Lewa Healthcare Annual Report - 2013 - FINAL · Clinic&Annual&report&2013% The!three!facilities!experienced!a!sharp!rise!in!the!number!of!patients!attended!in!2013.!The!number!of!medical!

Clinic&Annual&report& 2013%!

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HEALTHCARE%ANNUAL%REPORT%2013%

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By%Lucy%Ndirangu%Human%Resources%Manager%Lewa%Wildlife%Conservancy%[email protected]!

February%2014%


INTRODUCTION%%

The! Lewa! Wildlife! Conservancy! healthcare! programme! achieved! tremendous! infrastructural! and! service! delivery!

growth!in!the!year!2013.!Lewa!Clinic,!Leparua!Clinic!and!Ngare!Ndare!Clinic!remained!the!service!delivery!points!for!

the!programme.!Although!the!construction!for!Ntirimiti!dispensary! is!complete,!the!government!of!Kenya! is!yet!to!

finalise!plans!to!gazette!and!staff! the!building.!This!delay!was! largely!caused!by!the!devolution!of!healthcare!from!

the!national!government!to!the!county!government!in!line!with!the!Kenyan!constitution!enacted!in!2010.!The!county!

government!is!presently!establishing!structures!for!healthcare!management!including!the!legislative!framework.!All!

this!is!on!the!final!stages!and!Lewa!is!optimistic!that!Ntirimiti!dispensary!will!be!operational!soon.!!

!

Several!developmental!projects!were!completed!last!year.!They!include!the!waiting!bay!with!a!mural!depicting!the!

link! between! conservation! and! healthcare,! the! comprehensive! care! centre! (CCC),! the! microbiology! room! and!

electrical!rewiring!at!Lewa!Clinic,!completion!of!the!MCH!room!and!store!at!Leparua!and!construction!of!a!placenta!

pit! at! all! the! three! clinics.! These! facilities! have! immensely! aided! the! steady! achievement! of! the! programme’s!

objective!of!seamless!service!delivery!towards!a!healthy!staff!and!community.!The!construction!of!staff!housing!at!

Ntirimiti!dispensary!and!MCH!and!laboratory!at!Ngare!Ndare!clinic!also!started!in!the!same!year!are!progressing!well.!

All!this!was!made!possible!by!the!unwavering!support!of!our!generous!donors!and!other!committed!partners.!

Staff%

Our! healthcare! personnel! sustained! their! devotion! to! delivering! the! highest! quality! of! service! possible! in! their!

diverse!roles.!!The!programme!however!suffered!a!major!drawOback!in!February!2013!when!it!lost!Philip!Omwenga,!

the!ambulance!driver,!through!a!road!traffic!accident!in!Nairobi.!At!the!time!of!the!accident,!Philip!was!on!his!way!

for!an!advanced!ambulance!driver’s!first!aid!course!with!St.!John’s!Ambulance.!Philip!was!an!exceptionally!dedicated!

employee!and!a!darling!to!all!that!he!served.!In!the!same!year,!one!nurse!who!was!designated!to!the!Leparua!Clinic!

resigned.!This!temporarily!hampered!the!efficiency!of!service!delivery!at!the!facility.!These!two!gaps!have!since!been!

filled!and!the!new!staff!members!are!fitting!in!well.!!

!

!!!!!!!!!!!!!!! !!!!!!!!!!!!!!!!!!!!!!Ambulance!!Driver!assisting!with!clerical!work! ! ! !!!!!!!!!!!!!!!!!!!!!!!!!!!!!New!nurse!at!the!Lewa!clinic!

Dr.%Butt%!

With! the! expansion! of! the! scope! of! services! rendered! by! the! healthcare! programme,! it! is! becoming! increasingly!

necessary!to!continuously!upscale!the!diagnostic!competence!of!the!clinicians.!In!this!regard,!Dr.!Butt!was!pivotal!in!

the!service!delivery!of!the!programme!in!2013.!Besides!the!fortnightly!visit!to!our!Lewa!clinic,!he!was!available!for!

consultation!over!the!phone!at!all!times.!The!interactions!with!the!doctor!during!those!visits!and!over!the!phone!has!

mentored!the!skills!of!the!entire!clinical!team.!!Lewa!also!benefitted!from!the!services!of!Dr!Butt!as!an!Occupational!

