Kenya: Lwala Healthcare Project
Lwala Community Hospital Report Second Quarter, 2014
September 17, 2014
Katherine Falk and Jonathan White
Summary of Activities
- Funded maternal and child health costs including:
- Personnel costs for Nurses Rose Gayo and Geoffrey Orangi and Nurse Aid Rosemary Akello
- 58% of medicine costs
- Funded ambulance repairs and maintenance
- Funded fuel for ambulance to provide emergency transportation
Improved patient care and clinical operations
Mentorship and training
The Lwala Community Hospital provided an average of 2,709 monthly patient visits in Q2, down from an average 3,379 in Q1 with the Q1 spike in patient visits was likely due to the malaria outbreak. Staff confidence with long-term family planning procedures continues to increase through the clinical mentorship program
Improved access and facility infrastructure
Supplies procured and plans finalized
Final revisions were made for the hospital expansion designs for Phase II (connecting wing) and Phase III (inpatient ward). The tendering and bidding process is expected to begin in July and construction to start in September.
Expand and improve quality
- The ratio of girls to boys sitting for the KCPE (Kenya Certificate of Primary Education) exam in class 8 has increased every year since LCA’s girls’ education program began. The girl:boy ratio in primary school completion has improved from 37:63 in 2009 to 45:55 in 2014.
- 50 in-school Youth Peer Providers (YPPs) continue to facilitate monthly school clubs.
- A First Aid training was conducted for 6 teachers.
- 26 new students applied for secondary school sponsorship through LCA’s partnership with Kenya Education Fund (KEF).
Income generating activities
Build capacity of community members
- Through the Development in Gardening agricultural training program, five school gardens have now been established in collaboration with school faculty and students.
- Trainings were conducted in Q2 on farm profitability and business cycles, nutrition and gardening, and table banking.
- Three “widows groups” were created as a forum for widows to lend resources to one another through table banking.
Increase impact of health outreach programs
Community Based Outreach
- Community Health Workers (CHWs) are reaching out to all households with pregnant women and children under 5 under the “Thrive thru 5” program. A total of 1,857 households had been enrolled in the program by the end of Q2.
- 13 out of school Youth Peer Providers (YPPs) and 73 CHWs are actively generating demand for family planning services and distributing condoms in the community.
- A WASH (Water, Sanitation, and Hygiene) promotion event was held with more than 400 community members in attendance. The participants were divided into small groups for meaningful discussion and education on WASH practices.
Lwala is a village of approximately 1,500 people near Lake Victoria in western Kenya. Within an hour’s walk, approximately 3,000 additional people live in nearby villages accessible by dirt roads. Poor physical infrastructure, including impassable roads during the rainy season, lack of electricity and lack of reliable drinking water, have helped to create a critical healthcare challenge in Lwala. The mission of the Lwala Community Hospital is to meet the holistic health needs of all members of the Lwala community.
- Improve patient care and clinical operations
- Improve access and facility infrastructure
- Expand and improve quality of education programs
- Professionalize the organization through better policies and practices
- Properly procure and account for physical, financial, and human resources
- Increase impact of health outreach programs
- Build capacity of community members in income generating activities
- Improve programs through better communication and monitoring and evaluation
Click to enlarge
The Lwala Community Hospital provided an average of 2,709 monthly patient visits or 8,127 for the quarter. An average of 46 babies were born each month at a health facility, a slight decrease from an average of 49/month in Q1. In Q2, there was a record high of 61 clients receiving IUDs compared to 9 the previous quarter.
Real Medicine Foundation and World Children’s Fund visit Lwala
In late May, Real Medicine Foundation Founder and CEO Dr. Martina Fuchs, World Children’s Fund International Program Director Doug Kendrick, and photographer Angela Hess Gedde visited Lwala to see the progress, growth, and impact of Lwala Community Alliance’s programs firsthand.
During her 3 days on the ground, Dr. Fuchs participated in a variety of activities. She spent time in the Lwala Community Hospital, the pharmacy, and the lab and met with staff leadership to more fully understand the range of programs that are being implemented on the ground. She also visited one of Lwala Community Alliance’s partner schools, Kuna Primary School, where she participated in the distribution of pad kits to school girls in classes 6-8 and toured the school garden that is being managed and maintained by the students and teachers. Doug Kendricks arrived on the third day of Dr. Fuchs’ stay.
He was warmly welcomed by a group of Lwala community members who greeted him with singing and dancing and a sign that said “Karibuni (‘Welcome’), World Children’s Fund and Real Medicine Foundation.” He, Angela, and Dr. Fuchs spent the day touring the site, learning more about Thrive thru 5 (a program that aims to reduce under-5 mortality by half by the end the of 2016), meeting with staff, and attending a monthly review meeting for the Community Health team, including staff and 80 Community Health Workers. In reflecting on her time in Lwala, Dr. Fuchs explained that she was impressed by the growth in and quality of programs and how they are making an impact on the ground; she stated, “if what Lwala Community Alliance is doing could be done everywhere, it would be a different world.” We are grateful for the time that she and our friends from World Children’s Fund took to travel to Lwala and hope that they will be able to return again soon!
18 year-old Cellestine Adhiambo smiles as she talks about what she like to do for a job someday. “I would like to be a nurse,” she says, “and work at the hospital in Lwala.” Cellestine’s dreams for her future point to her resiliency and hard work, as she recently re-entered school after having dropped out for 6 months. When she was in Class 8 at Lwala Primary School, Cellestine became pregnant and stopped attending school once she gave birth to her baby girl, Francis Marion.
Cellestine is the 4th born out of five brothers and one sister. Her parents are subsistence farmers who grow maize and sugar cane. After giving birth, Cellestine dropped out of school since she felt she couldn’t balance her studies with taking care of her newborn child. Then, through her visits to the Lwala Community Hospital for her delivery and well-child visits, Cellestine heard from staff and other teen mothers about a group of out-of-school girls who were meeting together in a mentoring group called Salama Pamoja. Curious about the group, Cellestine attended her first mentoring session in May 2013 and remains in the group to this day.
She says, “In Salama Pamoja, I learned how to protect myself and I learned about reproduction. [The mentors] also told us if we continue with the spirit of going back to school, they can help us. They are always teaching us about how we can be courageous; if we get some challenges in our life, we can know how to solve them. As girls, you can know many things as you go to school.” When she first joined Salama Pamoja, Cellestine was trained in Lwala Community Alliance’s agricultural program and learned farming techniques so that she can learn to grow vegetables to sell in the local market. The female mentors have also created a safe space for Cellestine to can talk openly if she is experiencing difficulties and challenges. These same mentors also reached out to Cellestine’s parents and encouraged them to send her back to school.
As a result of what she was learning in Salama Pamoja as well as support for her parents, Cellestine re-enrolled in school in August 2013. She is now in Form 1 at Tuk Jowi Secondary School. Her favorite subjects are biology, English, mathematics, business, and agriculture. She hopes to be a role model for her younger sister and that someday Francis Marion will attend secondary school as well.
Cellestine is demonstrating that Salama Pamoja is effectively empowering girls to continue with their education, gain knowledge about sexual and reproductive health, and make wise choices that will protect them from the risk of violence and infection. She is also actively recruiting other girls to join the mentoring group. Cellestine remarks, “Nothing comes without working. I am always telling girls who have dropped out about the club in Lwala that is called Salama Pamoja. I tell them they can come with me. Some of them have come with me and two of these girls have now gone back to school.”