Somearelivestock farmers,othersgrow fruitsandvegeta bles, some grow flowersandplantsornurserycropsandsomeareagro-consultant specialists. Many oftheopera tions alsoadapttopart-timesituations.SOMECAREERSINPRODUCTIONAGRICULTURE:-Agronomy,animalbreeding,cattlemanagement,dairyman,farmmanagement,bee-keeping,fruitgrow ing, poultry, vegetable/green house growing.InourBahamasthereis a great need for increasedfoodself-sufficiency.Eachcountry shouldhaveaccess toadequatefood suppliesintimeof shortages.Intheeventofaninternationalfoodcrisis,TheBahamascanonly supplyitselfwithfoodfor a few weeks!Thevalueandneed for moreagricultureinourowncountryis clear. Consequently, on anationallevel,theGovernmentoftheCommonwealth ofTheBahamashascommitteditselfto placing ahigherpriorityonagriculturalproduction.5

PAGE 8

However,thisselfsufficiency will only betrulyrea lised whenouryouths become more consciousofandcommitted tothisstrugglebytakingupthechallengeandgoing abroad topursuecareersinthevariousdisci plines in agriculture. Iurgeyouhighschool leaversandotherswhohavealeaninginthisareatherefore to speak withyourschool counsellorsorcontacttheDepartmentofAgriculture. Good luckandgood growingwithagriculture!RADIOGRAPHYJANE TRECORadiography is a most fascinating profession.ItbringsyouindirectcontactwithpatientsastheRadiographer(X-ray TechnologistlX-ray Technician)astheyarecalled,takesX-rayswithandwithoutthesupervi sion oftheRadiologist physician specialisinginRa diography.Itis one of themajor aids to diagnosis.Eachday some new technique is being discoveredandmachinesarebeing improved.Inthisscientific age, Radiography continues to de velopintoone ofthemostinterestingoftheprofessionsandevengreaterknowledge will evolveinfutureyears. Qualificationsvaryin differentpartsoftheworld.IntheUnitedKingdomandtheUniversity oftheWest Indies,inorder to dothemembership Diploma, you need five 'O'levelsandtwo 'A'levels, three of whichmustbe English,Mathematicsandone oftheSciences (Biology,ChemistryorPhysics).InCanada,itistheequivalent.IntheU.s.A., if youdonothavethebasicentryrequirementsfor the course, youareallowed to dothefirstyearofa Science Degree course which will help you tothengointotrainingasa Radiographer.StartingsalaryinTheBahamasifyouhaveyour membership/certification from a recognised body istenthousanddollarsperannum.Without certification, applicantsmaybe appointed tostudentposts,workingalongwitha registered/certi fied technician over a twoyearperioduntiltheyhaveobtainedtherelevantbasicentryqualifications for uni versity.CAREER LIFE PLANNINGPORTIA JORDANBecause ofrapiddevelopmentsinscience, technolo gy, governmf::nt, andinternationalrelations,ourworld today offers countless new careers. Consequently,anindividual needs tolearnaboutthose opportunities which willneitherfrustratenorwastevaluabletimeandeffort. He/shemustbe ablenotonly to select a careerthatissuitableto his/hertemperamentor abili ty,butalso become flexible enough to accommodate a variety of jobs, as wellaspreparefor inevitable changes inthefuture. Before choosing a career, one should:1.know oneself (i.e one's interests, abilities, feelings,attitudesandvalues)62.beawareofjob qualifications (i.etheskills needed todothejob) 3. knowthejobmarket(i.e which jobsareindemandandwhich onesalreadysaturatethe market). Persons oftenrequestingassistanceinCareerPlanninginclude: a)studentsleavinghighschool toenterthejobmarketb)peopleenteringcollege who need to clarifytheircareerobjectives before choosingtheiracademicprogramme

PAGE 9

c)collegestudentswhohavebecome disenchantedwiththeircurrentacademic programmeandcareergoalsd)womenpreparingtomakeatransitionforhome-makerto collegestudentand/orsala ried employeee)peoplepreparingfor a firstcareerf)people dissatisfiedwiththeirpresenttypeofwork orcareerwho wish tomakeachangeforthebetterg)mid-lifecareerchangersseeking more satis factionintheircareer. Individualsinanycategorymaysuccessfully ac complishtheirgoalsiftheyareattainable.Tothisex tent,itisimportanttounderstandtherelationshipbe tweenhavingvocationalinterestandhavingtheabilitytopursuethatinterest.Forexample,themedical field offers avarietyofoccupations for professionalandskilledaspirantswhich include dentists, medical tech nologists (radiologists, surgical technicians),pharmacists, physicaltherapists,physicians,vaterinarians,dentalassistants,nurses.Yeteachrequiresspecific ap titudes in order to be successful. The world of work providesmanycareeropportuni ties foraspiringindividuals. Nevertheless,relevantvocationaltrainingisessentialbeforeseekingemploy-ment.Arecentsurvery,sponsored bytheNationalInstituteofEducation,USDepartmentofEducation, suggeststhatnew employeeswithrelevantvocational educationaremore productive,requireless on-the-jobtrainingandreceivehigherwagesthanthose new em ployeeswithoutrelevantvocationaltraining.Additio nally, employeeswithvocationaltrainingthatwasnotrelevanttotheircurrentjobs were no more productivethanotheremployeesinthatjobwithoutanyvocationaltraining.* Contemporarycareerassessmentprogrammes(similartothatexpectedattheCollege ofTheBahamasinSeptember, 1986)assistinidentifyingcareerinterestsandabilitiescrucial for success in avarietyofoccupa tions.Althoughtheaptitudetestsandinterestinventoriesdifferwithregardto formatandtheinformationtheyprovide,theyallassistindividualsinmakingmoreaccurateandintelligentcareerdecisions.Finally,thecareerquidance services offered bymanyschools,assiststudentsinidentifyingtheirinterestandabilities,aswellasprovide information ontherateof growth or declineinvariousoccupations,thusenablingthemtomakewise decisionsastheyplanacareerfor life.*NationalCenterfor Researchin Education: Columbus, Ohio, 1985.7

PAGE 10

FAMILYAWARENESS H:i:iWJ16 \ vt.z 0 0:: H >JJE-t>JJ<0:: U <:=> u p>JJi0) 0 '"pfJ.....:l()j0::4:J4:J CAREER8

PAGE 11

COMMUNITY HEALTH NURSING AN EXCITING PROFESSIONPHILABERTHA CARTERCommunityHealthNursingis a specializedareaof nursing; its basic purpose is to foster communityhealthbyapplyingNursingandPublicHealthmeasureswith in the framework ofthetotalhealtheffort. CommunityHealthNursingaimstoenablepersonstocopewithbarriersandthreatstohealthinordertomaximisetheirpotentialforhighlevel wellnessandalso to enablethemtorelatetotheirphysicalandso cial environment.CommunityHealthNursingis prac ticed in amultiplicityofcommunitysettings:egoclinics,schools, homesanddaycarefacilities. However,whereveritis practiced,CommunityHealthNursingis family-centeredandlooksateach clientasa wholepersonwithphysical,spiritualandpsychosocial needs. For me,asaCommunityHealthNurse,itis no longerjustMrs. 'B'lyinginthebedwithterminalbreast cancerandinneed ofananalgesic,butrather,I must relieveherpain,helpherto accepthercondition andsortoutherspiritualneeds,makeprovisions for the inevitableegohelpingherto seetheimportanceofmaking a family will.Herfamily would,quitenaturally, beundergoingmuchstress. Imusttherefore, by sup portive efforts, reducetheirstressandmaximisetheirability to copewiththesituation.Imust"bethere"for them.Currently,theCommunityHealthNursehasmanyroles to playandifsheis toplaythese roles effectively, shemusthavevery good communication skills which includekeenpowersofobservation to be able to graspwhatmayneverbe spoken; those eyesthatcon vey a completelydifferentstoryfromwhatthelipsarespeaking. Following is abriefoutlineoftherole oftheCom munityHealthNurse.TheCommunityHealthNurseis:-a provider ofPrimaryHealthCarewhich istheinitialservice providedwhenanindividual or a family (client)entersthehealthcaresystemseekinghelpfor illnessordisability.Thepreventativeaspects ofcommunityhealthnursingcannotbe overemphasisedanditis one ofthemainareasupon whichtheCommunityHealthNurseconcentratesegoimmunizationinearlychildhoodaspre ventionagainstseveralserious communicable dis eases. a provider ofpersonalcaretotheunhospitalized sick or disabled who perfers toremainathome orinaninformalcommunityfacility. a willing, knowledgeable, aggressive advocate who ismediatorbetweenthehealthcaresystemandtheclientandseeksto effect positive actions.anapproachableandconcerned advisor who is committed tothepersons served, beyondtheboundariesofmereimpersonal provision of serv ices, one who identifieswiththeirconcernsandgivesthemhealtheducationguidanceandcounsel ling. asensitiveobserver who, bytheextentofhertraining,isabletodetectanydeviation from normalbehaviouralpatternsinrespect of illness, growthanddevelopment,drugresponseandoverallwellbeingandis able to communicatethesefindingstotheappropriatemembersofthehealthcareteamordealwiththemeffectively herself. one who is expected to influence decisionsandproducechangeformorebeneficialhealthcarethroughherknowledge ofcommunityhealthprac ticesandnursing.anorganiserandmanager:beitcaringforthefamily,runninga clinic orliaisingbetweenhospitalandcommunitynursingservice,thecommunityhealthnurseendeavoursto keepeverythingincontrol.aninformedparticipantincommunityplanningandactionandone whocanprovideessentialpointsofinteresttothedecisionmakingprocessesina community. acontributorof knowledgeeitherby doing researchherselforaidingtheresearchofothersby supplyingthemwithpertinentdata.Itis clear,then,to seethatasa provider ofhealthcare,anadvocate,teacher,guidancecounsellor, observ er, decision-maker,managerandchangeagent,how weascommunityhealthnurses-arepractitionersinourownrightandno wonder -ittakesthreeyearsof basicnursingtraining,oneyearof post basictraininginmidwiferyandoneyearofcommunityhealthnursetraining;fivedynamicyearsoftraining,coupledwithmanyyearsofpracticalexperience tomakeuswhatweare... someofthemostimportantmembersofthehealthcateteam.Reference:FreemanandHeinrich...CommunityHealthNursingPractice.9

