My trip to Kisesini

Just coming to the end of 2 weeks in Kenya..
Today was exciting and very long.
I was called at 4 am to look at a head wound. It was probably a skull fracture and I sent him to the hospital which was an hour away.
At just before 6 am a woman came in labor.
Only one nurse was at the clinic since the other 2 were doing the transport to the hospital.
I heard the motorcycle drive up so got up to investigate.
The woman was in very active labor and delivered about 10 minutes after we got her on the table. A beautiful girl. It was an easy delivery and the first one that I really got to do myself. Mom was up and bathing in 30 minutes, but it was her 5th baby.
Then we went out to do the development evals on the children. Drove for about 1 1/2 hours to a place that had a tiny nursery school, and nothing else around that I could see.  The kids of course were very cute and mostly not too afraid. I think they all have pretty normal development and are amazing, since they can figure out how to put pegs in a peg board, even though I am sure they never even saw one before.
We finished the assessments and then had to wait for 2 hours for the truck to come pick us up. Drove another 1/2 hour, did a few more assessments and then it took 90 more minutes to get back. Finished at 6:30 pm, after leaving around 8 am.
We come home covered in dust. Take a bucket bath, but dusty again the next day.
We have numerous tough cases to try and find help for.
A boy with severe scoliosis at age 3.  A girl with a growth in her eye. It  is not affecting her vision, but it looks really weird.
I gave about $60 to a grandmother today to keep her daughter in school this term. Of course there are many more like them, but GHP can only support a few.
I really am amazed at the people here, they are kind, gentle and patient. The kids sometimes wait for 2-3 hours to get tested. They are happy for the pencil I give them.
Rifka Stern MD

GHP Supported Food Program

IMG_1343So many of the health problems faced by patients within GHP’s service area are caused or worsened by nutritional deficiencies.  Right now GHP helps support 18 families.  These families live on less than a dollar per day.  Many of them  are orphans or are being raised by desperately ill parents or grandparents.  Many of these children are HIV/AIDS orphans and victims.  The families are selected by their Community Health Workers, who know them very well, and are proposed for GHP support.  Each proposed family is visited personally by the head nurse at the Kisesini Health Center, Nicholas Mtu, who assesses their health and social situation.

Thank you, Nicholas, for working so hard for these poor families.  Thank you for your year round nutritional support for these families.  Some of the families are pictured here, receiving their special Christmas gifts of food.

Also thanks to Nicholas, GHP will provide support for school uniforms.  Children in Kenya cannot attend school without a uniform.  A simple gift of a school uniform allows these poor children to learn to read and write.

The new Maternity Center is nearly complete!

Maternity Center nears completion
Maternity Center nears completion

The new Maternity Center, adjacent to the Kisesini Health Center, is nearly complete.  Many, many thanks to the generous supporters of GHP and to the wonderful Kenyan nurses who have been overseeing the entire project.  Soon expectant mothers within the Kisesini service area will have professional assistance before, during and after delivery.

CHW Salinas assessing a newborn during a home visit

CHW Salinas assessing a newborn during a home visit

An infection recognized early can save a newborn’s life
After a long walk to the home of a mother and her newborn infant, Salinas promptly began her assessment of the infant. Salinas is a volunteer community health worker (CHW) who has more than two years of experience with newborn home visits, having participated in the first training program that was implemented by Global Health Partnerships. The infant that she is visiting today in a village of Makusya sublocation was born three days ago without complications or problems. When Salinas checked on the baby the first day after birth, all was going well and there were no signs of illness or problems. On today’s visit Salinas starts by greeting the mother, asking if breast feeding is going well and if the mother has any concerns or has noticed any problems. She notes that the baby seems alert and active, has no skin pustules or boils, and her temperature is normal. But when Salinas counts the breathing rate, she finds a rapid rate of more than 60 breaths per minute. Recognizing this danger sign of serious illness, she calls her supervisor Nicholas Mutuku, who quickly arranges for the mom and baby to be transported to the Kisesini clinic. Nicholas confirms the diagnosis of pneumonia, promptly starts antibiotic therapy, and arranges hospitalization of the infant. A few days later the young infant has recovered and is back at home with her mother.

