Kenya: Ochieng Memorial Lwala Community Hospital Second Quarter Report

July 21, 2011

Project Goal:
The Lwala Community Alliance is a non-profit health and development agency working in Nyanza Province, Kenya. Through the Lwala Community Hospital, the organization provides more than 15,000 patient visits each year. The mission of the organization is to meet the health needs of all people living in north Kamagambo, including its poorest. The hospital is part of a larger effort to achieve holistic development in Lwala, including educational and economic development.

Project Objectives during this reporting period:

1. Actively engage the community through preventative health education:
• Hold monthly Water, Sanitation, and Hygiene (WASH) trainings
• Conduct consistent weekly outreach by clinic staff
• Host Children’s Club every month
• Begin partnering on education initiatives and water infrastructure with 4 additional primary schools
• Implement pilot HIV education program at Kameji Secondary School

2. Continue Capacity Expansion
• Transfer clinical care to new building
• Staff and equip new building
• Recruit 2 new nurses for MCH and community health outreach
• Acquire more curricula, staff, and supplies for mobile health unit

3. Improve operating systems for better accountability
• Adhere to accounting protocol established in August
• Hire new accountant

4. Increase enrollment of patients in HIV Care

Results and/or accomplishments achieved during this reporting period:

Preventative Health and Education Outreach

2,087 Patients Treated at clinic over the course of 90 days. 
•Water, Sanitation, and Hygiene (WASH) trainings have been held each month this quarter, with very good attendance of 20-25 trainees. WASH Coordinator Elizabeth Akinyi has been conducting ongoing follow-up
• Preparation for implementation of WASH programs and girls’ education incentives in 2012 has begun at 4 additional primary schools.
• Umama Salama participants are actively integrated into clinical services at the hospital and assisting specifically with deliveries and postnatal care.
• New HIV and life skills curriculum (Tuko Pamoja) piloted at Kameji Secondary School
• Clinical staff enacted quick and active response to typhoid outbreak at Kameji Secondary School. Approximately 200 students were infected.
• Children’s Club conducted every month with more than 50 children in attendance each session
• Clinical staff has been conducting consistent mobilizations through PA announcements for NHIF (National Health Insurance Fund) registration

Capacity Expansion/Infrastructure
• New hospital wing opened at the end of April. Patient numbers have surged since opening.
• Running water established in June through a submersible pump at the new borehole. Piping, water storage tanks and new plumbing being installed. Hot water at new building is also established.

Systems Improvements
• New protocol for Kenya financials established and adhered to since August 2010
• New accountant with Quickbooks experience was hired at the end of June 2011
• LVDC (Lwala Village Development Committee) has reviewed and approved all budget and actuals before submission to the U.S.

HIV Care
• Nearly 800 people are currently on HIV care or treatment

Success story(s) highlighting project impact:

1. New Hospital Wing Opens

On April 30, 2011, the new clinical care and maternal health wing in Lwala opened for patient care. The expansion triples the infrastructure in Lwala, transforming the facility from a health center to a community hospital. With dedicated space for labor, delivery, and postnatal care, 12 inpatient beds, and 5 private consultation rooms, the organization will be able to care for many more people. Since opening, patient numbers have surged dramatically by 50%, from about 1,200 total patients per month to about 1,800 total patients per month. The average number of monthly deliveries has tripled and will continue to grow. More importantly, the variety and complexity of cases has increased, meaning inpatient needs are at times outpacing capacity. The 3 dozen staff in Lwala have been working very hard to provide outpatient care every weekday and emergency care 24 hours a day, 7 days a week. This growth in programs marks the fruition of a 3 year dream and makes the support of the Real Medicine Foundation more critical than ever.


2. Response to Recent Typhoid Outbreak

This June, a local secondary school near the Lwala Community Hospital saw a typhoid outbreak sweep through its dormitories and mess hall. Over a period of about two weeks, a number of students from Kameji Secondary School came to the Lwala Community Hospital and tested positive for typhoid. Clinicians and staff responded swiftly to these infections by going to the school to intervene directly.

Since the disease is transmitted via a fecal-oral route, water and food represented the prime suspects for transmission. Clinicians tested the seven food handlers who worked at the school; all seven tested positive and were subsequently treated. Lwala Community Alliance provided water filtration packets and new water tanks as well as funding for repairing the rain catchment systems. After a general education session about typhoid infection and prevention, clinicians carried out mass testing and treatment of the students. In the end, over 180 students registered positive for typhoid. As frightening as this outbreak has been, both the school and the local public health office have expressed deep gratitude to the Lwala Community Alliance for helping curb a potentially tragic situation.

3. Baby Paul

On a Tuesday afternoon in late June, a woman arrived at the Lwala Community Hospital in labor. Her contractions had started on Sunday, and she had traveled 6 km from her home on a motorbike in order to receive care and have a safe delivery at our facility. Later that evening, baby Paul was finally born. However, due to prolonged labor, the baby had aspirated and experienced fetal distress in the womb. Shortly after his delivery, Paul’s fever spiked to 102 degrees. The hospital staff quickly administered an intravenous antibiotic in an effort to bring his fever down. By Wednesday morning, Paul’s fever had decreased to 99 degrees. Paul and his mother were closely monitored in our postnatal unit for three days. At the end of this period, baby Paul had stabilized enough to safely return home.

Country Page: Kenya Initiative Page: Lwala Healthcare Project