PAGE 12

A VERY SPECIALVISITOROverthepasteightor so years,Bahamiansandmore especiallymembersoftheMinistryofHealthfam ily,havebeenhearingsuchslogans/phrasesas"HealthForAll By TheYear2000" (HFAl2000),PrimaryHealthCare,CommunityParticipation(CP),latterlyandsometimesinterchangeably,CommunityInvolvem'ent, (Cn,IntersectorallmultisectoralApproachandAppropriate Technology forHealth(ATH).HealthForAll istheoverall goalnotonly ofandforTheBahamasbutalso for alltheother165 memberswhich comprisetheWorldHealthOrganisation(WHO)respresentativeof 99% oftheworld's population.Theotherphrasesdescribethestrategiesby whichthisgoal is to be achieved.OnSundayJune15th, 1986, Dr. HAFDAN MAHL ER, DirectorGeneraloftheWorldHealthOrganisation(WHO) forthepastthirteenyears,arrivedinTheBahamasforanofficial vjsit. (Washisarrivalonthatdateofanyspecialand/or additional significance?) Dr.MahlerwasmetattheNassauInternationalAirport by officials fromtheMinistryofHealthandthelocal P AHO office. While here,theDirectorGeneralvisitedboththeAnn'sTown Clinic, offKempRoad,theDIRECTOR-GENERALOFWHOVISITSGGDr. HalfdanT.Mahler, director-generaloftheWorld Health Organization,paida visit to the Governor General, Sir Gerald CashonMonday. Dr. Mahlerwasbornin Vivid,DenmarkonApril21,1923.Heobtainedhis MedicalDegree fromtheUniversityofCopenhagen,andhasa postgraduatedegreeinPublicHealth.InSeptember,1970,Dr. Mahlerwasmadeassistantdirector-general inchargeoftheDivisionofStrenghteningofHealthServ icesandtheDivisionofFamilyqealth.InMay,1973,hewasappointeddirector-genera'oftheWorldHealthOr ganization bytheTwenty-sixfiWorldHealthAssembly. 10SandilandsRehabilitationCentreandthePrincessMargaretHospital,gavea publiclectureattheCollege ofTheBahamas,paidcourtesy calls ontheGovernorGeneralofTheBahamasSirGeraldCashandthePrimeMinisterofTheCommonwealthofTheBahamas,SirLyndenPindling,mettheMinistryofhealthStaffandthelocalPAHOstaff.ThehighlightofDr.Mahler'svisitfortheMinistryofHealthfamilyandthepublic,wasthepublic lecturehedeliveredattheCollegeofTheBahamastitled"TheChallengeofHealthForAllandPrimaryHealthCare" ontheeveningofMonday16thJune,1986. Despitethelatepublicityforthelectureandindeedtheentirevisit, public responsewasexcellent,norapparentlyweretheydisappointedwithwhattheyheard.Themajordisappointmentlayinthefactthatthey'were denied a period for questioning. IncludedinDr.Mahler'shecticroundof engagementswasanofficial welcomingdinneronSundayeveningattheCableBeachHotelanda receptionatBuenaVistaHotel on Monday. Dr.MahlerleftTheBahamasatlunchtimeonTuesday17thJune.Didhegetany"sandinhisshoes?" Heassumed-hisdutiesastheOrganization'sthirddirec tor-general inJuly1973andwasreappointeddirector generalofWHObytheThirty-firstandThirty-sixth WorldHealthAssembliesinMay1978andMay1983respectively for asecondandthird-fiveyearterm.Dr.Mahlerhasreceivednumeroushonours and. awardsand is theauthorofpublicationsrelatingto the epidemiologyandcontroloftuberculosis .. Shownabove in the photo from left torightare:SamAymer, council representa tionofthePanAmerican WorldHealthOrganization, Dr. Mahler,SirGerald,Dr.NormanGay, MinisterofHealthandLutherSmith,thepermanentsecretary.

PAGE 13

.A Dr. Mahler (farleft)inmeetingwithlocalP AHO staff.FromlefttorightDougWilliamsDEHSconsultant,MarkCrowley(hidden)StatisticanJeromeMcintosh,driver/messenger,BarbaraKnowles,AchierHall,SamAymer,Prog.coordinator,Dr.Mahler.TheChallengeofHealthForAllourPrimaryHealthCare-publicresponsetoDr.Mahler'slectureattheCollegeofTheBahamaswasgood.11

PAGE 14

12

PAGE 15

ANOVERVIEWOFTHE MEDICALRECORDSDEPARTMENTBRENDAINGRAHAMWhat istheimportanceoftheMedical Recordina health care setting?Inthistypeofsettingthemedical record issoimportantthatitstandsourasthedeciding factor towards ahealthylifeandeventualcareandre covery ofthepatient. The Medical RecordsDepartmenthasbecomethenucleus from whichmanyhospital activitiesemanatebecauseitsorganization, efficientmaintenanceandcon fidentialityareimportantfirsttothepatient,thephysi cian, the hospital,thecommunityandtointernationalagencies.Itcanals'"betermeda "storehouseandcen tral cleaning house" ofimmediate,accurate, complete and up-to-datedatawhichcanbeusedforplanninganddisseminatingstatisticalhealthinformation toInternational Agencies.THEROLEWhat is a Medical Record? A medical record is a compilation ofdatashowingdocumentaryevidence of a patient'streatmentandillness.Itisasimportantfor practicing medicineasmedicationsarefor effective treatment. The Medical RecordsDepartmentis one ofthemost importantadministrativedepartmentsinanyhospital and is committedtotheachievementof excellence be cause oftherolethemedical records play.Withoutthisrecord of continuity,the patient's medical history is losttothe Doctor,thequalityofcarecannotbe assessed and teachingandresearchefforts whicharesoimportantto improvingpatientcareandwhich should be a primary objectiveofanyhealthinstitution,areseverely impeded.Dataprovidedtodayby complex technological pro ceduresaretoonumerousanddiverse to be "stored"inanyhumanmind. Apatientoften deals,notwithone doctorbutanarrayof Consultants andparamedicalper sonnel whomusthaveamediumthroughwhichtheycan exchangeandcommunicatetheinformationusedindetermining medicaltreatments.Ina mobile society, thepatientmaymove from one source of medicalcaretoanothersourcethatis geographicallyina different locationwithinTheBahamas,aswellasto services abroad.Forthesereasons,themedical recordmustbe completeandaccuratebecauseithasbecome indispens ableasanaccount ofthepatient'scomplete medical biography.STRUCTUREThe Medical RecordsDepartmentofthePrincessMargaretHospitalissituatedintheNew Extension,phaseone,withcloseproximitytothePharmacy,GeneralPracticeClinic(Out-PatientsDepartment)AccidentandEmergencyandotherparamedicalandancillarydepartments.Itsoperatingactivitiesaredone on two floorsandis open on atwentyfourhourbasis.TheMedical RecordsDepartmentis responsible totheHospitalAdministratorwhohasdelegatedtheday todayadministrativerelationshipstotheDeputy HospitalAdministrator.TheSeniorRecords Officer isthehead ofthedepartment,responsible foritsoverall man agement.Dutiesandresponsibilities for specific func tionsaredelegatedbytheRecords Officer to seniorstaffmembers whoaredesignatedsupervisors. OneSupervisoris responsible forRegistrationandFiles which include activitiessuchasPatientRegistra tion,maintenanceofaMasterPatientIndex,StorageandRetrievalofMedical RecordsandSpecial Appoint ments.Furtherdelegation of responsibility for specific activities is givenwithineachgroup of keystaffmem bers fordaytodaydirection.AnotherSupervisoris responsible fortheMedical Records Activities whichstartwithcollection of records ofpatientsdischarged from wards,preparationof Medi cal Records Classificationofrecord content, utilization oftheMedical Recordandcomputerization of medical information. More recently, classification of diseaseshasbegun forGeneralPracticeClinic records.MEDICAL RECORDS SCIENCEASA CAREER Usually inTheBahamas,acareerinMedical Re cords Science isneverpursuedunlesspersonsareem ina hospitalsetting,buttherearecollegesanduniversitieswhichteachMedical Records Scienceasa career. OnecanobtainanAssociate DegreeinMedical Records Science whichtakestwoyearsanda Bachelor of Science DegreeinMedical RecordsAdministrationwhich willtakeanadditionaltwo years. Someofthecollegesanduniversitieswhereinterested persons canpursuethiscareerare,theUniversityoftheWest Indies,CaveHillCampusinBarbados,theCollege ofArtsScienceandTechnologyinJamaica,nu merous colleges inCanada,theUnitedStatesandUnited Kingdom.Theprerequisitesforentrytothesecolleges vary,butEnglish,Biology, TypingandMathematicsatG.C.E. 'O'level orequivalentwith"C" or abovegradesarecompulsory subjects, To be employedintheMedical Records Depart-

PAGE 16

UP-DATEment, PrincessMargaretHospitaltheapplicant is re quired tohaveaminimumof two G.C.E.'0'level sub jects, preferablyinBiologyandEnglish.Thereareorganizedorientationandtrainingpro grammes forstaffmemberswithtwo G.C.E.'0'level subjectsandno work experiencelastingoneyearbefore theyareplacedinanyspecificareato work.Therearealso organizedorientationandtrainingprogrammes forgraduateswithanAssociate Degreeandno work experienceaswellasthosewithanAsso ciate Degreeandprevious work experience. FELICITYAYMERHealthPromotionHEALTHEDUCATION DIVISIONAgain, Welcome,mayanyfuture visits to Rock Sound be less arduous,butequally excitingasyour first.HealthEducation Officer, Felicity Aymer visitedtheareaofRock Sound, SouthEleuthera,29th April -2ndMay, 1986, tomeetthehealthteamwitha view toextendinghealtheducation services tothearea.WhilethereshemetPrincipalsofSchoolsinallsettlementsfromBannermanTown toTarpumBay,theCommissioner fortheareaandother"influential" persons. Mrs. AymerreturnedtotheRock Sound district for a weekbeginning16thJunewhen she held a series of communityhealthawarenessmeetings inthesettlementsofTarpumBay, Greencastle, Deep CreekandRock Sound. She also addressed thegraduatingclasses oftheTarpumBay PrimaryandPrestonH. Albury Senior High Schools andtheGreencastle All Age School. Residentsintheareashowed ahighdegree ofinterestintheirhealth.Not only were most meet ings well attended,butthelevel of participation was very encouraging. Athirdvisit, to complete needsassessmentandpossibly begin planningforfuture action istentativelyscheduled forlaterintheyear. School children were extremely well behaved andattentive.ThechildrenattheGreencastleSchoolespecially, respondedenthusiasticallyto questions.HealthEducatorDwight ALLEN was introduced tothecommunityatthevarious meetings when he joined Mrs. Aymer ontheTuesday afternoon and accompaniedheron a busyanddemanding sched ule. vided by Mrs. Curtis.Theprogramme is, to allintentsandpurposes, progressingasexpected and will be atthebeginningof August.ExtensionofHealthEducationServicestotheFamilyIslandsThis programme encompasses two elements, exer ciseanddietandis essentially participatory inthattheparticipantsdesignedandareresponsible fortheactivities; guidanceandsupportareproIn response toMinisterGay's challenge inhisad dress totheannualconference oftheMedicalAssociation of TheBahamasandreiteratedinhis address tothenationon WorldHealthDay, 1986, a pilotHealthPromotion programme, involvingstaffoftheMinistry ofHealth(seventh floor), wasinstitutedby SeniorHealthEducator, Mrs. BarbaraCurtis,inearlyMay.*We wish you successandhappinessinour Division, Mr. Allenandhope you will risewithhonouranddis tinction totherole of aHealthEducator!Inaddition toassumingresponsibility for our Na tional FoodHandlerHealthEducation programme, Mr. Allenisexpected to play a leading roleinpreparing some ofthelocally producedmaterialssobadly needed intheDivision. Welcome toHealthEducation Mr. DWIGHT ALLEN. 'Dwight'asheisaffectionately called by moststaffmembers, joinedtheDivision on5thMay ontransferfromtheDepartmentofEnvironmentalHealthServ ices. Mr. Allenhasspecial skillsin"camera work"and"thearts"whicharealreadybeing eagerly exploited byhiscolleagues. Hehasalso visited SouthEleutherawherehe"assistedinexploring ways" of extendinghealtheducation services tothearea.14

