Kenya

Project Goal: Enable the District Hospital to fulfill its role of providing back-up referral health care for the Turkana region.

Project Objectives:

• Rehabilitate the infrastructure at Lodwar District Hospital, beginning with the pediatric ward
• Rehabilitate equipment set at Lodwar District Hospital, beginning with the pediatric ward.
• 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 emergency care

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

Infrastructure:
RMF/MMI continued to improve the general overlook of the pediatric ward at the Hospital through funding. The medicine cupboards at the nurses’ station at the pediatric ward were fixed as the ones that were previously there, were totally worn out, old and almost falling from the wall. The lighting system of the 8 rooms at the pediatric ward consisting of fluorescent lighting, switches and lighting bulbs was repaired and now the wards are bright as compared to the previous quarter where patients had to use torch lights at night since the wards were dark. The drainage system was also repaired and all the blockages were repaired. Broken glasses on the ward doors and windows which posed a danger to the children admitted at the ward were also repaired. A pit latrine is also in the process of being constructed at the moment at the pediatric ward to improve further on sanitation and proper hygiene. Proper reporting and pictures of the same will be captured in the next quarter report and in the next web entry immediately when it is finished.

Equipment:
RMF continued with its bid to ensure that all the urgent equipments and those that are not supplied by GOK are available. Equipments like suction machine, medicine trolley, food trolley, laundry trolley, ambu bags, ward bed mattresses, dressing trolleys and digital weighing scale were purchased. An internal meeting involving the medical staff was held at the Hospital to emphasize on the general care and maintenance of the equipments and its importance to both the staff and the patients at large. Major equipment training for staff is being organized as a refresher and a benefit to them as well so as to prevent frequent equipment breakdown. This should also be captured in our next quarter report.

Laboratory Reagents:
Laboratory reagents were also purchased in the reporting quarter. Reagents like Field stain powder A and B, Anti Sera A, B and D, VDRL Kit and blood agar base amongst other reagents were purchased. The last time the Hospital received reagents from the Government was 2 years ago. This has enabled the patients to have their tests done for FREE at the Hospital without having to refer them to nearby clinics/laboratories for these same tests.

Medical supplies:
Non pharmaceuticals like plaster of Paris, crepe bandage, and skin traction were purchased in this quarter. In a bid to ensure that there is a constant supply of drugs, RMF once again purchased Dextran 70 and Ceftriaxone, drugs which had previously been supplied in April and had run out. Pharmaceutical purchases are important since initially patients had to go into town, find and buy their own medicines when they were not available at the District Hospital.
 

Results and/or accomplishments achieved during this reporting period:

• There has been a remarkable improvement in inpatient care hence increase in patients admitted under the short period i.e. 467 from the previous quarter to 1,000 patients in this quarter.
• Reduction in Hospital stays from an average of 6 days to an average of 3 days. This is due to the availability of drugs and non-pharmaceuticals.
• Reduction in diarrheal diseases as a result of improvement in sanitation and hygiene after RMF/MMI renovated and fixed the drainage system and water supplies at the pediatric ward. We believe that things will improve further with the ongoing construction of a pit latrine to further increase the implementation of health practices and sanitation.
• We improved lighting system especially in the night after RMF did the lighting repairs at the pediatric ward.
• Patients are now able to have their laboratory tests done with the availability of laboratory reagents that had not been supplied by KEMSA for more than a year.
• Due to the purchase of the Oxygen concentrator, pediatric pneumonia cases can be treated adequately, reflecting in a reduced number of pneumonia-related deaths (10 in the last quarter, 0 this quarter).

Number served/number of direct project beneficiaries:

Number of indirect project beneficiaries (geographic coverage):

• Over 900,000 residents of the Turkana region; Even though Lodwar District Hospital officially only covers Turkana Central, in practice the district hospitals in Turkana North and South are not functional, hence the patients from those areas also come to Lodwar for referral care.
• People living along Lake Turkana, i.e. Pokots
• People from South Sudan, i.e. the Kapweta and Nadapal because of the war come all the way for treatment at Lodwar District Hospital.
• Karamojong in Uganda through the boarder to access medical treatment.

Referrals from all 90 Health Centers and dispensaries except Kakuma Mission:
Kalolkol-(60kms) 15 referrals
Kaleng-(200kms) 15 referrals
Uganda-(350kms) 2 referrals
Lokichar-(120kms) 7 referrals
Kapua-(70kms) 2 referrals
Kibish-(550kms) 2 referrals
Kalemngorok-(150kms) 2 referrals
Turkwel-(100kms) 10 referrals
Kakuma-(120kms) 20 referrals
Kainuk-(250kms) 9 referrals
Kalemnyang-(200kms) 2 referrals
Loima-(300kms) 3 referrals
Nariokotome-(200kms) 5 referrals
Kakuma refugee camp-(120kms) 10 referrals
Lokitaung-(215kms) 8 referrals
Kerio-(60kms) 7 referrals