Kenya: Lodwar District Hospital Support
Livelihood Project Provides for Food-Insecure Families: Q4 2016
April 03, 2017
Summary of Activities
Patients continue to access quality health care in a clean, friendly environment conductive to healing. Real Medicine Foundation’s approach of being needs-oriented and working with flexibility has brought change to Lodwar County & Referral Hospital (formerly Lodwar District Hospital) as a whole. The hospital continues to remain clean and hygienic; nosocomial infections are kept as low as possible.
The entire hospital staff and local community have benefited from the project. The hospital staff, i.e. the medical officers, nurses, and support staff, have profited by working in better conditions, in terms of infrastructure and medical supplies. The pediatric patients continue to benefit from our program by receiving free emergency medical treatment when admitted.
Availability of supplies has also consistently motivated the hospital staff in serving the Turkana people/patients, making it much easier for them to do their work effectively. The community has benefited tremendously in the sense that drugs and non-pharmaceuticals are available. The locals no longer have to buy (or do without) costly drugs, syringes, gauze rolls, cotton wool, and emergency drugs, as these are supplied by RMF for the inpatient units at the hospital.
Not only have the Pediatric ward and Male and Female wards benefited from the project, but the Operating Theatre has also been improved by RMF’s support. Patients with fractures coming to the hospital from Lodwar and neighboring communities can now be attended to by the surgeon without further referral, since all the equipment has been supplied by RMF.
Consistent availability of medical supplies in the Pediatric ward has also enabled patients to be treated and discharged at no cost. The hospital staff continues to be very motivated thanks to the continued support they get from RMF/MMI.
Availability of food from greenhouse farming will not only eradicate malnutrition among HIV clients at Lodwar County & Referral Hospital (formerly Lodwar District Hospital), but will also help improve clients’ drugs adherence, health status, CD4 count, viral load, and overall wellbeing.
Aiding Vulnerable Families
RMF has initiated a greenhouse farming project for food-insecure and vulnerable families and HIV-positive community members and their families. The project will target 150 households, primarily those of HIV-positive women and mothers of childbearing age.
This project aims to improve the nutritional status of HIV-affected families by providing farming supplies, training, crop storage facilities, and assistance with the marketing and transportation of crops. In offering this support, it is RMF’s goal to provide vulnerable women and families with long-term food security and skills, improving their nutritional status and overall health and lowering mothers’ chances of passing the disease on to their children.
Five Departments Served
During this quarter, RMF continued its strong support of Lodwar County & Referral Hospital (LCRH) by supplying the hospital’s departments with needed medical equipment. Departments that received new equipment include the Maternity ward, Pediatric ward, Operating Theatre, Occupational Therapy ward, and Physiotherapy department.
- The Maternity ward received ambu bags and glucometer strips. Glucometer strips, in particular, were needed to confirm mothers’ glucose levels before conducting emergency cesarean sections.
- The Pediatric ward received ambu bags and face masks.
- The Operating Theatre received minor cesarean sets.
- The Occupational Therapy ward received cervical collars, a hammer massager, an Energy King massager, and a powerful massager.
- And lastly, the Physiotherapy department received orthopedic casting tape: 3”, 4”, and 5”. They also received elastic shoulder supports.
Supporting the Entire Hospital
As always, to support the entire hospital, RMF continues to purchase non-pharmaceutical supplies. Non-pharmaceuticals purchased include glucometer strips, gauze rolls, strapping adhesives, granular gauges, gloves, surgical spirit, examination gloves, crepe bandages, and paraffin gauze, among other essential non-pharmaceuticals. These non-pharmaceuticals are not only important in the day-to-day running of the hospital, but also in the case of emergencies with urgent needs, such as traffic accidents, and when the hospital is in a crisis because of many patients needing care at the same time, when large amounts of non-pharmaceuticals are required.
Keeping Mortality Numbers Low
Continuing its emphasis on pediatric support, RMF purchased comprehensive medical supplies for the Pediatric ward. Emergency drugs that are never supplied by KEMSA have continued to be supplied by RMF/MMI for the pediatric patients. Before these drugs were provided by RMF/MMI, patients were asked to purchase them from local clinics, and many patients could not afford to do so. The constant supply of these essential drugs and many others have gone a long way in benefitting the pediatric patients and ensuring that the Pediatric ward continues to register low mortality numbers.
