Hanry Alansyari

10/304703/KU/14122

1






Home Visit
Block 1.6 Basic Medical Practice

Hanry Alansyari
10/304703/KU/14122
Group 11
International Programme
Faculty Of Medicine
Universitas Gadjah Mada












Hanry Alansyari
10/304703/KU/14122

2


General Description



My group and I visited a Family Physician on the 27
th
June 2011 to get a patient for our home visit
session. I approached Mrs. Y with two of my colleagues while she was sitting patiently at the waiting
room with one of her son. We greeted her, introduced ourselves and briefly explained to her the
assignment that we need to accomplish. She mixed some Javanese word while talking to us, so its a
bit hard to understand but overall we could make out what she said.

Mrs Y. is a single mother having been left twice by her husbands death. On top of this she also had
twelve children, (4 were hers and the other eight was adopted) although most of them are married
and have jobs and only one was still in high school. Even though she is 57 years old, she still works at
her home as a massager to support her family.

She lives in a small house that her last husband inherited from his family. Her house is located in the
middle of the city and five minute drive to the Puskesmas. The house has several rooms which were
for her childrens and one for her, there is also s small kitchen and a bathroom. The house is
surrounded by many other homes, we had to pass a lot of narrow street to get there. The pathway
that leads to her house is small that we had to park our transportation on another place and then
walked there.

As Mrs. Y house is located in the middle of the city, access to a health care wasnt that hard. There
are health care near her house that is walking distance away. She prefers to go to a family physician
because she knew the doctor even though shes not a patient with health insurance from the
government.

Another thing to add is that Mrs. Y also has a disabled right leg. This happened because she had car
accident three years ago while going back from a traditional therapy session near Parangtritis. She
was the only one who managed to survive out of eight people even though she had a near death
experience. So wherever she wants to go she needs her walking aids.



Specific Observation



Mrs. Y visited the family physican due to itching (pruritus) on some parts of her body and shortness of
breath (dyspnea) . She also added that this was mainly because of what happened three months ago
when her husband left her. All the family got the itchy after her husband incident which was that he
had symptom brain tumour and eventually died because it grew larger. She showed us some x-ray
picture of her husband and the chronology og the tumour. The itching maybe contagious and was
obtained from the hospital while visiting her husband and it got transmitted to the whole family. She
explained her shortness of breath was due to her crying and stress because at times she
remembered her husbands death.

Although she has a limited education, having finished school up to elementary school, she has some
but not extensive education on health. She may gained some health education from her experience
on her patient as a massager. Apart from this, there are no other sources of education of health she
couldve gotten. Mrs Y doesnt have health insurance from the governemen so she is responsible for
the cost involved for her care, and the government or primary health centre doesnt educate her in
health apects.

We had the time to observe the house and the first thing I noticed is the lighting of the house. There
are no windows in her house, so when we visited in the evening the house was dark, only the room
lights were lit. The second thing is the ventilation of the house, because there were no windows it
seems that the main door that acts as an entrance to the house was always open as well as the rear
door. This maybe done so that the air in the house circulates. The roof of the house wasnt intact,
Hanry Alansyari
10/304703/KU/14122

3

there were small holes on the roof, therefore debris and rain water could go inside the house. The
house is also not cleaned regulary, the household furniture were all dusty only the concrete floor
seems clean.


Mrs. Y have her childrens to cook for the family. Her staple food is rice, in addition to this she eats
vegetables, eggs, spices and etc. She eats very little meat, this maybe be due to the low income of
her household. The source of water she gets is from her neighbour, as the water pumper inside her
house is broken. They get the water from the neigbour when they are in the house, if they arent they
have to manage with the liitle amount of water they store in buckets, bowl and any other kitchen and
bathroom utensils that they can use to store the water. For drinking the water is cooked/boiled, it is
also used for washing, cleaning, take a bath for five people in the house, so water is very scarce in
this family.

Some of the description above are risk factors that involve in her diease. An example is her stress
and the amount of water available to drink is limited, therefore the dry skin adds the itchiness to her
skin which may have been infected from the hospital. She said that the cause of her shortness of
breath was her excessive crying, but it maybe because of the unsanitised house. The dust may have
partly obstruced her breathing passage. Other than this maybe due to the lack of exercise and moving
about as she has a disabled leg, therefore the flow of air coming in and out of her lungs may not be as
normal.

Although Mrs. Y is only currently facing two disease the household may offer other change of health
risk. At her age she could potentially suffer other disease in the future such as diabetes mellitus,
hypertension or arthritis. Her house dustiness could lead to other resipiratory complication even
though she doesnt smoke.



Discussion



There is a lot of improvement that could be made to imporve the quality of life and reduce the risk
factors inside Mrs.Y house. One of the ways is to improve the quality of food and applying a better
and more nutritious diet. They also have to import clean water and the amount of water available for
use for the whole family. The house conditon itself need to be repaired, such as repairing the roof and
improve the lighting (as this have an impact on the circadian rhythm) . Even though these small
changes can decrease the health risk assosciated with their lives.

After having done the home visit session, I gained some knowledge on the kind of neighbourhood that
is in the city and the risk factors that they are prone to. Some families are educated and know how to
prevent the health risk but some are not and dont know what cause their diseease in thefirst place. I




References

- Block 1.3 Health Interview (Survey)

- Block 1.6 Laboratory Manual

- Lecture - Briefing on Field Visit by Dr. Adi Utarini

- Lecture - Behaviour and its prevention by Yayi Suryo Prabandari