PAGE 17

WELCOME** **TotheDepartmentofEnvironmentHealthServices:Mrs.OLIVIA WATKINS OBE, on19thMay, 1986.Mrs.WatkinsretiredfromtheMinistry of Youth, Sports, Community AffairsandLabour (Labour Department)earlierthisyearandhasbeen re-em ployedwiththeMinistry ofHealth(DEHS) where she has responsibility for personnel. Mrs.Watkinsseems very happyinhernew "environment"andis*enjoyingthechallenges of personnel work.Tothe PrincessMargaretHospital Senior House Officer CLAUDIA WALTER-CHIN and GAIL RICHARDS-NICHOLAS Dr. Walter Chin joinedtheAccidentandEmergency Depart ment of Medicine on14thJuly.monwealthHeadsofGovernmentMeeting(CHOGM) heldinNassauinOctober oflastyear, ataskwhichhecompleted with considerable ease.Marriedtotheformer PAULA NOTTAGE, a Reg isteredNursetrainedinOperatingTheatreTech niques,theWhitfieldshaveone son.JOININGHANDS FOR HEALTH wishes you continuing successinyour professionalandprivate lives Dr. Whitfield. Mr. LINCOLN DAVIS formerly SeniorNursingOfficer workingattheSRC, onassumingdutiesasPNOatthesameinstitutionfollowingthe"eleva tion" of Mrs Beverly Forde totheSeventh Floor as Deputy Director ofNursing(DDON).JOININGHANDS FOR HEALTH wishes you ev ery successinyour new role Mr. Davisandgood luck.CONGRATULATIONSWelcomeback*Mrs. ESMERELDA RUTHERFORD oftheDepartmentofNursingEducation, Midwifery programme and sincere congratulations onhavingobtained a Masters of PublicHealth(MPH) specialisinginMaternalandChildHealthfromTulaneUniversi ty, New Orleans. Mrs. Rutherfordreturnedto workattheDNEinJanuaryofthisyearandis looking forward tosharingher"updated"knowledgewithcolleagues. Alltheverybestto you, Mrs. Rutherford, may you soon begin to realiseatleastsome of your dreams! ) *Toall those newNursingAuxiliaries who recently joinedthestaffofthePMH.JOININGHANDS FOR HEALTH wishes youallevery successin your new positions. Dr. PATRICK WHITFIELD on your promotionatthe relatively young age...totheposition ofConsultantinFamilyMedicineatthePrincessMargaretHospital on1stMarch 1986. Dr. Whit field is agraduateoftheUniversity oftheWest Indies Medical School, Mona,Jamaica.He didhisinternshipatboththeUniversityandPrincessMargaretHospitalsandhasworkedatthePMH -Departmentof andGynaecology.Duringhis residency -FamilyMedicine 1981-85 he workedinKemps Bay, Andros; St. LuciaandFreeportanddidresearchin ObesityandPrimaryHealthCare.Havinggraduatedwith a Doctor of Medicine(DM)inFamilyMedicine, Dr. Whitfield is presentlytryingto establish aDepartmentofFamilyMedicineatthePMHwitha view to pro viding a more holistic approach tohealthcare. Dr. Whitfield alsohadtheunenviabletaskof provi ding/coordinating medical services fortheCom-**Mrs.JENNIE(JEANIE) ISAACS oftheDepartmentofNursingEducation (DNE) on your appointmentto PrincipalNursingOfficer, effective October, 1983. Mrs. IsaacshasbeenattheDNE for more years no doubtthanshecares to recallanditseems only fittingthatshe assumethese onerous chores.JOININGHANDS FOR HEALTH wishes youcontinuingsuccessinthisdynamic position oftraining youngandnotsoyoung nurses, Mrs. Isaacs. DPS VETA BROWN on your recent promotion to Acting Undersecretary, Ministry of Health, Mrs. Brownhasbeen a "tower ofstrength"to us inHealthEducationandno doubt totheMinistry of Health. Despiteherconsistently hectic schedule, she can always find aminuteto listenandoffer a word of wisdom.JOININGHANDS FOR HEALTH wishes you every successatthislevel Mrs. Brown. We know you will enjoyitas you seem to be one of thoserarebirds whothriveson challenge. Good Luck!Congratulationstothetwentyfive HEALTH AIDES whohavecompletedtheoneyearcourse. This isthefifth group tohavecompletedthistrainingandtheywill now swelltheranksofhealthcare providers throughouttheCommonwealth. To date, 206 persons, mostly young women,havebenefitted fromthepro gramme.TheirGraduationProgramme ("Commence ment", to quotetheMinisterof Health) is always a memorable occasion;theevening of Monday 7thJuly,1986, was no exception. The ceremony, heldintheCoralRoom ofthePilotHouse Hotel,EastBay Street, was chaired by Mr.JohnThompson, Administrator of the PMH. The room wasbarelylarge enough to accommo date relativesandwell wishes ofthe group who were very fetchingly dressedinwhitewithred corsages. t5

PAGE 18

*CONTINUING EDUCATIONTheMinisterofHealth,theHonourable Dr. NormanGay, deliveredtheaddressandstressedtheimportantroleHealthAides playin assistir:g otherhealthprofessionalsinreachingthegoal of TheBahamasinbringingessentialhealthcaretopeople intheplacesinwhichtheyliveandwork. Certificates were awarded by Mrs. Carol Gay, wife oftheMinisteranda physicaininherownright(Dr. Chaney). Dr. Chaney-Gay wasapparentlyparticularly impressed bytheelegance oftheonly maleinthegroup! Ashasbeen custon ary also,thegroupentertainedtheirquestsinsong whichthisyear, stressedthe"hardworkandfaith" which were essential elementsinhelp ingthemreachtheirgoal.HealthAideFayeLewis de livered ashortaddress which "broughtthehouse down" while Betsy Richards gave a most sincere Vote ofThanksinwhich she apologised foranyomissions she may have made. BothHealthAidesarefrom New Prov idence .. Mostofthesegraduates(sixteen)arefromandwillreturntotheFamilyIslands. ResidentsinMatthewTown,InaguaandHarbourIsland,Eleuthera,especial ly, should now benefit fromhavingHealthAides work ing among them.OtherFamilyIslands represented were Abaco, Andros,CatIsland,EleutheraandGrandBahama.Musicalinterludeswere provided by Mr. ArmbristeroftheDEHS.JOININGHANDS FOR HEALTH wishes you all a most enjoyable periodinyour respective communitiesasyou joinotherhealthprovidersinthestruggle to bringhealthtoallpeoplesinTheBahamas,we sincere ly hope you willmaketheopportunities to realisethepromise youhaveshown overthepastyear,thatyour colleagues willassistyouinsodoingandthatyour consumers find your presence amongthembeneficial.Mayallyour experiences be rewarding. 16 *****CongratulationstotheNurseswhograduatedonFridaynight,11thJuly.They included fortyRegistered Nurses,threeTrainedClinical Nurses, sevenTCNs who completedthecourseinMaternalandChildHealthNursing,nurseswho completedthecourseinIntensiveCareNursing. The popula tion should be servedmuchbetterfor your gradua tion, nurses.Unfortunately,for avarietyof rea sons,therearealways those who leave,so then neverseemstobe enoughnursesto"go round".JOININGHANDSFORHEALTH wishes you all challengingandrewardingcareerandhopesyOlwill continue long enough toshareyour experi enceswithsomeofthose who will followinyou footsteps. AlltheverybestNurses. A group ofnursesrecently completed a course h CriticalNursingCareatthePrincess Margare Hospital.Anorientationprogrammefor allNursingAuxiliariesatthePHMbegan on28thApril, 1986. Dr. ERIC BROWN, Medical Officer, P\lblic HealtlDepartment,attendedathreeweeksummel coursebeginning23rdJune,1986,ingeneral Epi demiologyandBiostatisticsattheJohnsHopkil Medical School, Baltimore. CommunityNursingOfficer ROSA MAE BAIl' andHospital Infection ControlNursePAMRICi FERGUSON recentlyattendedathreeday cours,inHospital Acquired InfectionattheCaribbeal EpidemiologicalCentre(CAREC). The Coral Room ofthePilot House Hotel, Nassauwasthevenuefor a twoweeksub-regiona Workshop ontheInternationalClassification0Diseases 9 (lCD9)andVital Statistics 2nd-13tlJune,1986.

