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.

The Ground is Broken On the New Maternity Center For the Kisesini Community Health Project

The construction of the maternity center for the Kisesini Community Health Project is now underway!  This is a dream, many years in the making, come true.

Many women in Africa die in childbirth, and many of their newborn infants die during or soon after birth from lack of professional health care. The community that is served by the Kisesini project in Kenya has been seeking that professional care, with an increasing number of women arriving at the clinic to deliver their babies. Until now, they have been delivering in an exam room, and immediately walk back home with their newborn infant, sometimes walking for many hours. With the generous support of GHP donors, the construction has begun of a building next to the Kisesini clinic that will serve as a maternity center. The women and their newborns will soon have a safer and healthy environment for childbirth and newborn care.   

To date this project has been done ahead of schedule and under budget, thanks to the expert supervision of our nursing staff at the Kisesini Community Health Project. 

Next we need some beds, linens, equipment and supplies to make this a top notch Kenyan Maternity Center.  Please consider a contribution to this worthy project.

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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

Man unable to speak for 5 months, diabetes, other cases

Friday Aug 5 2011.

Rifka Stern, MD

Today started out slow but got busier and more complicated. I saw some very interesting cases.

    The first one was an elderly gentleman who stopped speaking about 5 months ago. His son said he was doing other strange behaviors like eating paper. He would wander off during the day but came home for meals. He seems to understand some things but did not have any expression or response. He did not seem in pain and could feed himself but he was incontinent of stool and urine. He had been very healthy before this happened and had no known medical problems but did drink a lot of alcohol. On exam he also had a large lump by the right hip. It had been there for years and felt partly soft and partly hard. Neither Angelo or myself had any idea about what was wrong with him. He clearly needed further testing but it was not something that could be done in the clinic.
   After that a man came into the clinic with an extremely high blood sugar. His diabetes had been out of control for so long that his muscles had wasted away. He had been refusing insulin. When we saw him today he could barely hold his head up and his sugars were over 600 (normal is up to 125).  Someone with a sugar that high is very dehydrated and we started an IV and finally he agreed to take insulin and it took about 3 hours to get his level down. Then we gave instructions to his family about giving insulin shots.
   The other providers had a women with HIV who was not on treatment and had  a one month old baby. The mom finally agreed to give the baby medication to prevent transmission of HIV and then the mom is waiting for more testing to see if she needs meds. The clinic staff had been trying for a month to get the mom to accept treatment, so we were all very happy.
Luckly, HIV is not a big problem here. There is only about 5% rate of HIV infection in the country and lower in this area.
   The last was a severly malnourished 5 month old baby with a mom who was only 19 y/o. The mom has some psychiatric problems and is not very capable of taking care of her children. The baby was so anemic that it was decided to take her to the hospital. We are still waiting to hear how she is.