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 general equipment use and care and pediatric emergency care

Summary of RMF/MMI-sponsored activities carried out during the reporting period under each project objective:

Infrastructure:
It was a busy quarter for RMF in terms of infrastructure. The pediatric ward had a totally different look after everything was done as there were so many renovations and constructions. The pediatric ward was painted with drawings to specifically be child friendly and suit the children who are admitted at the wards. The walls were painted with cartoons/pictures and they looked brighter than how they looked before. The floor renovations were done too. RMF fixed floor tiles in all the 8 cubicles, nurses’ room and store of the pediatric ward.

Photos: Before and after upgrade of the pediatric ward.

Initially the floor at the pediatric ward posed as a danger to the children in case of falls, but now after the renovations, the floor not only looks good, but the children are safe and the ward looks cleaner and brighter. RMF constructed a children play unit at the pediatric ward. This is a first in Lodwar and the whole of Turkana region. RMF also bought new assorted toys for the children to play with while at the pediatric ward. Afternoons at the pediatric ward are not the same anymore as the children are now able to spend their time playing and doing creative work thus helping in quick recovery and discharges.

Photos above: Before and after upgrade of latrine upgrade.

The old pit latrine was in a bad shape and almost falling apart. RMF came through and constructed a new pit latrine one specifically for the children and the other for the guardians to the children. The new pit latrine has helped in reduction of infections to the mothers of the admitted children and the children themselves. The bed wards at the pediatric ward were also in a very poor state. RMF renovated the 40 beds at the pediatric ward.

Photos above: Before and after floor upgrade

Equipment:
Within the quarter, the pediatric ward also benefited from the continuous supply of medical equipments like bed cradles, oxygen flow meter and drip stands. Before the drip stands came in, the hospital used to use sticks mounted on the beds as drip stands. And now with the supply of drip stands, patients can be able to use them.

Photos above: Delivery of new equipment

Training:
 RMF also organized for the equipment training for the staff at Lodwar District Hospital during the quarter. The five day training had a total of 25 participants. The trainee participants included, bio medical engineers, nurses from all departments within the hospital, medical officers, laboratory personnel, dental and maternity just to mention but a few. The training was held to sensitize the staff on good equipment handling, usage and maintenance. With the training having been done, we are now sure that the equipments will be handled, used and maintained in a good way. This was seen as a great achievement and yet another first from RMF as this type of training had never been held in the hospital or organized by any other partner at Lodwar District Hospital.

Medical supplies:
 RMF continued to supply the pediatric ward and the hospital in general with non pharmaceuticals like branulars, gauzes and plaster of paris just so as to ensure that the hospital does not run out of supplies.  We experienced a Malaria outbreak within the quarter and so there was need for us to procure emergency drugs like Fortum and Quinitas drops for the patients.

Disinfectant solutions:
With the construction of the pit latrine at the pediatric ward, RMF also ensured that it is kept clean and is well maintained. They supplied the pediatric ward with disinfectant solutions like Jik, cleaning bleach like vim, detergents and liquid soap. This has ensured that the latrines are clean and smell good. Detol disinfectant was also purchased to clean patients admitted with wounds and before they are dressed by the nurses.
 

Results and/or accomplishments achieved during this reporting period:

• With all the renovations done, Pediatric ward has been rated as the best facility in Turkana County with the availability of the basic equipments, pharmaceuticals, non-pharmaceuticals in place which has enabled the unit to achieve the WHO standards.
• RMF was able to train 25 health workers on routine use, care and maintenance of equipment. During training it became clear that most equipment breakdown is due to lack of knowledge, know how to use and minor servicing which contribute up to 75% of the breakdown. The remaining 25% of breakdown was attributed to normal wear and tear and aging of the equipments.
• With the establishment of the children play area, the pediatric ward is now children friendly and that has enabled children admitted being able to involve themselves with positive activities hence improving their recovery process.
• Patients still continue to benefit from the continuous medical supply at the pediatric ward.
• We were proud to receive both RMF and MMI as visitors to Lodwar in September.

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

Patients are now able to access quality care in a conducive and friendly environment especially the children who now have a playground. It improves, stimulates and enhances quick recovery. Real Medicine Foundation’s approach of being needs oriented and work with flexibility has brought change to the Lodwar District Hospital as a whole within a short period of time topping up the list of partners who have been around longer and for over 5 years with visible and measurable results. Lodwar District Hospital has also been able to handle mass accidents which occurred on September 25th, 2011 due to the availability of pharmaceuticals and non pharmaceuticals procured by RMF.
 

Number served/number of direct project beneficiaries:

• Malaria-110
• Dehydration- 155
• Severe Acute Malnutrition-132
• Pneumonia-77
• Anaemia-9
• Burns-12
• Snake bites-5
• Spider bites-6
• Scorpion bites-7
• Meningitis-12
• Typhoid Fever-25
• Fracture-2
• Food Poisoning-5
• Quadriplegia Polio-1

Number of indirect project beneficiaries (geographic coverage):

• 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.

Referrals from all 90 Health Centers and dispensaries except Kakuma Mission:
• Kalolkol-(60kms) 7 referrals
• Kaleng-(200kms) 5 referrals
• Uganda-(350kms) 2 referrals
• Lokichar-(120kms) 17 referrals
• Kapua-(70kms) 1 referrals
• Kibish-(550kms) 2 referrals
• Kalemngorok-(150kms) 5 referrals
• Turkwel-(100kms) 12 referrals
• Kakuma-(120kms) 32 referrals
• Kainuk-(250kms) 5 referrals
• Loima-(300kms) 3 referrals
• Kakuma refugee camp-(120kms) 17 referrals
• Lokitaung-(215kms) 5 referrals
• Kerio-(60kms) 7 referrals

Success story(s) highlighting project impact:

The pediatric ward has become the best facility in the whole District in terms of infrastructure and supplies. This can be clearly seen on the before and after pictures attached. With the Hospital now having the triple number of patients being seen in the quarter since RMF/MMI began the project in February 2011 with minimal to no referral cases. The kind of approach RMF came in with on the ground (focusing on the hospital needs), has made RMF/MMI become a role model for other partners at the hospital. Proving that so much can be achieved together within a short period of time.

Dr. Martina Fuchs (Founder and CEO of RMF) and the Medical Mission International team, led by Mr. Doug Kendrick visited Lodwar in September and honored the progress made at the Lodwar District Hospital. Doug Kendrick had previously traveled to Lodwar in 2010. Following that visit, he decided to take on the rehabilitation and upgrade of the Lodwar District Hospital – with fantastic success!