Health! Practitioner! when! he! conducted! medical! examinations! on! staff! whose! nature! of! work! exposes! them! to!

occupational!injuries!and!diseases.!!The!medical!examinations!were!conducted!at!the!Lewa!clinic,!thus!the!staff!did!


not!have!to!travel!to!farOoff!hospitals!for!this!service,!with!the!exemption!of!those!that!required!specialized!medical!

tests!not!available!at!the!clinic!such!as!eye!and!audiometric!tests.!

!

!

!!Dr!Butt,!at!the!Lewa!Clinic!

!

Courtesy!of!the!Lewa!Safaricom!Marathon!fund!that!is!deposited!at!Nanyuki!Cottage!Hospital!(NCH)!for!management!

of! human!wildlife! conflict! patients! around! the! Laikipia! region,!Dr.! Butt! handled! several!wildlife! related! injuries! in!

2013.!His!service!is!critical!in!not!only!augmenting!the!conservation!cause!in!the!community!but!also!ensuring!that!

the!unfortunate!victims!of!wildlife!conflict!regain!their!fitness!in!the!shortest!time!possible.!There!were!a!number!of!

snake!bites!and!rabid!dog!bites!from!the!catchment!area!that!the!doctor!dealt!with!in!2013.!

LEWA!HEALTHCARE!OPERATIONS!IN!2013!

Services%offered%at%the%three%Clinics%!

The!Lewa!healthcare!programme’s!fundamental!purpose! is!the!delivery!of!health!treatment,!care!and!diagnosis!as!

well! as! health! promotion! and! preventative! services! to! the! Lewa! staff,! as! well! members! of! the! surrounding!

communities.!!Services!range!from!child!welfare!clinic,!to!reproductive!health!and!treatment!of!the!sick!and!inured.!!

Below!is!a!table!that!shows!the!number!of!patients!attended!to!at!the!Lewa!clinics!in!2013!for!the!various!services!

offered.!


!

The! three! facilities! experienced! a! sharp! rise! in! the! number! of! patients! attended! in! 2013.! The!number! of!medical!

cases!rose!from!10,232!patients!in!2012!to!a!total!of!12,437!patients!in!2013,!a!22.5%!rise.!This!can!be!attributed!to!

the! increasing! confidence! levels! among! the! members! of! the! community! in! the! light! of! acquisition! of! medical!

laboratory!equipment!which!has!enhanced! the!diagnosis!and!management!of!medical! cases.!The!chart!below! is!a!

summary!of!the!conditions!treated!at!the!Lewa!clinic!in!2013:!

%Patients%Over%5%Years%Old:%

!

!

!

!

!

!

!

!

!

%

Under%5%Year%Old%Patients:%!

7482!

665! 536!105!

378!2!

6535!

3537!

778!

247! 165! 124! 0!

2370!

1418!1102!

190! 156! 263!0!

694!

0!

1000!

2000!

3000!

4000!

5000!

6000!

7000!

8000!

SERVICES'OFFERED'IN'THE'HEALTHCARE'PROGRAMME'IN'2013'

Lewa!Clinic! Ngarendare!Clinic!Leparua!Clinic!

!!!!!

!!!!!!

!

!

!

NO.'OF''''''''PATI'ENTS

SERVICES'

108! 55!220!

1465!

7!

657! 723!

14! 36! 140!

1982!

947!

77!

0!

500!

1000!

1500!

2000!

2500!

FREQUENCY'OF'CASES''

Cardiac!

Dental!

Dermatology!

Gastrointesbnal!

Gynaecology!

Infecbon!

Musculoskeletal!


%

%

%

%

%

%

%

%

%

%

%

Auxiliary%Services%Rendered%by%the%Clinics%in%2013:%!

