Assessment of Community Served by the Health CentreA community assessment is conducted to understand problems facing community members, identify community strengths, weaknesses and resources that are available and accessible within and outside of the community.The Community of Palm Grove Court is a new subdivision in the established community of Oak Glades. Majority of the residents have been living there for five (5) years or more. Over the years, there have been changes as the Oak Glades health center has recently been opened to the public to accommodate residents. Before, the residents had to travel to Hagley Park health center or Maxfield Park to receive health care. There has also been an increase in crime and violence. The community consists of both old and young persons, Single Parent families and Common Law unions. The population of the community is homogenous with persons of African descent. Christianity is the dominant religion as churches are situated in the community.The community of Oak Glades is of a clean appearance and the roadways are free of garbage. The air quality is clean and the houses are relatively spaced from each other. A number of small cook shops are located in the community and it is supplied with safe water from the National Water Commission (NWC). Some of the residents reported being diagnosed with one or more of the non-communicable diseases (Diabetes, Hypertension, Heart Disease etc.) From observations during the clinical experience it was noticed that some residents contracted one or more of the Sexually Transmitted Infection (STIs) and were treated. Additionally several of the children suffer from the respiratory illness asthma. The community is served by the newly opened Oak Glades health center. The residents utilize the Kingston Public Hospital, nursing homes, social service facilities, Three miles police station, Denham Town fire station and the Bellevue Hospital which is outside the community however, it is accessible. There are no industries or facilities for employment in the community therefore majority of the population is unemployed. However, there are several grocery corner shops and small cook shops where residents earn a living. Additionally, some residents reported juggling in downtown Kingston to earn an income.Transportation is safe as persons get around via public transportation such as JUTC, taxis and mini buses as well as private transportation. Sidewalks are visible and are utilized by pedestrians and persons with disabilities in wheelchair. For persons who dont own a wheelchair residents reported assisting them. The political party with which the Oak Glades community is affiliated is The Peoples National Party (PNP). There is an elected mayor and residents are involved in decision making at the local government unit. In addition there is a PNP office situated opposite the Oak Glades health center where residents frequently visit to voice their concerns. A community center is in close proximity to the PNP office where people gather for meetings etc. Residents are informed of current issues via the print (Gleaner, Observer) and electronic media (Television, Radio). There are two early childhood schools in the community which function under the Ministry of Education. There are Physical Education sessions where the children play and interact. There are no school nurses as the health center is in close proximity to these schools. Primary, secondary and tertiary institutions are available and assessable outside the community. Children and youths residing in the community play in the yards of their homes, or at the community center. Football is played at the Browns Land Community football field. Residents reported that they believe that their community is a good place to reside and has a clean environment. The strength of this community is the unity of the citizens. They reported that on public holidays such as Emancipation or Heroes Day they have regular cook outs in the community where the interact and share with eachother. Additionally residents are currently working on a community development project to construct a football field and basketball court in the community. The weakness of the community is the level or crime and violence.As human beings we are able to adapt to our environments and if adaptation is not possible, measures are often taken to improve the environment to make it suitable. Residents of the Oak Glades community are faced with frequent water lock-offs and mosquito infestation. These two factors will have a direct impact on the health of the residents, thus being knowledgeable of such, precautionary measures should be implemented and the correct nursing intervention made to ensure their health and well-being is maintained. Community Strategies Employed by CitizensUpon visiting the Oak Glades Community and interacting with residents of the community, many of them highlighted two major problems that were directly affecting them. These two problems include that of frequent water lock-offs that persist for months and secondly the problem of mosquito infestation. Many of the residents expressed their discomfort with the problems mentioned and have decided to implement strategies to address these issues that are pertinent to their welfare. Some of the strategies that these residents of Oak Glades have implemented will be discussed in details:Frequent water lock-offs Upon interviewing community members, the major measures were highlighted. Some of which include both direct and indirect ways of addressing