In Kenya 40% of childhood deaths occur during the neonatal period (the first month of life), and three- fourths of those neonatal deaths happen in the first seven days. Young infants can become very ill and succumb to their illness quickly. The key to reducing the death rate is early recognition and prompt treatment. Over the past three months Salinas and the other 19 CHWs visited a total 198 infants during their first week of life. The visits were conducted on days one, three, and seven of that first week, as recommended by UNICEF. There were no deaths. In the absence of the newborn home visitation program, 4 or 5 of those 198 young infants would likely have died, based on the national neonatal mortality rate in Kenya. The dedicated CHWs of the Kisesini Community Health Project have accomplished this successful effort because of your donations to this GlobalGiving project. If adequate funding can be found, GHP is planning an expansion of the project so that a larger number of newborn infants can be included.

Infant losing weight, goes for supplement

weighing baby
Weighing the baby is part of diagnosis

6 Aug 2011

by Katie Chisholm, Kathryn Chinn, Sydney Ryan, Sai Cheruvu, MD

The first stop at the Outreach Clinic in Syokisinga was child malnutrtion screening with Sai and Katie, CHW Mutinda and others.  The children were weighed and measured to determine nutrition status.

Mother arriving at clinic

The severity of malnutrition is based on the weight for height measurement .  .  Although the majority of children were considered malnourished, the number that met the criteria for supplements was small.

  One of the most memorable children was this 12 month old boy who had been on unimix but still had lost weight.  When the volunteers brought out a package of PlumpiNut, the child lit up and devoured the contents.
PlumpiNut is a a fortified peanut butter product that is given to the most malnourished infants (3 standard deviations below normal weight, older children and slightly less malnourished children may be given Unimix, a fortified whole grain porridge.
see this recent allafrica news story
Baby Enjoying PlumpiNut
Baby Enjoying PlumpiNut

Extremely malnourished child, victim of poverty and drought

Aug 3 2011. Late in the day we were called to the clinic to see a severely malnourished child who was 10 months old but weighed only 10 lbs, about half of normal according to WHO standard growth curves.

Little Income

The mother, Patricia, 35, had stopped producing milk when little Katwili was only one month old. She substituted goat milk and a little porridge. She has not thrived. Patricia has 7 other children aged 3 to 15 years old. Her husband hauls water and sell it at the market. No one else in the family can work, and with the drought the garden produced nothing last year.

No Supplemental Food

The have a few chickens, but no other animals. Today, the baby had a cough, Patricia took her to the Katangi Health Center, but seeing the malnourished state of the baby and because they had no PlumpiNut for supplemental feeding, they sent her to our clinic–several hours on a motorcycle taxi away.

Large Family

On investigation, we learned that there are six other children and a husband in the family. Mbitha was a twin and her brother died last month after a brief illness.

Your support can help

Would you like to help this family? Global Health Partnerships is establishing a fund to be administered by the head nurse to help the most vulnerable families. Consider setting up monthly credit card donation of $50, $1.60 per day, for Patricia and her family. Every cent will help this family and we’ll send you occasional updates and photos.

Kamba Basket Co-op shows wares

Sunday 31 July . Finally  a rest day. I (Rifka) tried to sleep in but the sunrise was too beautiful and the rooster was crowing . David made coffee and  lots of fried potatoes for breakfast. We also had scrambled eggs, chapatis and fresh papaya.

Yesterday, David experimented making a solar oven of a cardboard box and aluminum foil.  We painted a pot black and sealed it in a plastic bag.  Temps can reach 200F. We cooked a little bit of chard in about 2 hours (see www.solarcookers.org)
Justine (our lab tech who lives here with her two children) made 2 cakes today. One she cooked on her charcoal burner, the other we tried to bake in the solar oven.Unfortunately we waited till the afternoon and the sun went away so the solar oven didn’t work. The first cake came out great, just a little bit of burned crust on the top.
The village basket weavers came and showed us how to make baskets. It is a many step process, but we tried to roll the sisal (a little like maguey or century plant) fibers into string and then weave them together. It is amazing to watch how fast they can do it.
   Rifka brought little bottles of  nail polish that she gave to the ladies in the basket coop. It was a big hit and they all put  the nail polish on right away. You’ve got to see the pictures of David painting Chairlady Mbette’s fingernails!
   The basket co-op displayed of over 100 baskets for sale and it was very hard to choose, because there were so many colors and different styles. I did my best to support the economy.  The basket co-op has existed for years and currently has more than 600 members.  Baskets are priced by size a medium-sized one costs around $10 and takes 2-4 wks to make.  Tomorrow, the co-op will sell 300 baskets to a crafts wholesaler in Machakos.