21-15
This is how the blackboard looked after the health workers had finished figuring
out the most likely cause of the woman’s swollen feet:
Luckily for the woman, the swelling was probably due to the pressure of the baby
in her womb causing poor blood circulation in her legs. This is a common but minor
problem during the last months of pregnancy. (The other possible causes are all
serious health problems.)
The group reassured the woman that her problem did not seem to be dangerous.
They suggested that she rest with her feet up as often as possible. They advised
her to keep eating nutritious food, but with relatively little salt. And they also
suggested that she drink a tea made from maize silk (see Where There Is No
Doctor, page 12). Then they explained the signs of pre-eclampsia, warned her
to watch for them, and asked her to come back immediately if any danger signs
appeared.
The role play might have ended there. But the health workers who had actually
seen the pregnant woman reminded their fellow students to think more about
prevention and about other minor problems common in the last months of
pregnancy. With this in mind, the students checked their books and decided they
should give the woman a second tetanus vaccination. (According to her chart,
she had been given the first at 6 months.) And some students offered her advice
about other minor problems she might expect in the coming weeks: constipation,
heartburn, varicose veins, shortness of breath, and frequent urination. Last of all,
they recorded the information on the line opposite the 7th month on the RECORD
OF PRENATAL CARE.
Note: When students do role plays or actual consultations, try having
them use the CHECKLIST FOR EVALUATING A CONSULTATION (page
8-10 of this book) to see how well they have done.