1. 'Comprehensive'Care' !

!

2013!was!a!very!significant!year!in!the!development!of!the!Lewa!healthcare!programme.!The!!

construction!and!furnishing!of!a!comprehensive!care!clinic!to!care!for!HIV/AIDS!patients!was!momentous!!

and!a!strong!step!in!the!right!direction!to!address!the!needs!of!this!stigmatized!group.!The!comprehensive!

care!unit!opened!its!doors!in!September!2013!and!by!the!close!of!the!year!it!has!already!enlisted!30!patients!

who! are! on! antiretroviral! therapy.! Some! of! the! nurses! have! been! trained! on! both! adult! and! paediatric!

Antiretroviral!Therapy!(ART)!and!there!is!a!plan!to!train!the!rest.!The!opening!of!this!service!has!injected!new!

impetus! into! holistic! provision! of! healthcare! in! the! programme.! The! beneficiaries! of! the! services! were!

hitherto! going! for! the! same! either! in! Meru,! Isiolo,! Timau! or! Kiirua.! This! long! distance! travelling! was! a!

financial!strain!to!a!majority!and!occasioned!inconsistency!to!some!further!compromising!on!their!wellbeing.!

Not! only! are! these! clients! able! to! access! antiretroviral! therapy! at! the! Lewa! clinic,! but! they! are! also!

benefitting!from!laboratory!tests!such!as!CD4!count,!liver!function!and!electrolyte!tests.!!These!clients!do!not!

need! to! be! referred! to! any! other! facility! for! further! tests.! Although! stigma! remains! a! hurdle,! there! is! a!

gradual!improvement!and!measures!are!in!place!to!mitigate!it.!!!

!

2. 'Reproductive'Health!

!

The! nurses! have! aggressively! sensitized! the! communities! surrounding! the! conservancy! on! the! merits! of!

modern!methods!of!family!planning.!Although,!there!are!many!myths!associated!with!family!planning,!2013!

showed!encouraging!acceptance,!with!the!Jadelle!implant!emerging!as!a!favourite!for!the!majority!of!women!

served! by! the! Lewa! clinics.! ! Cervical! cancer! screening,! breast! cancer! screening! and! health! education! on!

reproductive!matters!was!also!enhanced!in!the!year!in!review.!In!2013,!1,007!women!benefitted!from!family!

planning!services.!Out!of!this!number,!110!women!went!for!longOterm!family!planning!methods!and!the!rest!

accessed!short!term!methods.!The!Ministry!of!Health!is!advocating!!longOterm!family!planning!methods!and!

thus! the! Lewa! nurses!will! continue! educating!women! on! the! importance! of! opting! for! these! longerOterm!

solutions.!!!

3. School'Health'Care'Programme!

0! 2!110!

273!

0! 33! 0! 0! 0! 28!

664!

57! 104!

0!100!200!300!400!500!600!700!

FREQUENCY'OF'CASES''

Cardiac!

Dental!

Dermatology!

Gastrointesbnal!

Endocrinology!

Infecbon!


!

!

A! total! of! 19! schools! benefited! from! the! school! healthcare! programme.! They! included! all! the! Lewa!

supported!schools!and!others!neighbouring!the!conservancy.!A!total!of!9,599!children!benefitted!from!this!

exercise!in!2013.!Routine!visits!were!made!each!school!term!and!the!services!offered!included!deworming,!

treating!the!sick!and!health!education!on!relevant!issues.!In!2013,!the!programme!incorporated!the!pupils’!

parents!and!siblings!who!have!traditionally!been! left!out.! !This! is!because!they!went!to!the!school!seeking!

medical!care!on!the!days!that!Lewa!nurses!visited.!!!

!