PAGE 19

ParticipantsoftheICD9Workshopfrom12Caricomcountries.TheonlyMaleisfromSuriname.Dr.MiriamGazinovitchPAHO'sstaffmember,Washingtonofficer,assheaddressedtheWorkshop.This workshop, sponsored inthemainbythePanAmericanHealthOrganisation(PAHO),wasthefirstregionalactivityinwhich Medical Records Officers fromtheCARICOM region cametogethertoclarifyandstandardisetheprocessing, analys ingandclassificationofmorbidityandmortalitydata.Undertheveryableguidance of PAHOstaffmember, Dr. MIRIAM GAZINOVITCH, Senior Re gionalAdviseronStatisticsbasedinthePAHO officeinWashingtonDC,withassistance fromMarkCrowley,PAHO'sresidentStatisticianinTheBahamas,theworkshop provedextremelyenlighteningtoallparticipantsofthetwelve territo-ries-Antigua,Bahamas(New ProvidenceandGrandBahama),Barbados,Bermuda,BritishVir gin Islands, Dominica,Grenada,Guyana,Montserrat,St. Lucia, St.VincentandSuriname.AsMinisterGay said inhisopeningremarks,theworkshop willenableMinistriesofHealthtomoreintelligentlyprocessrawfactsandfiguresandthisshould add a new dimension totheirability toquantifythehealthstatusoftheirpopulationsandultimately,improvethequalityof life -thegoal ofHealthForAll. To allintentsandpurposes,the"visitors" enjoyednotonlytheworshop,butalsotheirstay. On completion ofthecourseParticipantswereawardedCertificates. Becausethebiggestcontingentwas from home, we expectincrementalimprovementsinqualityofdatathatwillbecome available. However, theseimprovementswill only beasgoodasthedatawhichthesestaffmembersaregiven, byusinthefield, physiciansandnurses. Weareallawareofthedearthof"harddata"onthelocal scene,datawhichareaccurateanddefinitive reflections ofthe"qualityof life". Not only is suchdatacritical totheMinistryofHealthinplanningforandguidingthenation,buttheyarealsovitalto specific communitiesifwe seriously desire toinviteandallow for effectivecommunityparticipationandattainthatgoal ofHealthForAll by 2000. Completing formsandsubmittingaccurateinformationregularly,tediousthoughitmaybe, is morethana necessary evilinventedby idle administrators,itunlocks doors toqualityof life forourpeople, allowsustoplanmore effectivelyandcompareourperformanceatthenational, regional

PAGE 20

andinternationallevels.Tostresstheimportance oftherole ofthephysi cian inthesubmission ofdata,a special session was scheduled forthisgroup ofhealthprofession al.AshowofBahamianhospitality.Mr.Saunders,MedicalRecordsDept.PMHsaysthankyouforajobwelldonetoDr.MiriamGazinovitchwhileDr.GayandSamAymerlookon.*CongratulationstoNursingOfficer 1IRENECOAKLEYofthePMH on successfully completing athreeyearcourseinChristianEducationatTheBahamasBible Institute,JeanStreet, Gleniston Gardensandon receiving your Diploma. Mrs. Coakley is a member oftheMission Baptist Church,HayStreet, Nassau. Alltheverybestinyour new career, Mrs. Coak ley. especiallyattheannualFamilyIslandHealthConfer ences where shehasplayed such aquietbutdominant role. The following Senior House Officers PMH, re signed on30thJune,1986: TCNPaulaMAJOR transferred fromtheSRC tothePMH. Mrs. ROSE MAE THOMPSON, Acting DeputyPermanentSecretaryatthePMH, Administration,hasbeentransferredtotheMinistry of Transport with effect1stJune,1986. Mrs. RODGERShasbeen transferred from general administration, SRC tothePNO's office. JOINING HANDS FOR HEALTH hopesthatyou all will continue to find your jobsstimulatingandhealthstressful. STAFF NURSE SHELDON BOWE-PRATT NINATHOMPSON-MAJORandERVINESTUBBS transferred fromtheCommunity Nursing Services tothePrincessMargaretHospital where you are warmly welcomed. Mrs. ORLENE LIGHTBOURNE, Secretary to the PrincipalNursingOfficer (PNO) Sandilands Reha bilitationCentre,hasbeen transferred to secretarialduties intheChief Psychiatrist's Office.CommunityHealthNurseVIVIAN BRAITH WAITE,EightMile Rock Clinic, Grand Bahama,hasresigned fromtheservice effective mid-May. NurseBraithwaitehasenbarkedon a new and excitingcareerin Occupational Nursing. The em ployeesatFranklinChemicals should benefit enor mously fromherwealthof experienceinpromotive and preventive health. Allthevery best Nurse Braithwaite, please keep in touch. Dr.JULIANSTEWARTDepartmentof Obstet ricsandGynaecology Dr. DAVID BARRETTDepartmentof Surgery Dr. HOMER BLOOMFIELDDepartmentofObstetricsandGynaecology.Wewish you every success Doctors.** * **JOININGHANDS FOR HEALTH wishes you all the very best in your new roleattheMinistry of Educa tion, Mrs Brookes.PatientsatthePMH weretreatedto a musical performance by the Morningside High School Chamber Singers on 25thJune,courtesy oftheMinistry of Tourism. The singers were very well receivedandthePMH wishes to extend sincerethanksto boththeMinistry of Tourism for arrang ingtheentertainmentand totheMorningside Singers fortheirvery good performance. Please come again. The PMH wasthesite for a special visit by ninety visitors ofthecruise shipCarnivalCruise, on Fri day 2nd May, 1986. Why wasthisa special visit?Ithappened to bepartof alearningexercise, in deed,theentirecruise was aseminarcruise.Whatapleasantway to learn!* *CHANGE AND??? On Wednesday, 25thJune,colleaguesandfriends met to wishFirstAssistantSecretary (FAS)ASTRID BROOKES, Godspeedandblessingsasshe moves to wardsanothergoalinhercareerintheCivil Service. Mrs. Brookeshasspentthelastnine years moving up the ladderintheMinistry ofHealthandwill be missed*TCNJuliaWILLIAMS transferred from OperatingTheatrePMH totheSRC. The followingnurseshave resigned from thePMH:-Sheila CARROLL, Cheryl CAMPBELL, Kathleen 187

PAGE 21

COMINGEVENTSThe"HealthEducation Council" isplanningits annual exhibition for September.*The NationalHealthEducation Council (Baha mas) TCNNeliaDAMES, Andros, recentlyattendeda six week Refresher CourseinNew Providence as did: TCN CoralieTURNERofCatIsland. We hope you foundthecoursetruly"refreshing"andthatyourcommunities benefit fromyourreThe CNS wishestosaya sincere"thankyou" to thosestaffnurseswho"rotatedthrough"theirdepartmentoverthepastyearandprovided suchsterlingservicetotheirpatientsandwho have nowreturnedtotheiroriginalpostings:-StaffNurses-Melva'DELEVEAUX,NinaMAJOR, Sheldon PRA'IT, IrvineSTUBBS all ofthePMHandCynthiaJOHNSONoftheSRC. OnceagainThankYou Nurses.Congratulationsto TCNEvangelistCatherineCHISHOLM onherordination totheministryon15thJune1986. Congratulations alsotoMrs. Shirley SAUNDERS formerly oftheAnn'sTown Clinicandnow doingsterlingworkwiththeBahamasPlannedParenthood Association (BPPA) who was recognized forhavingcompletedthirtyyearsofnursingattheabovegraduatingceremony heldthisyearattheSheratonGrandHotel (formerGrandHoteD onParadiseIsland. The CommunityNursingServices extends congrat ulations to those five Registered NursesandthreeTrainedClinicalNurseswho graduated/completedtheMCH Course onFriday11thJuly.BoththeBlue Hill RoadandCoconut Grove Clin icsarebeing extendedandshould be ready for use byearlyAugust. Mothersandchildren, not to mention staff, should be considerably more com fortable. sponsible forthecareofcancer patients, shouldpresentthestateoftheartinrespectofpracticeandresearchinCancernursing. Topics include:HealthCaretrendsandCancerNursingNew Modelsinbreastcancer Oncologic emergenciesCancerandtheelderly Cancer, copingandcaringThe faculty consistsofnurseswhoarerecognizedintheUSinthefieldofcancer nursing;attendance qualifies for 17 contacthoursbytheGeorgiaNursesAssociation.Furtherdetailsmaybe obtained fromthePresidentoftheNursesAssociation of TheBahamas,Mr. Andil LaRoda,DepartmentofNursingEduca tion,. telephone 325-5551.*** *FROMTHECOMMUNITYNURSINGSERVICES*The Holiday Inn,ParadiseIsland, will betheve nue of a special conference coordinated by Educa tional Excursions,Atlanta,Georgia, November 5 9 on Contemporary Approaches to Cancer Nurses. The Conference, designed fornurseswhoarereInFebruaryof every year, followingthedeathof Mrs. EloisePENN,former PrincipalNursingOffi cer oftheSRC, awalkathonisheld to raise funds for the EloisePennMemorial Scholarship Fund. ThisyearsixnursesattheSRC were beneficiaries of this fund. They were able to complete aDrugAwarenessProgrammeconducted bytheSocial SciencesDepartmentoftheCollege of The Baha mas. This programmewasthefirst to be offered bytheSocial Workersinthatdepartment.Itwasrunover a period of fourteen weeks or two semesters. JOINING HANDSFORHEALTH hopesthatnotonly you benefit fromattendanceatthiscourse. CoUeaguesatthePMHtakethisopportunity to wish NO IIHannaGRANT, presently residing(atthetimeof going to press) onthePrivateSurgical Ward (PMH)and"Muffins" allthevery best for a safeandconfortable deliveryanda happy period of bonding. Good luckNurseGrant.TheCaribbeanNurses' Organization Conference scheduled for October 12-17, 1986, St. Thomas, US Virgin Islands, will explorethemanyissues asso ciatedwiththehealthandwelfare oftheelderlyunderthetheme"Care oftheElderly intheCarib bean". Registration iscurrentlyinprogressanddetails may be obtained fromthe1stVicePresidentoftheNurses' Association, Mrs. Gloria Ferguson,attheDNE, telephone 325-5551. JOINING HANDS FOR HEALTH wishes you ev ery successinyour new"areaof endeavour", may you continue to move forwardandupward. FUZZELL,MaryGOULDING, Elsie HEPBURN, Marva LONGLEY,MaureenSEYMOUR, ChristinaSMITH. Mr.BarryRassin, Hospital Administrator oftheRassin Hospitalandthefirst elected President oftheCouncil has onceagainagreed to serveinthatcapacity. CurrentlyotherofficersareMrs. Elvia Rolle Secre tary and a founding member oftheCouncil while BishopHarcourtPindercontinuesasTreasurer.***19

