As the appearance of permanency develops in the camps, the organization and sophistication of the medical effort continues to improve. Currently, several of the best NGO teams are beginning to institute very effective community health and surveillance programs that greatly reduce morbidity and mortality. This has been achieved by first marking each individual hut in the area with a number and recording this address on a master map. Each family member was then issued a health care card which verified the address and a name and allowed space for medical entries concerning diagnosis and treatment. A central field hospital and outpatient complex housed in tents developed over a 6-month period, and now serves about 60,000 refugees with a staff of less than 30 team members.
Patients report to the outpatient clinic and are triaged as they wait to be cared for.
Each presents his card, or a new one is issued if the patient has not yet entered the system. After being seen by the medical provider, the patient's diagnosis and treatment are entered on the health card. Follow-up visits are scheduled and, if they are not kept, a locally recruited and trained health worker is sent out into camp to check on the patient at his address. Excellent follow-up and continuity of care has been achieved in this way. Much effort has been expended to recruit Rwandan physicians, nurses and other workers to provide a sense of community involvement.