the problem. These measures include: 1. Collecting and storing water in buckets and bottles- Residents explained that they would have to acquire water from neighbouring communities and store it via such mediums to ensure that the basic domestic needs of their households were met. 2. Decreasing the amount of water used to perform duties- Upon talking to some residents they explained that they have to implement measures of decreasing the amount of water used to perform domestic duties and even if the amount of water was not decreased; after using the water to complete tasks, it would also be used to complete other tasks. E.g. After washing the dishes, water used to rinse them would be used to flush toilets or water plants.3. Holding community meeting with members of parliament-According to residents, they have also taken the initiative to inform their political representatives of the problem, this is done through community meetings in which residents ensure their concerns about the matter are heard and ways for handling the problem instigated. E.g. providing a water truck to supply the community twice per week with water. Mosquito InfestationFrom interviewing members of the community a common concern was the infestation of mosquitoes. Many of the residents expressed annoyance at the problem while others were tolerant. However, residents have implemented strategies to decrease the extent to which they are affected by this problem. Some of these strategies are discussed below.1. Proper storage of water- Water storage containers may be a habitat for mosquitoes. Some residents also highlighted the importance of storing water in lock-tight containers. 2. Installing meshes- Some residents have meshed their doors and windows. These meshes are made by individuals within the community as a means of control for the vectors and at the same time providing needed ventilation. 3. Using Insect sprays/ repellants- Residents reported using insect sprays and (destroyers) to control mosquito infestation.4. Wearing protective clothing- By wearing protective clothing e.g. long shirts and pants, residents seek to control the impact that the mosquitoes have on them personally as such clothing provides a means of protection against mosquito bites.Specific Community Health Issues/ProblemsIn assessing the community two health problems were identified. These are Mosquito Infestation and Frequent Water lock-offs.Problem: Frequent water lock-offs and mosquito infestation. Diagnosis: Risk of exposure to infectious agents and diseases.Risk to Community: Due to the mosquito infestation and frequent water lock-offs in the community all residents are exposed to contracting vector (mosquito) borne diseases, water borne diseases and infectious diseases faecal orally.Persons affected: All persons working, living in and around the community as well as those assessing the surroundings.Community Factors: Improper drainage system. Malfunctioning water pump and pipes. Community leader is ineffective in solving problems. Lack of information and communication among community members.Mosquito InfestationDengue Fever- Dengue fever are viral diseases transmitted by the Aedes Aegypti mosquito. Dengue viruses spread to humans by the bite of female mosquitoes. These mosquitoes acquire the virus while feeding on the blood of an infected person. The virus circulates in the blood of infected humans for 2 7 days leading to fever. Dengue presents with fever, rash, severe headache, pain behind the eyes, pain in the joints and muscles.Malaria- According to the World Health Organization (2013), malaria is caused by a parasite called plasmodium. These parasites are spread to people through the bites of infected Anopheles mosquitoes. It can also be transmitted from an infected mother to her unborn baby during or before delivery. The virus can also be transmitted via blood transfusion. General symptoms include fever, chills, headache, muscle pains, and, in some cases, skin disorders such as cold sores, hives, or a rash.Frequent water lock-offsOn assessing the community it was observed that quite a number of individuals came to the health center with complaints of diarrhea and vomiting which are common symptoms of gastrointestinal infections.Diarrhoea, Vomiting and Dehydration- Diarrhoea is defined as the passage of three or more loose or liquid stools per day. Diarrhea and vomiting are caused by viruses such as the rotaviruses and bacteria such as salmonella or shigella. Infection is spread through contaminated food or drinking-water, or from person-to-person as a result of poor hygiene. Vomiting is the ejection of matter from the stomach through the mouth. Vomiting often accompanies diarrhoea which often results in dehydration. Dehydration occurs when water and electrolytes (sodium, chloride, potassium and bicarbonate) are lost through liquid stools and vomit. Mosquito Infestation and Frequent Water lock-offsHand Foot and Mouth Disease - Hand, foot, and mouth disease, is a contagious illness caused by different viruses. Infants and children younger than 5 years are more likely to get this disease. However, older children and adults can also contract the disease. Jamaica has had outbreaks of this disease in 2012 with over 22 cases in KSA. Symptoms usually begin with a fever, reduced appetite, sore throat. Painful sores, rash and blisters can develop in the mouth. A skin rash with flat red spots may also develop on the palms of the hands and soles of the feet. This can sometimes occur on the knees, elbows, and buttocks as well.