Kenya: Progress Report for Lwala Community Health Center
July 23, 2010
Jonathan White and James Nardella
During this most recent reporting period of March ’10 through the end of May ’10, there continued to be significant achievement by our health care staff at the Lwala Community Health Center. The primary beneficiaries of the Lwala Community Health Center’s work are children, pregnant women, HIV infected persons and the elderly. Prior to the establishment of the clinic, there was no immediate access to primary health care or HIV/AIDS testing and care. For this reason, the Lwala health intervention has focused on primary care for children, access to medicines (particularly vaccines and antimalarials), HIV testing and care, public health outreach and safe maternity.
During this last 3 month reporting period, the clinic provided primary care services for a total of 3,739 patients. Of these patients, 1,520 were under the age of 5. There were a total of 95 women visiting the ANC clinic for their first antenatal clinic visit and 57 women initiating a family planning method after attending our family planning clinic. The children of 4 HIV positive mothers were delivered with mothers provided with full PMTCT care. 91 children were seen at the Children’s clinic with 37 of those being fully immunized. The clinic has also arranged for the future transfer of local HIV patients who are currently being treated by the Tabaka Mission over to the Lwala clinic’s care, adding about 100 patients to those receiving care over next 6 months.
In June we expect to see a major shift in patient numbers following the implementation of the new patient fee system. We were previously seeing 85% of our patients at no charge, an unsustainable practice because our catchment area has been ever expanding due to the free care. The new fee system, which is pegged to the MoH price range in our area, will inevitably drive down our numbers at the start but we do expect to see them rebound within a few months. In addition to this new fee system the clinic will also be piloting a new patient recording system to further improve efficiency.
Outreach programs and Mobile Clinic
The Safe Motherhood (Umama Salama) Community Education Program continues to provide the community with valuable educational opportunities. Three Umama Salama workshops were held during which men and women were trained in all safe motherhood lessons. Three of the very popular Children’s Club sessions were held for the area’s HIV positive children.
Thanks to a generous grant from Ronald McDonald Charities the new Mobile Health Care Vehicle hasbeen purchased and the recruiting of health care staff to implement this new mobile health program has begun. We look forward to further news of the mobile clinic in action.
The new toilet construction has been completed at the Lwala Primary School and the architects have finished the designs for the new Maternity building and mobilized bids by 5 contractors. Community based hygiene and sanitation training at Lwala Primary School begins on June 8.
A local women’s sewing group is currently engaged in making satchels in partnership with Thistle Farms for a product line to be sold at Whole Foods (www.thistlefarms.org)
Watoto Wabili – Two Babies and our 100th!
On May 28, 2010 the Lwala Community Alliance welcomed two 18 year old first time mothers on a Saturday morning: Millicent, a nearly silent struggler in one corner, and Maureen, a vigorous and loud laborer in the other. There was never better proof of the need for a larger space for deliveries, so Real Medicine’s support of the new maternity center is much appreciated. Despite the small space, Clinic Officer Michael Omollo and clinic founder Milton Ochieng’, MD were smiling as silent Millicent pushed out a crying healthy baby girl. Maureen’s vigorous, athletic, and loud labor response was a stark contrast and kept the team on their toes.
A second crying and healthy baby girl was welcomed about an hour later. This was baby 100 for Lwala! These children have all been born in what was originally designed as a kitchen and was converted to a birthing facility when laboring mothers began to come. Groundbreaking for a proper maternity is planned for July 2010.
Malaria, Modern Medicine and Opiyo’s story
Malaria is endemic in the lowlands of Lwala, Kenya near Lake Victoria. Children under age 5 are at the greatest risk of dying. Opiyo, 6 months old, was near death when he arrived after dark at Lwala Clinic. His racing heart and panting lungs were trying hard to push oxygen and anemic blood through his small body. Fluids, a transfusion, and malaria medicine were desperately needed. Unfortunately Opiyo’s dehydrated body prevented the clinical officer, a visiting Pediatrician, and Milton Ochieng, MD from getting an intravenous line started.
Opiyo and mother, Milton and Fred Ochieng, and driver Joseph “Boy” piled into the Real Medicine funded 4 wheel drive ambulance and quickly headed for Kisii Provincial Hospital, one hour away. Again the emergency room staff could not gain standard intravenous access. Milton’s recent intensive care experience in St. Louis kept him from stopping.
After explaining a risky jugular vein IV insertion to Opiyo’s mother, obtaining consent, and saying a short prayer, Milton proceeded to insert a jugular line, blood was started, and Opiyo was on the road to recovery.
The many parents of other sick children in the jammed emergency department had watched the drama, and sighed with relief and awe for Opiyo.