PAGE 22

NewPremises*TCNEloiseHANNAofthePostNatalservicesretiredattheendofApril. WewishNurseHannamanyyearsofactiveandenjoyableretirement.*centlyacquiredadditionalknowledge.TheDepartmentofNursingEducationis looking forwardwitheageranticipationtomovingintomore spaciousandcustombuiltpremisesontheothersideofthePrincessMargaretHospitalandnectdoortotheMinistryofEducationBuilding.IfyouhavedrivenupGROSVENOR Close recent ly,youwillhavenoticedconstructionunderway.Thequarryhasbeen"hewninto" to accommodatethebuilding-theschool will beinthebrow oftherock.Intakesoffuturestudent's,from 1987, should beabletolook forward tostudyinginrelativequietwithouttheconstantroarofpassingtrafficandfeelsafeingettingtoandfrom classes.Facultyalsomustbebreathingmanysighsofreliefthattheywillnolongerhaveto climballthosestairtogetto classes. You willmisstheexercise! WeinHealthEducationwillnolongerarrivefor Sessions hotandbotherednotonly fromtryingtofind aparkingspacebutalso from climbing thosestairs.Perhapsnow we'llwalktothesessionsandarrivetheepitomeofgoodhealth!area-hasrecentlydonatedthefollowingitemstotheClinicatRockSound:-OnerefrigeratorforthestorageofvaccinesOnewashingmachineforlaunderingcliniclinenOneX-raymachine.TheMinistryofHealthandmoreespeciallythestafftotheclinicatRockSoundisgratefultoandappreciativetothegenerosityoftheCottonBayFoundation.*TheDoctor'sresidenceis to be given a "face lift". SupplieshavebeendeliveredandDr.Guinaandthecommunitylook forward to abright,cheerful residencewhichwilladdtothecharmandbeautyofKingStreet,Rock Sound.FROMGRANDBAHAMA*CongratulationsDr.KomaraginNEHRU,DistrictMedical Officer,HawksbillClinic,GrandBahama,onreceivingtheDistinguishedCitizenAwardfor workinthegovernmentfromtheGrandBahamaChamberofCommerce.Thisawardwasbestowedattheirannualbanquetheldon30thApril, 1986.*CommunityHealthEducationiscontinuingwithtalksgivenby Dr.Chutkanon Foot problems intheNewbornandDr.NehruonUrethritis.FROMTHEDEPARTMENTOFSOCIALSERVICESHELPFORTHEYOUTH*TheYouthDivisionoftheMinistryof Youth, Sports,CommunityAffairsandLabourhasrecentlyin troduced a"Call-inCounsellingService" which is de signed tohelpyoungpeopledealwiththeirday-to-day concerns.Parents/Guardiansareinvitedtousetheserv ice.FurtherinformationmaybeobtainedbycallingMr.LeroyHannaorMs. Debbi Dillet. Telephone 22549or68519orwritingtothematP.O. Box N-10114.NEWSFROMROCKSOUND,SOUTHELEUTHERATheDepartmentof Social Services (DSS)startedtheyearon amostpositivenotewhentheymoved offices fromtheClarenceA.BainBuilding(groundandfirstfloors)ThompsonBoulevard, tomorespa cious accommodation onthesecond floor oftheBoulevardBuildingComplex,nearertotheOakesFieldShoppingCentre,Thompson Boulevard.Notonlyarestaffmembersalltogetheronthesamefloorbutalsothedepartmentitselfis now inmuchcloserproximitytotheirMinistry,lessthantheproverbial"stone'sthrow".Thismustbe administrativelyandmutuallybeneficial.Theirnewtelephonenumberare60526, 60255,60457,60525and65560.* *20CongratulationstoTrainedClinical NurselMidwifeGloriaSTRACHANonbeingrecentlyhonouredbytheChildCareDivisionoftheDepartmentofSo cial Services for services to children,duringChildCareWeek713 April, 1986. DespitehernumerousdutiesattheRockSoundClinic,NurseStrachanhasalwaysfoundtimefor activitiesandhasbeenareliablefostermotherinhercommunityfor anumberofyears.KeepupthegoodworkNurseStrachan.THECOTTONBAYFOUNDATION-a groupofhomeownersinterestedinthewelfareoftheFamilyIslandresidentsinAbaco,AndrosandEIeutherashouldnow beexperiencingimprovementsinthequalityoftheirserviceswiththeaddition ofanofficer toeachofthefirsttwoislandsandareplacementinthethird.Therearenowtherefore:-twotrainedworkersinAbaco oneatCooper's TownandoneatMarshHarbourtwotrainedworkersinAndrosoneatNicholls TownandoneatFreshCreekonetrainedworkerinGovernor'sHarbour,EleutheraandoneinExumainadditiontothestaffinGrandBahama.

PAGE 23

BIRTHSMARRIAGES*The Social Services Coordinating Committeeunderthechairmanshipof Mr.HubertDean, Deputy QQvernor oftheCentralBank, was officially formedinMarch to supportandencourage pro grammesandactivities concernedwiththewelfare of childrenandfamiliesandtoenlistthesupport of community membersinefforts designedtostrengthen existing foster careandadoptive pro grammes. Members ofthiscommitteearealllead ersintheirindividualrightandinclude:-MessrsCalsey Johnson, Broadcasting Corporation of The Bahamas, Roy Davis,EasternAirlines, Mrs. Ver nice Symonette,PatriciaBethelandCarolHannaandtheLyford Cay Foundation. This committee willassistthedepartmentinspe cial projects.*CongratulationstoMrs.ShielaJOHNSON,ChiefClerk,Purchasing,intheSupplies SectionofthePrincessMargaretHospital onthebirthofyour first grandson, Christopher,inBatonRouge,Louisiana,on24thSeptemberlast. Christopheritseems isalreadyamemberofthe''jet set" groupashevisitedhisgrandparentsinNassauearlierthisyear.OfcourseMrs.Johsnonisstillexudingthepleasureofgrandmothership! Lucky forChristopherthatyou won't bearoundto "spoilhimrotten"Mrs.Johnson!**JOINING HANDSFORHEALTH addsitscon gratulations tothefollowingstaffmembers whograduatedfromtheCollege of The Bahamas, Ad vanced CertificateinSocial Work onFriday11th July: Beryl ARMBRISTER,JenniferCASH, Zenovia COAKLEY,CharlemayFERNANDER,PatriciaJONES,LilianQUANT, Deva ROBERTS. This isthefirstgraduatinggroupinthiscourse. The course lasted fourteen months. An "exciting experiment" is soontobeinstituted. The depardment,incollaborationwithTheBaha mas Red Cross Societyhasrecently acquired a house ontheFox Hill Roadinwhich six senior citizens (threemenandthreewomen) will be ac commodated. These premises should helptoreducethepressureonthePrincessMargaretHospitalandatthesametimehelp these individualstoregain/maintainsome degreeofindependence. Wedding Bellsrangourfor:-*NADaphneIdenaSTRACHANofthePMHandCornell Norris FERGUSON on1stMarch.*SNArnetaDoralee SANDSofthePMHandPhilipCharlesCLARKon29thMarch.*NAPaulaMaeBRICEofthePHMandJohnFirtzgeraldHALLon26thApril.Congratulationsandbestwishes formanyyearsofhappymarriage.DEATHSJOININGHANDSFORHEALTHtogetherwiththestaffoftheCommunityNursingServices,extendcondo lences to Ms. IclynPRATToftheDistrictNursingServ ice onthedeathofhermotheronFriday20thJune,1986.FuneralservicewasheldatSt. Agnes Church, Blue Hill Road onSunday29thJune,1986. MayGodgrantyoustrengthinyourtimeoflossNursePratt.VITALSTATISTICSChristopherJohnsonagethreemonths.*Sincere condolencestoMs.JaniceTHOMPSON, Case Aide,DepartmentofSocial Services, Rock Sound,SouthEleutheraonthetragicdeathof your babydaughterthroughfireattheage of fivemonthsinDeepCreekonFriday20thJune.LittleMiquelwasasleepinherbedroomatthetimethefirestartedandhergrandauntwho wasathome, wasunableto rescure her. 21

PAGE 24

r 22WHATNURSESAREMADEFOREnidRuddock Nursesare made tocare, When nobody else cares Nurses are made tobedoctors' wives Nurses are made ofrock-stone heartandiron flesh Nurses are notpaidseroants but nurses, Nurses are not born nurses,NursesevolveasGod's merciful people. Nurses, dressedinwhite, Must always wear ahalfround smile, Nursesmustnot wear make-upatall.Nursesmustalways be ready, With pen, watchandscissors,Nursesmustalways speak, Softly, politelyandfriendly To patientsandtheir visitors NursesmustneversaynoToquestions asked, Nursesmustonly stoptorest, When the task is finished,Attheendofthe day. Nursesmustalways meet the needsOfthe sick, before meeting theirs, Nursesmustalwaysbeready To oblige without regarding Whom they oblige.

PAGE 25

DIETETICS-ACARINGPROFESSIONROSALIEFOULKESOne ofthemost respected professions isthatof caring forthesick. A person who contributes tothatcare cantakeprideinhislher work. Thepatientor cli entisthe mostimportantpersoninanyhealthcare institution. Today,healthcareincludestheconcept of continu ity of caremeaningthetransferof care ofthepatientfromthe hospital tothehome setting. Toensureconti nuity of carewithrespect tothenutritionalneeds of the patientrequiresconscientious assistanceandeffortofthe administrators, physicians, surgeons, nurses, di etitians andd social workers.Dietitiansplayanintegraland significant roleinproviding optimalnutritionalcare. They devote agreatdeal oftimeto counselling individualsandfamilies emphasizingtheimportance of avoiding excessive calories,saturatedfats, simple sug ars, refined foods, alcoholic beveragesandsalt. Over the course of aIlifetime,theseexcesses can lead to obesi ty and dental cariesandareconsideredtoberiskfac tors inheartdisease, hypertension, diabetesandgastro intestinal disorders. Adietitian'sjob isnotjustanotherprofession,itis a dedicationtohumanwelfare. Dieteticscanbe technically definedasthecom bined scienceandartregulatingtheplanning, prepara tion and serving ofmealsto individualsorgroups un der various conditionsofhealth.The objective is to motivate individualsatalleconomic levels, betheywell orill,to adopt soundnutritionalhabits. Individuals therefore, whoareconsidering acareerindietetics must beinterestedinthepersonalaswellastheprofes sional characteristics deemed necessaryinexecuting their responsibilities. Attheverybeginningofanycourse of study,itisadvisable forthestudenttosetsome specific objectives. Regardless of one'sfuture "professional careerindietet ics,thestudy ofnutritionshould first be directedtooneself.Inotherwords, those who expectanddesire to helpotherpeople achievebetterhealththroughnutritionmustbeenthusiasticandliving examples ofthebenefits oftheapplicationofnutritionknowledge.Togainthisknowledge,studentsmustprepare themselves by followingandcompleting a curriculumthatwillassurea soundandliberaleducation. High schoolstudentsshouldhavea good feel forthesciences, namely, Chemistry, Biochemistry,andPhysiology.ThecollegeentrancerequirementintheUnitedStatesnor mallystatesa 'C'averageorbetterinall subjects. Credits obtained from a twoyearscience oriented programmeatTheCollege ofTheBahamas,Nassau, Baha mas,aretransferableto accredited CollegesintheUnited States.Studentswho willbeselectingthisareaofspecialityshould becomefamiliarandeventuallyinvolve them selveswithvariousprofessional organizations which would affordthemtheopportunity for professionalandpersonal development.Tonamea few,theAmerican Dietetic Association (A.D.A.)isthelargestprofessional organizationofdietitiansanddietetics technicians. Foundedin1917, A.D.A.hasgrown to include morethan52,000nutritionprofessionals. Closer to home, wehavetheCaribbeanAssociationofNutritionistsandDietitians(CANDI) which consists of approximately 150 members.Presently,thereisaBahamiandietitianpursuinga oneyearpost-graduateintershipinTrinidad, West Indies, sponsoredandorganizedbyCANDI.Interestedandaspiringstudentsareadvisedtoobtaina copyofthe'DirectoryofDieteticProgrammes'.Thisbookletcanbe most beneficial to youinthecourse ofdetennninga Collegeofyourchoice.Italso includesthefollowing information: a.generalinformationpertainingtoA.D.A.;b.accreditedcoordinatedundergraduatepro-grammes;c.postbaccalaureatedietetic internships;d.approved dietetic technician programmes;ande.advanced degree programmes. Keepinginmindthedifficultythatconfronts mostundergraduatesingainingacceptance into dietetic in ternships,itishighlyrecommendedthatyou select a collegethatoffersthecoordinatedundergraduatepro gramme.Thistypeofcoordinated experience givesthestudenttheopportunitytoputintopracticethetheoryaspects oftheclassroom teaching. Copiesoftheabove mentioned'DirectoryofDi-eteticProgrammes'areavailablefrom:TheAmerican Dietetic AssociationSalesOrderDepartmentP.O. Box 10960 Chicago, Illinois 60610 0960CatalogueNumber: 0401 The following definitions, acadamic qualificationsandresponsibilitiesatthevariousfunctioning levelsaresetoutbelow tohelpreadersunderstandthetermi nologyrelatedtotheprofession. A.D.A.Dietitian:a specialist, educated totakerespon sibility forthenutritionalcareofindividualsandgroups.Thisis a person whohasearneda bachelor's orhigherdegreeinoneofthefollowing areas: Dietetics, FoodandNutrition,NutritionandFood/service Systems Management.23