4. 'The'Laboratory'Services'

'

!With!the!addition!of!the!microbiology!room,!the!laboratory!services!are!now!delivered!in!a!very!conducive!

environment.!The!additional! lab!equipment!including!chemistry!analyser,!electrolyte!machine,!elisa!reader,!

autoclave,!CD4!machine,!among!others,!have!widened!the!scope!of!the!investigations!that!can!be!conducted!

at! the! Lewa! clinic! laboratory.! ! Another! major! stride! made! in! improving! the! diagnostic! capacity! of! the!

programme:! laboratory! services! were! introduced! at! Ngare! Ndare! Clinic.! Although! they! are! basic,! it! has!

bolstered!the!confidence!the!patients!and!clients! in!the!clinic.!The!chart!below!summarises!the! laboratory!

investigations!conducted!at!the!Lewa!Clinic!laboratory!in!2013:!

!

!

TBC STOOL O/C

URINALYSIS MALARIA

PREGNANCY RBS FBS Salmonella Ag Helicobacter Blood group VDRL RF ESR Brucella HIV HVS ZN Electrolytes D ͧᵘ CD4

COUNT CD4 % LFT ROTA VIRUS

URETHRAL SWAB CHOLESTEROL

1016 794 843 1329 207 153 333 10 329 395 94 247 99 207 39 490 9 63 61 1 23 0 16 1 1 2 0


5. 'Health'Education!

!The! healthcare! team! continued! its! health! education! outreach! in! 2013.! It! is! clear! that! this! education! is!

yielding! fruit,! because! communicable! diseases! such! as! diarrhoea,! worms,! eye! infections,! and! STI/HIV!

infections!are!on!the!decline.!Examples!of!communities!that!benefited!from!health!education!workshops!are!

Leparua,!Subuiga,!Ntumburi,!Sang’a!and!Manayagalo.!

!Nurse!Martin!educating!Manyagalo!community!memebers!during!a!medical!camp!

!

!

!

!

6. Outreach!

!

Community!outreach!clinics!were!conducted!on!monthly!basis!in!Leparua.!Four!other!outreach!programmes!

were! conducted! in! other! communities! neighbouring! Lewa.! ! These! outreach! visits! were! conducted! every!

quarter! and! benefitted! the! following! communities:! Ntumburi,! Manyangalo,! Ngare! Ndare! and! Sang’a.!

Services!offered!during!these!trips!included!treatment!of!communicable!diseases,!family!planning,!screening!

for!cervical!cancer,!health!education,!immunization,!anteOnatal!and!postOnatal!clinics!and!jigger!treatment.!

!

! ! &Manyagalo!community!health!outreach! ! ! !!!!!!!!!!Ntumburi!community!health!outreach!


!

!

!

7. Polio'Campaign!'!The!healthcare!programme!participated! in!a!government!polio!campaign!that!targeted!children!under!the!

age!of!five!years!in!August!and!November!in!communities!surrounding!the!conservancy.!The!objective!of!the!

campaign!was!to!increase!population!immunity!in!the!children!and!the!healthcare!team!conducted!a!house!

to!house!vaccination!campaign.!

'!

Infrastructural%Development%!

The!following!are!photos!of!some!of!the!facilities!constructed!in!2013:!

!

! !Lewa!Clinic!Comprehensive!Care!Centre! Leparua!MCH!

! !Lewa!Clinic!Waiting!Bay! Ntirimiti!Staff!House!–!Work!in!progress!


! !Ngarendare!Clinic!MCH!–!Work!in!progress! Lewa!Clinic!Waiting!Bay!–!Mural!at!the!front!

! !

%Summary'

All! the! success! stories! registered! in! the! healthcare! programme! would! not! have! been! achieved! without! the!

remarkable!support!of!our!donors!and!other!partners.!For!this,!LWC!remains!exceptionally!grateful!on!behalf!of!all!

the! beneficiaries! of! the! services! rendered! to! the! communities.! With! improved! healthcare,! our! neighbours! are!

enjoying!better!quality!of!life!and!thus!furthering!the!conservation!agenda.!!!

Documents

Lewa Healthcare Annual Report - 2013 - FINAL · Clinic&Annual&report&2013% The!three!facilities!experienced!a!sharp!rise!in!the!number!of!patients!attended!in!2013.!The!number!of!medical!