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© Brendan Bannon
30 May 17 14 Nov 17

The MSF Sapling Nursery: Josie's perspective

Josie Gilday is an experienced MSF nurse. In January 2017, she was part of a Sapling Nursery-funded design team aiming to create a sustainable solution to keeping IV bags secure and stable in Land Cruisers during patient transfers.

Here, she offers her perspective on the Sapling Nursery.

The importance of the Sapling Nursery

"With Sapling Nursery funding, we now have the possibility to do something about our problems, instead of just complaining!

We now have a channel for all the amazing ideas people have in the field to become realities, allowing time to be saved and then spent elsewhere.

It’s such a great initiative; ideas generated from the field, developed by those from the field and then implemented to improve the work done in the field! Without field staff knowing about it, the initiative doesn't work, so please help spread the word.

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My next idea for Sapling Nursery funding

There are several issues in the field I would like to address, but after reading about the increasing resistance to antibiotics I decided I would change the drug bags MSF uses to give patients their medication.

It's a plastic bag that seals at the top and has four pictures on it; the sun rising, the sun high in the sky, the sun setting and a moon. Under each picture is an empty box in which you can either draw the number of pills that need to be taken, or tally them.

"All of this effort, made by both staff and patients, would be wasted if our patients aren't taking their medication properly. I think we can do better than this."
josie gildaymsf nurse

Initially I thought this was great, but on my assignment in the Ivory Coast I realised it wasn't as good as I thought. When assisting in the pharmacy, I watched the pharmacists give up to five or six of these bags of medication to patients, often mothers who had come to seek treatment for themselves, their toddler and their baby.

Lying awake that night I worried that a mother might mix up the medications, which could lead to adverse effects and none of the patients receiving the correct treatment.

My solution

So I got up and drew the picture of a baby, a little girl and a little boy and an adult on the medical card bags, which are slightly bigger. This way the medication for each person could be grouped together and it would hopefully be a little clearer which medication belonged to whom. 

I then made a huge poster out of cardboard boxes with the different times of day and the different family members, and at our next mobile clinic I hung them on the wall of the pharmacy.

While patients waited for medication, one of the national staff talked them through the different pictures and why it was important to complete the full course of medication given, even if they felt better before it was finished. This, like the glove as an IV fluid holder, was a quick fix but saved a huge amount of time. Which meant I slept better!

We can do better

Patients make the trip to our clinics, wait patiently to be seen and wait again for their medication. Our staff get up at 6am, load the cars, travel hours to the clinic. They spend the whole day seeing patients, pack up and travel back to base.

All of this effort, made by both staff and patients, would be waisted if our patients aren't taking their medication properly. I think we can do better than this."

The Sapling Nursery is a fund for finding new, innovative approaches to field problems. Read more details about the fund and how to apply by following the link below.

The msf oca sapling nursery funD >