PAGE 26

,RegisteredDietitian(R.D.): This is a person who meetsalltherequirementsfor membershipintheAmerican Dietetic Association, whohassuccessfully completedtheexaminationfor registration,andwhomaintainscontinuingeducation requirements.Thiscer tification process encourageshighstandardsofperfor mancetoprotestthehealth,safetyandwelfareofthepublic.Onthejob, ... RegisteredDietitian(R.D.)hasthesame responsibilitiesastheA.D.A. Dietitian.FoodServiceManager;TheFood ServiceManagerassumestheresponsibility fortheadministrationoftheFood ServiceDepartment.ThedutiesareverysimilartothoseofanAdministrativeDietitian. The profession is encouragingthisspecialistnotonlytopursueanas sociate degreeorequivalent,butalsotoundertakea fouryeardegree courseinInstitutionalManagement. Themainreason forthisisthattheFood/service Managerneedstobecognizantoftechniques forthepreparationoffoods,aswellasimportantprinciplesinsuchareasasMathematics, Psychology, Chemistry, Micro biology, Cost ControlandSupervision.SupportivePersonnel:TheDieteticTechnicianprogramme is a twoyearprogrammeleadingtoanassociate degree. This programmeisa combination of dieteticsandclinical expe rience.The technician worksundertheguidance of a fully qualifieddietitianandhasresponsibilitiesinas signedareasinFood service Management,teachingFoodandNutritionPrinciplesandDietaryCounselling.DieteticAssistant:A skilled person whohassuccess fully completed ahighschool education orequivalentanda dieteticassistant'sprogramme which meetsthestandardsestablishedbytheAmerican Dietetics Asso ciation.Thedieteticassistant,workingundertheguidanceofa fully qualifieddietitian,or a technician,hasresponsibilityinassignedareasforfoodservicetoindividualsandgroups. Many oftheresponsibilities mentioned abovehavetodowithteachingortraining.Much ofthedietitian's workingdayisdevotedtothisactivity,eitherformally or informally, therefore anyone wishingtoenterdietet-24icsmustbepreparedto teach,anactivity which should prove challengingandrewarding. TodayinTheBahamas,thereareapproximatelytenacademically qualified dietitians.Apartfrom a very smallnumberwho serveintheschool systemasHome Economics Teachers,themajority ofthedietitiansare dispersedthroughoutthethreemainhospitals. Thelocal clinicsandFamilyIslandclinicsareyettobe serv iced by dietitians.Nutritioneducationmustbecomeanessential component ofthecurriculum inallElementaryandSecondary Schools.Indeveloped countries,therearemanyopportunities fordietitiansinprivate industries. They find employmentinairlines compa nies, hotelsandrestaurants,foodmanufacturers, phar maceutical companiesandasprivateconsultants. Other major employersarecorrectional institutions, day care centres,nursinghomesandbusiness firmsthatprovidefoodfortheiremployees.Thinkingahead;futuredietitianswill bereturninghome fromtheirstudiesandwill be seeking opportuni ties toputtheirtalentsandskills to use.Wemustbearinmindthatmost ofthesegraduatesmay not have undergoneanapprovedinternshipandso will need to be placedundertheguidanceandsupervision of a pra tising dietitian.Itis hopedthatopportunities will be providedtoallow forcareerprogressionanddiversifica tion.Havingaconsultantdietitianwitha supportiveteamfunctionasanadjunct totheMinistry ofHealthcan only be viewedasbeneficialandprogressive. This appointed group would be specifically responsible for developingandevaluatinginformationalmaterialsand equallyimportant,provide directionandleadership for quality dietetic practiceandeducation. The foregoing is onlyandintroduction. As readersareaware, educationmeanschanges in behaviour.Itmovestheindividual from lack ofinterestandigno rancetoincreasing appreciationandknowledgeandfinally,toaction.Nutritioneducation offers agreatopportunity for individuals tolearnabouttheessentials ofnutritionforhealthandtotakesteps to improve the quality oftheirdietsandthusthewell-being of the population.

PAGE 27

PHYSIOTHERAPYVELMABURROWSPhysiotherapy,asdehnedInthecurriculum oftheChartered Society of Physiotherapy (CSP), 1976, isthetreatment of diseaseandinjury by physical means. HISTORY Physiotherapy istheoldestbranchofthemedical profession.Itisthatprehistoricbranchof medicine where people touched, strokedandhelped eachotherby manual therapyanddatesback totheancient Greeks, ChineseandEgyptians.Inancient Greece,thegymnasiaweretheplaces where onewentfor helpandadvicewithproblems for pain and function.Therewere directors who were ex pertsinmassageandexercisesegoPRODITUS who was describedintheliteraturepredatingHIPPOCRATES. According totheRoyalCharter,Physiotherapyhasthree components:1.Massage2.Medical Gymnastics3.Medical Electricity.Todatethen,Physiotherapistsarecarryingon a tradition thousands ofyearsold. Physiotherapy is a mo bile professioninhealthcareandis, byitsverynatureofdevelopment, a service-oriented profession. MASSAGE:thisis ahandson profession -ituti lisestheareasoftissuemanipulation, mobilisa tion,stretchingandjointmanipulation. To beaneffectiveTherapisttherefore, onemustlove people. Onemustlove to touchandbe touched becauseitisthroughtouchthatthehealingprocess becomes effective. MEDICAL GYMN.A.8TICS hasledTherapiststo becomeexpertsinnormalandabnormalhumanmovements.TheTherapistis well qualifiedinthebiomechanicsofthephysiology of performanceandtoteachingandexercise theory. BecausePhysiotherapistsareexpertsinteaching andindealingwiththemotivational basis of problemsofdisabilityandfunction,theyhandlepatientsboth physicallyandmentally.MEDICAL ELECTRICITY:thismodality usesthenaturalagencies which affect cellular activities,painandfunctionandisthedifference between medicineandphysiotherapy.Inthemedical model one dealswithpathology (ill ness), one labelsitandlooks fortreatmentandcure.Itis a model whichputsahighpriority on saving life. The physiotherapy model ontheotherhand,isaboutdisordersandproblemsoffunctionanddisabilityratherthanpathology diagnosis,althoughmuchtimeisspentlearningaboutpathological diagnosis. Physiotherapyisa competentandindependent pro fession.TheTherapistworks WITHandnotFORthePhysician.Physiotherapistsarecapable of assessing,evaluatingandplanningtreatmentprogrammes inde pendently,withoutphysician referrals. PhysiotherapistsareMANUALtherapists,theyusetheirhands.Itisa profession which uses touch for sensory the rapeuticinputandhealing, one which usesmanualskills for manipulation. Asinthemedical professiontherearemanyspe cialtyareassoitisinphysiotherapy, for example Paediatrics, Gynaecology&Obstetrics, Gerontology, Or thopaedics, Neurology, RespiratoryandHydrotherapy tonamea few.ACADEMICREQUIREMENTSTheminimumentryrequirementsfor a physiothe rapy programme depend on locationandareasfollows:1.JAMAICA: five G.C.E."0"Levels 2. UNITED KINGDOMandCANADA: five G.C.E."0"Levelsandtwo "A" Levels -anassociate degreeinthesciencesmaybesubstitutedforthetwo "A" Levels. 3. U.S.A:Thiswill dependontheUniversity. Youmaygainentrywithfive G.C.E."0"Levels,anassociate degreeor firstdegreeinthesci ences. ThetrainingperiodinJamaicaisthreeacademic schoolyearsandfouryearsintheUnitedKingdom,CanadaandU.S.A.

