East Africa Partnership: Health Care

Healthcare

Four years ago, the East Africa Partnership (EAP) developed a problem to provide high quality local healthcare with a focus on prevention and education. There were originally two components to this program: 1) Develop self-sustaining health facilities in areas with minimal or no healthcare and 2) Develop a parish nursing program to focus on the prevention of disease and health education. During the past four years, we have developed 10 health facilities with 12 more in process and trained 42 parish nurses. Each health facility reaches about 25,000 people without health services and reaches almost 100,000 people through its mobile clinics.

The Partnership sends approximately $3,000,000 (240 million KS) in medical equipment and drugs to Kenya each year and makes 4 trips to Kenya each year to provide medical education and treatment. EAP now includes several hospitals in Kenya and the U.S. led by Hoag Memorial Hospital Presbyterian, one of the best hospitals in the U.S. Over 80 companies and not-for-profit organizations have donated medical equipment, supplies and drugs for these dispensaries, hospitals and government facilities. If we are made aware of a need, we publish it on a list of needed medical products and pray for a donation to arrive. For example, Tigoni District Hospital asked us for an anesthesia machine, which they designated as their greatest need. We placed this request on our list. Within 2 weeks, we received a call from a U.S. anesthesiologist, who said that his hospital was replacing an anesthesia machine. A member of EAP met with the CEO of the hospital and he agreed to donate the device. EAP paid to have it maintained and is shipping it to Kenya. The custom fees on these goods are waived by the Kenya government. This system has worked well until our last shipment, which has been stuck in Mombasa waiting for clearance for more than a year costing the people in Kenya approximately $500,000 (4 million KS) in drugs, which have expired in while stuck in storage.

The EAP responds to requests from the local community to establish its health facilities. The community must have a building, electricity and water in the proposed area. EAP then investigates the area and assesses the need. If the assessment meets our requirements, EAP agrees to establish a health facility. For the last two years, EAP has shipped containers with enough equipment to establish 4-5 health facilities, which contain at least 5 rooms. Each facility has hospital beds, a crib, a gurney, exam tables, suction, microscope, centrifuge, hematocrit, glucometer, EKG, AED, simple surgical tools, cautery, etc. Further, each facility receives a supply of drugs from the government, purchases drugs from MEDS (a division of the Christian Health Association of Kenya) and receives drugs from the U.S. Finally, each staff member receives three months of training from U.S. personnel plus Kenya personnel certified by the U.S. teams as trainers. They also receive additional training from U.S. medical teams four times a year.

Each of these health facilities provides immunizations, pre-natal care, family care, birthing services, and AIDs counseling in addition to sick visits. The facilities are staffed by a nurse or clinical officer, a laboratory technician and a nurse’s aide. These facilities provide excellent quality of service, clinical diagnosis and laboratory confirmation of disease and a full array of excellent medications. The successful first time diagnosis rate of these clinics is 85%. These clinics also provide periodic ophthalmic and dental care and regular preventative medicine treatments and lectures on subjects such as nutrition, hygiene, and lower back pain.

In addition, EAP has trained 42 parish nurses and numerous healthcare workers. The parish nurses are nurses or healthcare workers, who have additional training and are given a backpack of supplies for diagnosis, simple treatment and medications and first aid instructions. They attend churches and schools at least twice a month to provide educational seminars and to provide preventative treatment as necessary. These nurses will be used for the school program to provide medical care to incoming students. The healthcare workers are trained mostly as AIDs educators and in first aid. They regularly support a home visit program to the terminally ill, AIDs patients and emergency cases.

Riders for Health has supplied 10 motorbikes that are used for transport of medications and conducting medical clinics. EAP conducts 2-4 mobile clinics each week in areas where there is no health facility. Often these clinics are conducted in buildings that the community hopes will one day house a health facility. This program reaches a large population of Kenyans, who have no readily accessible healthcare.

Finally, each year approximately four teams of health professionals visit Kenya on medical mission trips. They conduct free treatment camps, provide drugs, train Kenyan professionals and perform many other services. This year, one team focused on the treatment of handicapped children and treated 3500 people in 2 weeks. Another team will provide surgery. A third team contained 3 professional nurse educators from a U.S. college, who lectured to beginning nursing students as well as to hospital nurses. These teams focus on training Kenyan medical staff, not just treating patients.

The health services program is largely self-sustaining and each facility must be self-sufficient within 6-24 months. This program relies on the generous support of the Kenyan government and the local MOH, which provide medication. In addition, the government promised to second one nurse to each facility once the facility saw 35/patients per day in populous areas and 15 patients/per day in very rural communities. The government has only supported one person to date. Without this support, EAP has been forced to delay the opening of 12 new health facilities. We have the resources to stock these facilities with drugs and equipment, but cannot begin a new facility while still paying the salaries of three medical people at each facility. If the government can fulfill its commitment to EAP by paying the salary of one of our personnel after the first six months and after volume targets have been met, then we can start one new facility for each person supported.

It is the goal of EAP to continue to improve the health of the Kenyan people by providing low-cost, quality, accessible healthcare locally and by providing education on the prevention of disease.