Lodwar Clinic, Turkana, Q3 2013 Report

October 31, 2013

Derrick Lowoto and Jonathan White

Summary of RMF/MMI-sponsored activities carried out during the reporting period under each project objective (note any changes from original plans):

  • A total of 4,662 patients were treated both in the Lodwar Clinic and through outreach mobile clinics.
  • Twenty-eight (28) outreach clinics were conducted in the rural villages this third quarter.
  • Fourteen (14) home visits in the rural villages and villages within Lodwar.
  • Twenty-three (23) referrals were made, mostly collecting patients from rural villages for transport to health facilities in Lodwar and other tertiary health facilities in the country.
  • Continued public health education done at the beginning of every clinic session.
  • The program purchased medicine three times from pharmaceutical company in Nairobi, Kenya.
  • The program also paid staff salaries.
  • Maintenance was done on the mobile clinic vehicle.
  • The program met the costs of medical fees for some patients whom we referred for treatment in other tertiary health facilities. 
  • This quarter three staff members attended patient-related courses on HIV/AIDS and disease surveillance on communicable diseases.

Results and/or accomplishments achieved during this reporting period:

  • A total of 4,662 patients in the health clinic and outreach mobile clinics were treated.
  • 28 outreach clinics were conducted in rural villages where health services are difficult to access.
  • 14 home visits, mostly to villages in Lodwar Town, were conducted, treating elderly patients and those with chronic illnesses.
  • 23 referrals were made, predominately from rural villages to health facilities in Lodwar and other tertiary health facilities in the country.
  • Public health education was conducted at the beginning of every clinic day for patients who arrive early and individual teaching on specific cases in the course of treatment.
  • Medicines were purchased three times from a major pharmaceutical company in Nairobi, Kenya.
  • For maintenance of the clinic’s vehicle, one major service and a few minor mechanical repairs were made.
  • Salaries were paid for the clinic’s hired staff.
  • Three staff members were equipped with new knowledge on patient management after attending three different short trainings on HIV/AIDS and disease surveillance on communicable diseases.
  • 2,004 tests were carried out in the laboratory with 1,112 tests testing positive for various communicable and non-communicable diseases

Impact this project has on the community (who is benefiting and how)

Having adequate medical personnel and medicine stores has enabled us to treat more patients and combat a wider range of diseases on a regular basis, especially in the remote villages of Turkana. Our target population of this project continues to be at 79,800.
The villages we serve do not have access to other regular medical care.  We are able to provide predictable clinic coverage monthly as well as follow up if patients can travel to the Lodwar Clinic.  The nomadic nature of the Turkana tribe causes the population of these villages to migrate about every 4 months and to be a new group of villagers about every 4 months; therefore we are providing service to more than the estimated population of persons living in each village at one time.  The improved quality and regularity of medication purchase from MEDS in Nairobi through RMF/MMI funding has allowed the clinics to be conducted and improved the quality of the service.  Previous to RMF/MMI involvement, medication was scarce and depended on availability of specific donations each month.
The clinic staff serves all villagers who come for treatment, but we see an especially high number of children and pregnant women.  Prior to the funding provided through RMF/MMI, there were an average of one to two mobile clinics per month, based on variable funding availability through private donors; now there is an average of 8 mobile clinics each month.  Previously, there was often not enough medicine in stock to treat all patients; now the proper medication is always available.

Number served/number of direct project beneficiaries (for example, average number treated per day or month and if possible, per health condition).

  • A total of 4,662 patients and 5,542 cases were treated during the 3rd Quarter.

If applicable, please list the medical services provided:

  • Outpatient diagnosis and treatment
  • Medication available with pharmacy counseling
  • Minor surgery
  • Wound care
  • Referral to tertiary care centers
  • Public health education lectures with each clinic session
  • Nutrition supplementation to the elderly, malnourished children and terminally ill during mobile clinics and home
  •   visitations
  • Care of special patients: arranging transport and accompaniment by staff if needed to referral centers for special
  •   consultations, procedures, etc.