PAGE 28

THE FIELDOFSOCIALWORKLORENECLARKE"SocialWorkandSocialWelfareactivitiesconstitutesoneofthemostimportantfunctionsintermsoffinancialexpenditureandhumanefforts."SOCIALWORKDEFINEDA Classic DefinitionOnetheorist,MaryRichmond, sees SocialWorkas"those processeswhichdeveloppersonalitythroughadjustmentsconsciously effected,individualbyindividual,betweenmenandtheirsocialenvironment."Another sees itas"theartofbringingvariousresourcestobearonindividual,groupandcommunityneedsandtheap plicationofa scientificmethodofhelpingpeopletohelpthemselves."Whilesome.theorists see SocialWorkfromthepys cho-socialpointofviewandothersseeitfrom a pure pointofview,therole -theproblemandtheinstitutions,inanutshellSocial Work, is seen asahelpingprocess,wheretheworkerhelpstheindividualtohelphimlherself,asanindividual,inthefamilyandinthelargerenvironment.Thishelpingiseffectedmainlythroughthefollow-ingprocesses:-1.theCaseWorkProcess 2.theGroupWorkProcessor3.theCommunityOrganizationProcess.TheCaseWorkProcessisa onetoonerelationshipinwhichtheworkerworkswiththeindividualand/orthefamilyasa whole.TheGroupWorkProcessisagroupingofseveralindividualswithsimilarproblems,meetingonaregularbasistodiscusstheirproblemandtheircoping mech anism.Inthisprocesstheworkeris involvedasa facilitator.TheCommunityOrganizationProcess occurs on amuchwiderbasisanddealswithmarshallingcommunityresources soastoconductprojectsthatwillbenefitthecommunityasa whole.Heretheworker'srole isthatofanenabler.ThereareanumberofspecialtyareasinSocial Work, forexample:-1.PsychiatricSocialWork2. Medical SocialWork3.ChildCare4. SocialWorkerswhoworkwithSenior Citizens 5.MaritalCounselling6.AttachedtoCorrectionalInstitutionsTRAININGSocialWorktrainingdrawsonmanydisciplinessuchaspsychology, sociologyandeconomics.Thereare, however, core subjectsrelatedtotheprofession of Social Work alone. SocialWorkisthereforea disciplineinitself.Trainingcanbeattainedlocallyandabroad.Locally,theCollegeofTheBahamasoffers two programmes1)thetwo-yearDiplomainSocial Work,gearedtopersonswiththreeG.C.E."0"Levelsandespecially forthoseinvolvedinthefieldofSocial WorkbutwithnoformaltraininginSocialWorkand2)theAdvancedCertificateinSocial Work,gearedtowardsequippingthoseindividuals-graduatesorpost graduateswhoareinvolvedorinterestedinthefield of Social Work,butwho donotpossessthenecessaryformaltraininginthearea.TrainingcanbepursuedattheUniversityoftheWestIndies-a twoyearCertificateCourseora Bach elor of ScienceinSocialWork(threeyearcourse). ProfessionaltrainingcanbeobtainedatschoolsintheUnitedStatesofAmerica,CanadaandtheUnitedKingdomandcanrangefromtheCertificateto Doctoratelevels.CAREERPOSSIBILITIESANDENTRYQUALIFICATIONThebasicqualificationneededforthejobasaSocialWorkeris aDiplomainSocial Workandis obtaina bleattheCollegeofTheBahamas.Amatureindividualwithagenuineinterestinalleviatinghumansuffering is desirable. Possibilities forcareerdevelopmentinSocial Workareverygoodatthistimeasourcountryis developingrapidlyandthesociety is becoming moreawareofthismostvitalrole. So far, wehavetwoDepartmentseachheadedby a Director,withAssistantDirectorsandtwootherareaswithHeadsoftheirDepartmentinanequivalentposition to Directors.Expansionsoccur on aregularbasis.Thereisattimes,a misconceptionthata "reli gious"personwould be amoreeffective Social Worker.Thisisnotnecessarilythecase. Acaringperson who feelstheneedtobecome involvedwithanotherpersoninahelpingway; one whogainstheconfidence and respectofhis/herclientandis willing to gothatextrastepforhisfellowhumanbeing, would be effective as a Social Worker.Thesearethebasichumanrequirementsforthefield of Social Work.Anothermisconception isthatonemustbe marriedwitha familyandhavehadthesameexperience if he/she is tomakeeffectiveintervention.Thisalso is a

PAGE 29

myth.ProfessionaltrainingintheareaofSocial Work, coupledwithempathyisallthatisneeded. SocialWorkcanbeaveryrewardingprofession.Itrequiresmaturity,sensitivityandagenuineconcernforthewell-beingofothers.ONBECOMINGA PHARMACIST SYPIERREWhatisPharmacy?Pharmacyhasbeendefinedasthatprofession which isconcernedwiththeartandscienceofpreparing fromnaturalandsyntheticsources,suitableandconvenientmaterialsfordistributionanduseinthetreatmentandpreventionofdisease.Itembracesa knowledgeoftheidentification,selection, pharmacologicaction,preservation,combination,analysisandstandardizationof drugs andmedicines.Pharmacyalsoin cludesproperandsafedistributionanduseofdrugs.Theword"pharmacy"isderivedfromtheGreekwork"pharmakon",meaningmedicineordrug.Apharmacististherefore'theexpertondrugs'.TrainingAtpresent,therearetwogradesofpharmacistinTheBahamas,GradeIandGradeII.TheminimumrequirementsnecessarytoqualifyasaGradeIPharmacist is aBachelorisa SciencedegreeinPharmacyfromanapprovedorrecognisedCollegeofPharmacy.Allpharmacyprogrammeslastfiveyears.Thefirsttwo years (ofthepharmacyschoolcurriculum)(called pre pharmacy)consistofcourseswhichprovideafirmfoun dationinthephysicalandbiological sciences,egochem istry, physicsandbiologyandmathematics.Overthenextthreeyears,thecurriculumconsistsprimarilyofprofessionalpharmacycourses.Thesecourses, basic to allpharmacyschools,includepharmacognosy,biology, biochemistryandcommerceofnaturalproducts;pharmacology,thestudyoftheactionanduseofdrugs;pharmaceuticalchemistry,theapplicationofbasicor ganicandinorganicchemistry,pharmaceuticalsandtherelationoftheseprinciplestodruguse;pharmacypharmaceuticals,thisincludescalculations,preparations,dispensingpharmacyandphysicalpharmacy;clinical pharmacy,whichisthatdivisionofpharmacywhichdealswithpatientcarewithparticularemphasison drugtherapy;andpharmacyadministration,whichdealswiththeprinciplesandpracticeofbusinessandlawastheyapplytopharmacypractice.Generally,aftercompletingthedegreecourse, aPharmacyBoardexaminationistakenandthesuccessfulstudentisthena licensedorregisteredpharmacistwhichgrantshimIherthelegalrightto"independentlyengageinthepracticeofpharmacy".InordertobecomeaGradeIIPharmacist,theindividualmusthaveobtainedaminimumoffivegeneralcertificateofeducation(GeE)subjects(withaminimumofC-Grade),whichmustincludeMathematics,Englishandonesciencesubject.He/shemustthenundergoatleastfouryearsofinservicetrainingorapprenticeshipinapharmacyunderthedirection/supervisionofalicensedpharmacist.ThefinalstepinobtaininggradeIIlicensureistotakeclasses(givenbyalicensedpharmacist)inordertositthepharmacyexaminationadministeredbythePHARMACYBOARD.OnecanalsobecomeaPharmacyTechnician,whichinvolveslessintensetrainingbutallowsthepersontoparticipateinthetechnicalaspectsofpharmacyunderthesupervisionofalicensedpharmacist.AdegreewhichisfastbecomingpopularintheUnitedStatesisthedegreeof"DoctorofPharmacy"(Pharm.D),nottobe confused withtheDoctorofPhilosophy (PhD)degree.ThePharm.D.isaclinicaldegree(as opposedtoresearch)andrequiresaminimumofsixyearsstudy.ThedegreeissimilartotheBachelorofSciencedegreeinpharmacy,buttheadditionalyearinvolvesextensivetraininginclinicalpharmacyandmayalsoinvolvespecializationinareassuchasoncolo gy,psychiatry,paediatrics,generalmedicine,ambulatorycare,clinical(pharmacokinetics)nutritionalsupport,drugtoxicology.Itshouldbenotedthattherearealsoresearchorienteddegreeswhichmaybeobtainedinspecificareasencompassedbypharmacy.ThesearetheMasterof Science (M.S.)andtheDoctorofPhilosophy(PhD.) degrees.TheM.S.andPhD.degreesarepost-graduatedegreeswhichcanbeobtainedintwoandfouryearsaftercompletionoftheBachelorofScienceorDoctorofPharmacydegree.Thesepost-graduatedegreesareinspecialtyareassuchaspharmacology,medicinalchem-27

PAGE 30

istryandbiopharrnaceutics.CareersinPharmacyFinally,I wouldliketotouchuponthedifferentcareersinwhichonecanengage.FirstthereistheCommunityPharmacistmorepharmacistsareinvolvedincommunitypracticethaninanyotherareaof Thisisthepharmacistmost oftenseenbythepublic who practicesinanindependentlyownedorchainpharmacystore.Anothercareerinpharmacyisthatof HospitalPharmacist.Thesepharmacistspracticeinprivateandgovernment-owned hospitals.Thereis alsotheWholesalePharmacist.ThisPharmacistaswithotherwholesalers)actsa "middleman" betweenthemanufacturerandthecommunitypharmacist. Becauseofthespecialnatureand legal restrictions oftheproductshandled,mostwholesale drug firms em ploy a licensedpharmacistina supervisory capacity.Industrialpharmacyisanothercareerwhich offers opportunities topharmacistsof all educational levels. ThisincludescareerssuchastheMedical Service Representative(ordetailman)who isincontactwithboth physicianandpharmacistregardinghiscompany's products.Pharmacistsarealso employedinsupervisoryandadministrativepositionsinindustry.Industryalso offersopportunitiesto thosewithresearchoriented de greesinsuchareasasproductdevelopment,qualitycontrol,testingandthediscoveryofnewdrugsandothertherapeuticagents.Inconclusion -pharmacyencompasses a broadareaofknowledgeinboththebasicandclinical sci enceswithspecialemphasisondruginformation. A careerinpharmacycanberewardingandfulfillingifonly because apharmacistisanessentialmemberofanyhealthcareteam.IMMUNIZATIONAWARDSCEREMONYINPICTURES/ ?'R.

PAGE 31

29

PAGE 32

30Our men aresoSPECIAL!!!