Meeting Patients’ Needs
Medical Services Provided
- Curative: treatment of illness, diagnosis (lab investigations, x-rays), management and follow-up review with a medical doctor and/or clinical officer
- Preventive: promotion of good health education, such as safe water, safe motherhood, HIV prevention, and school health programs
- Rehabilitative: occupational therapy and physiotherapy
- Eye clinic
- Dental services
Lodwar District Hospital (DH) is the only functional government regional referral hospital for all of Turkana region, spanning a population of almost 1,000,000. This is where the vast majority of the Turkana and other populations of Northwestern Kenya as well as people from across the borders to Uganda and South Sudan seek help when they need more advanced care requiring medical equipment and specialized skills that cannot be provided at dispensaries, health centers, or private health clinics. Lodwar DH has been struggling for years with wards in need of major repair, and supplies and drugs that come in with great irregularity from the government health supplies department in Nairobi.
- Rehabilitate the infrastructure at Lodwar District Hospital, beginning with the pediatric ward and proceeding to male and female wards.
- Rehabilitate equipment set at Lodwar District Hospital, beginning with the pediatric ward and proceeding to male and female wards, outpatient department, operating theatre and physiotherapy department.
- Provide regularity to supplies of basic medical devices, disposables, and pharmaceuticals, complementing the items from Kenya Medical Supplies (KEMSA).
- Provide equipment maintenance and spare parts management.
- Organize on-site clinical training, beginning with general equipment use and care, and pediatric emergency care.
- Provide outreach campaigns.
- 31,418 outpatients (8,686 being pediatric outpatients) were treated at Lodwar County & Referral Hospital (formerly Lodwar District Hospital) in the fourth quarter of 2016.
- 1,294 inpatients (795 pediatric inpatients) were treated in Q4 2016.
- 423 occupational therapy patients were treated at Lodwar County & Referral Hospital (formerly Lodwar District Hospital) in the fourth quarter of 2016.
Age: 14 months old
Precious was admitted with complaints of diarrhea, severe wasting, loss of appetite, headache, and fever. She had a temperature of 38.6 degrees. This was the third time Precious was admitted with these symptoms. She was born at home and taken to the hospital for immunizations. According to the hospital records, Precious got all the immunizations as recommended by the MOH. Her parents were tested for HIV and turned out HIV-negative. Precious is the youngest child in a family of five children. She has a history of malnutrition at 6 months and malaria.
Diagnosis: Malnutrition with Acute G.E.
- Folic acid 5 g od
- Multivitamin 5 ml 5/7
- Zinc tablets
Management of Malnutrition:
Therapeutic milk F-75 130 ml/kg for 3 days without any food. After stabilization, give F-100 until the baby is stable, i.e. able to feed on her own.
Age: 2 years and 5 months
Benard was admitted through the Outpatient department (OPD) with complaints of fever, diarrhea, joint pain, abdominal pain, and wasting. He is a CCC client. This was the second time he was admitted with these symptoms. The first time, Benard was admitted with moderate acute malnutrition (MAM) and enrolled in the outpatient program (OTP), but he defaulted due to an unwilling caregiver. This was a follow-up visit. Benard is currently on ARVs. He was born in the hospital weighing 2.3 kg (underweight), and according to the hospital records, he got all of the immunizations recommended by the MOH. Benard is the firstborn and only child in his family; his mother died during delivery and currently his grandmother is taking care of him.
Diagnosis: Malaria/ISS with Severe Acute Malnutrition (SAM)
- Blood slide (for malaria), positive
- Malnutrition, Severe Acute Malnutrition (SAM)
- Artesunate 3 mg/kg
Management of Malnutrition:
Therapeutic milks: F-100 and F-75 and Plumpy’Nut RUTF (ready-to-use therapeutic food). Benard also received a high dose of Vitamin A on admission (50,000 IU to 200,000 IU depending on age) and was given zinc for management of diarrhea. He should be started on ARV drug treatment as soon as possible after stabilization of metabolic complications.