Please list the five most common health problems observed within your region.

  • Malaria
  • Respiratory tract infections
  • Eye infections
  • Skin diseases
  • Gastroenteritis and gastrointestinal infections

Notable project challenges and obstacles:

  • The present maternal and child health clinic does not have adequate space to cater to the population requiring its services. Two additional rooms in the clinic are required to build upon the small and congested building, which currently lacks a friendly environment for women presenting for prenatal care and for children visiting the clinic for immunizations.
  • Maternal-child health services are currently not sufficient to provide for all the patients in rural villages needing these services, where, i.e. children are not immunized against childhood immunizable diseases. The major problem is a shortage of staff that can offer these services to mothers and children. Three additional staff members are required to run these programs to ensure adequate provision of maternal-child healthcare to the population we are serving.

If applicable, plans for next reporting:

  • Continue providing medical outpatient services at Lodwar Clinic from Monday to Friday and mobile clinics in the rural villages from Wednesday to Friday – three mobile clinics per week – since our focus is on providing care in  the rural villages where other health care services are not accessible.
  • Conduct emergency trips to villages and offer transport to Lodwar District Hospital, if required, especially for complicated deliveries and medical conditions needing advanced care.
  • Fifteen hospice services (home visits) to be conducted in the 4th Quarter.
  • Continued consideration into how best to meet the needs of special cases, which currently require additional funds that are not allocated in the available budget.
  • Maintenance of mobile clinic vehicle.
  • Pay salaries for the clinic staff.
  • Purchase medicine from pharmaceutical company in Nairobi, Kenya, on (at least) a monthly basis.

Success Stories

Mr. Ewoi (below) suffered a snake bite 30 miles west of Lodwar Town. A snake bit Mr. Ewoi at night while he was searching for his lost goats and he does not live in an area that has access to hospital services. Fortunately, a Good Samaritan who was heading to Lodwar Town encountered Mr. Ewoi lying in the bush and called his relative who was living in Lodwar Town to look for people who could help the patient.
Early the next morning, Mr. Ewoi came to our Clinic just as we were about to leave to conduct a mobile clinic in another village. Having learned the urgency of his situation, we arranged for vehicle and staff to go and collect Mr. Ewoi. An hour passed and he was brought to Lodwar District Hospital for further management. After, four days, Mr. Ewoi was discharged in a fair state. He thanked us a lot that we saved his life.

Mr. Peter Ewoi examined by a health worker at his home before referral to Lodwar District Hospital

photo: Peter Ewoi boards the mobile clinic vehicle bringing him to Lodwar District Hospital for further management

Health Education
Health education plays a key role in Turkanaland. Many diseases occur due to lack of knowledge about prevention. Lack of education in the community about various diseases and illnesses has allowed their rampant occurrence in this community. So far, our program in this quarter has managed to conduct extensive public health education outreaches on various common conditions in the community. Management of malnutrition, which is common in Turkanaland, was emphasized to all villages as well as numerous other conditions. Malnutrition in children is common here and cases are seen in almost all villages. Most people manage their daily budget on less than one dollar a day. Our emphasis is on the management of malnutrition utilizing locally available food. Additionally, we provide education for the people of Turkana on prevention of malnutrition and on nutritious food.
We usually buy food in limited amounts for patients with malnutrition for distribution during our mobile clinic outreaches in rural villages. This enables us to have some impact though there is still more to be done.

photo: a group of patients receives public health education following their treatment

photo: individualized health education is conducted during our mobile clinic outreaches in rural villages

Maternal Child Health
Maternal-Child Health services are critical services among communities living in the rural villages. Health facilities are few and as a result, mothers and children rarely receive this much-needed service. We fill this gap by providing maternal and child health services in selected rural villages. Financial constraints have hindered the availability and adequate number of staff that can offer these services to all of the villages that need it.  Additionally, there are many more very remote villages that urgently need these services.

photo: a baby is given an oral polio vaccine

photo: an expectant mother receiving tetanus toxoid during one of our mobile outreach clinics