PAGE 33

U\ I I'" HEALTHEDUCATIONINMOTIONFELICITY AYMERAlthoughtheartandpractice ofhealtheducation dates back toantiquity,thephraseisrelativelynew having onlybeencoinedandadoptedearlythiscentury.The practiceandacceptance ofhealtheducationhashad a very chequeredlife,nearlyfalling into oblivionatone pointandowes is revitalisationto epidemics occur ring midlastcenturyandtheturnof this. SincethenHealthEducationhasgainedsteadycredence overthelasteightyorsoyearsandis nowbeinghailedasthepanacea for allthemoderndayhealthproblems.Butwhatis it,whatdoesthe"healtheducation" do? Surely allhealthandindeed alliedhealthprofessionals/providersarehealtheducators?Ofcoursetheyare.Themother/guardianwho-teachesheryoungchildhealthfulhabits,thecommunitynursewhohelpsherclients tonurtureherfamilyorsuggestsalternativewaysofhousekeepingto accommodate a sick child, dis abledorelderlyrelative,theEnvironmentalHealthOfficer whopersuadeshislherconstituentsto "catch"theirplantsinsoil/sandratherthanwater,thephysician, bedsidenurse,theteacher,areallfunctioningashealtheducators.WhatthendoesthehealtheducatorlHealthEduca31

PAGE 34

tion Specialist do?Theanswertothatlies essentiallyinunderstandingwhathealtheducation is about. The essence ofhealtheducation liesin"voluntaryadaptationsofbehaviourconducive to healthful living".TheWHO'sExpertCommittee onHealthEducation ofthepublic (Technical Report Series No. 89)statestheaim ofhealtheducationisto help people to achievehealthbytheirown actionsandefforts ... Thegeneralpurposes1.tomakehealtha valued communityasset2.tohelp individuals to become competentinandtocarryon those activitiestheymustundertakefor themselvesasindividuals orinsmall groupsinordertorealise fullythestateofhealth...3.topromotethedevelopmentandproper use ofhealthservices.Healtheducation is a "people-centred" activity. Thetrainedhealtheducator's function is to plan, conductandevaluatehealtheducation programmeswhetherthey are institutionally,community. school or occupa tionally based. Thehealtheducation specialistasshelhe isinternationally known istrainedinthebiological, physicalandsocial sciences;ineducationandeducational psychology;inhygieneandpublichealth;inpublic administra tion;andinthespecial skillsrequiredinthediscipline.6 AplanningmeetingforaprogrammeofhealtheducationintheGeneralPractice,PMH.Lefttoright:Dr.Gray,(GPC),DwightAllen,CherylThompson,Dr.Whitfield,Dr.KingChungandMrs.Ferguson.32TheHealthEducationDivision oftheMinistry ofHealthis asmallserviceareaoftheMinistry, strug glingitseems often,againstall odds,butwearegrad uallyandinexorably moving fromthepositioninwhich we were perceivedas"showing a film or giving a lecture"totheplanningimplementationandevaluationofhealtheducation programmesstatus.Healtheducation employsanynumberandor com bination of education/communicationstrategiesto effect "voluntarybehaviourchange". One ofthesemethods istheuse oftheelectronic media. For anumberof yearstheDivisionhashadsole responsibility for coordinatingandproducingtheMinistry ofHealth'sweeklyhalfhourradioprogrammeheardover RadioBahamasZNS 1 onSundayat1 p.m. The practice ofhealtheducation isaninteresting, challengingandevenattimes,rewardingone.Itdemandsconviction,determinationandtheability to "laughatoneself'.Italso demandsthatwelistentoandhearourpublicsandareable to communicate effective ly not onlywiththembutalsowithourleadersintheMinistry ofHealthifwearenotto losesightoftheraisond'etreofourexistance, effecting behaviour change. WiththechallengeofHealthFor All BytheYear 2000 (HFAJ2000)healtheducation is enjoyingandun precedented resurgence,theopportunities for playing avitalroleinthe"questforhealth"presently existandwill exist for sometimeto come.HealthEducationOfficerFELICITYAYMER,enjoysalightheartedmomentfollowingarecordingoftheweeklyMinistryofHealth'sRadioprogrammewithherguestDr.HerbertOrlander. ._

PAGE 35

A BRIEFONTHE HEALTH INSPECfORATEMELONYMcKENZIEEnvironmentalHealthScience isthecontrol of all those factorsinman'sphysical environment which exert or may exert a deleterious effect on his physical development,healthandsurvival. The Department ofEnvironmentalHealthServices(DEHS),adepartmentoftheMinistry of Health, is headed by a Director who is ultimately, responsible for the coordinationandperformance of all divisions. The Director's office is locatedintheMosko Building, "Haw kins Hill" Mount Royal Avenue, Nassau. Administra tive responsibilitiesaresharedby a Deputy Director. The Department is comprisedofsix units. Theseare:-1.TheHealthInspectorate2.Solid Waste Collection&Disposal Division3.The PublicAnalystLaboratory4.Vector Control5.Roads&Parks6.Garage. THEHEALTHINSPECTORATETheHealthInspectorate Division, located in prem isesonSchool Lane, is headed by aChiefHealthIn spector, who is assisted by a DeputyChiefHealthIn spector. This Division is responsible forfoodandwaterquality control, building control, porthealth,meatin spection, licensing,foodinspections, general inspec tions, investigation of environmental complaints, house and yard inspectionsandepidemiological investiga tions.Tofacilitate coverage ofthisisland, New Provi dence is divided into twelve districts each of which is the responsibilityofaHealthOfficer. Each officer is responsible fortheentireenvironmentalstatusof hislh er district. The maintenance ofanefficient system of supervis ing and controllingtheproduction, presentation, stor age and distribution ofthenation'sfoodsupply isanimportant function ofthedepartment. The recently es tablishedfoodunithasresponsibility for1)licensing of business houses;2)Sampling offoodand water;3)In spection of premises for schoolfoodvendors and tempo raryfoodvendors.PortHealthPortHealthincludes inspectionatall ports ofentryof all imported meats, inspection of allinternationalvessels and inspection for deratization certificates. Strict attention ispaidtotheimportation of used cloth ing and all imported used clothingmustbe accompa nied by a Certificate of Fumigation fromthepoint of shipping.Theclothesaresubject to inspection by aHealthOfficer.BuildingControlAll building applicationsmustbesubmitted tothedepartment. toobtainapproval,allenviromentalhealthrequirementsmustbe met.Atpresent,theislandisdivided intoeastandwestandinspectionofall build ingsandbuildingplansintheseareasistheresponsibi lity of two Officers.EpidemiologicalInvestigationsEpidemiological investigationsandmeatinspection are also responsibilitiesofthedepartment.Meatinspec tion is performed by all qualifiedHealth InspectOrs onarotation basis. TheyareassistedbyaHealthAssistantorHealthAide.Atpresent one officer is responsible for all emidemiological investigations.StaffingStaffoftheInspectorateinNew Providence consistof:-tenHealthInspectors, fiveHealthAssistants, fiveHealthAides.VECTORCONTROLThe coordination oftheVector ControlUnitis di vided into InsectandRodent Control headed by two foremen, one for Insectandone for Rodents. Theunitis responsible fortheidentificationandcontrol of all vectorsegomosquitoes, rodents.TheAedes aegypti control programme consistsofVector Control Officers whomakesystematic visits toallpremises. All receptacles holdingwateraretreatedwithinsecticides and breeding sitesareinspected to determinetheeffec tiveness ofthetreatment.All ports ofentryinNew Providenceareundersurveillance for Aedes aegyptiandmustbefreeofthismosquito topreventdisease transmission. Surveillance encompasses placement of (ovi)trapsfor egg laying mosquitoesinstrategic locations. Thesetrapsareserviced on a weekly basis, ''paddles''aretakentothemosquito indentification laboratory to determine whetherornotthereis breeding. Positive ovi paddlesareplacedinpansandincubated.Theresultantlarvaearethenkilled, indentifiedandpreserved.Inadditiontothetwo foremen,staffofVector Con trolunitcomprisetwentyVector Control Officers. 33

PAGE 36

FELICITY AYMERVELMA BURROWS PHILABERTHACARTERLORENECLARKEDONALDCOOPERCECIL DORSETT ROSALIEFOULKESBRENDA INGRAHAM PORTIAJORDANMELONY McKENZIEKAYLAMUSGROVESYPIERREENIDRUDDOCKJANETRECO Photographs: Courtesy:34ABOUTTHECONTRIBUTORSHealthEducationOfficer,MinistryofHealthandEditoristheDeputyChiefPhysiotherapistatthePrincessMargaretHospital. is aCommunityNurse,NursingOfficerattheCoconut Grove Clinic, AcklinsStreet,Nassau.istheChiefWelfare OfficerintheDepartmentof Social Services. isanAssistantDirectorintheDepartmentofEnvironmentalHealthServicesandthePublic Analyst. Dr. Cooper holds aPhDinMicrobiology. is a SeniorAgriculturalExtensionOfficerintheDepartmentofAgriculture'sRock Sound,EleutheraOffice,Ministryof Economic Affairs. is RegisteredDietitianandtheOfficerinchargeof Food ServicesattheSandilandsRehabilitationCentre. istheSenior Records Officer Medical RecordsDepartmentandofficerinchargeoftheDepartment.istheCoordinatorofCounselling ServicesattheCollege ofTheBahamasandholds aPhDinCounselling. isanOfficer oftheDepartmentofEnvironmentalHealthServices,HealthInspectorateDivision. is arecentgraduateoftheAcadiaUniversity,Nova ScotiaandhasworkedasasummerstudentintheCytology SectionoftheLaboratory,PMH.is a medicalstudentatMaharryMedical College, Nashville,TennesseeandatrainedPharmacist.is aCommunityNurseinFreshCreek, Andros. is aRadiographerGrade 1atthePrincessMargaretHospital. Mr.AnthonyBrown, Audio VisualUnit,PrincessMargaretHospitalandMr.KenBarkooftheEditorial Committee.

PAGE 37

FELICITY A YMEREDITORIAL COMMITfEEHealthEducation Division STEPHANIE CARROLL AUDREY DEVEAUX ASHWARDFERGUSON KEN OFOSU-BARKO HARCOURT PINDER CARLTON SMITH DONNA SMITH-DIAL CHERYL THOMPSONBahamasAssociation of LifeInsurersNational Insurance Board Architect, Ministry of Works Medical Officer, PublicHealthDepartment NationalHealthEducation Council (Bahamas) The Counsellors Broadcasting Corporation of TheBahamasHealthEducation Division.-----._.------------------------------------------------------------.---------------EVALUAll0NHelpustomakethenewsletterasinterestingand informative as possible. Please complete, detachandreturnthisshortevaluationformtotheHealth Educ:ationDivision. PublicHealthDepartment, Nassau, Bahamas.Tickthemost appropriate response.1.How did you findthenewsletter? a) veryinterestingb)interestingc)somewhat interesting d) uninteresting e)did DOt read2.Wasthereanyarticle ofparticularinteresttoyou? Yes0No0Ifyes, please givetitle. 3.Whatchanges,ifany,would youliketosee?...........................................................................................................................................................................................-4.Whattopics would youlikeinfuture issues? .5.Would you like to contribute tothisnewsletter?YesoNooIfyes, please givenameandaddress. Name:__. Address: __ _.Thankyoufor your co-operation!35

PAGE 38

36 ill P.O.BOX N-3729NASSAU,BAHAMAS.

PAGE 39

HEALTH CARE PROVIDERS THE WORD FOR86?SELF-CARETHE WAYTOBETToERHEALTHNASSAU,BAHAMASCover Designby:-THEOPHILUS THOMPSON LESLIE JOHNSON ASHWARD FERGUSONPRINTED IN THE BAHAMAS BYTHE NASSAU GUARDIAN (1844) LTOo