Day 2: From Tragedy to Resilience, Community Health Workers See All

Vanessa Churchill, Dr. Ed Bekeris and Dr. Michael Hawkes meeting with Community Health Workers

Vanessa Churchill, Dr. Ed Bekeris and Dr. Michael Hawkes meeting with Community Health Workers

Jumbo everyone!

We had a great first full day at Fluorspar.  So good to be back here.  After a lovely breakfast at the main house we left for the clinic.  The morning began as always with medical rounds.

One of the cases was a mother of two-month old twins who were quite ill.  While on the way to the clinic one of the twins died.  A heartbreaking outcome to say the very least.   And my main observation was how stoic the mother was during the examination of her surviving baby.  No emotion and even managed a smile at one point.  I think a testament to the strength of character and resiliency of the Kenyan people.

The surviving twin was diagnosed with possible sepsis, which is a life-threatening condition with neonatal babies.   He will be treated with very strong antibiotic and will be monitored closely over the next 2 weeks.  Dr. Michael is cautiously optimistic for a full recovery.

Dr. Sidiqa was busy with the final screening on the first 15 patients who will receive cataract surgeries tomorrow.  3 patients unfortunately were turned away as they had a secondary condition which would likely result in them having worse sight if we had done the surgery. 

Medcan Naweza donated to the clinic an opthalmoscope, which is used to look in the back of the eye and better enable them to provide general eye health examinations.

Dr. Sidiqa training Noah and Jemimah on the ophthalmoscop 

Dr. Sidiqa training Noah and Jemimah on the ophthalmoscop 

Dr. Sidiqa began training Jemimah and Noah on the opthalmoscope as well as other general eye health.

Vanessa met with two community health workers (CHWs): Helen and Alan.  The afternoon was spent presenting the chronic disease kit that they will use to educate the community when they go door to door to assess their risk of chronic disease.  As a refresher, the CHWs are currently assessing the risk of chronic disease in their community by utilizing an SMS program that we’ve developed.  They input 5 data points into their phone and transmit the data to the computer that resides at the clinic.  Within 30 seconds the computer will send via an SMS message whether the patient is a green, yellow or red risk, each of which requires a different treatment strategy.

Now that we’ve identified the at-risk patients, our next step is to develop an electronic medical record (EMR), which will help us manage the patients that require treatment and follow-up.  We’ve met with the developer who helped us write the risk assessment program and he has now begun the development phase of the chronic disease management EMR.

We had an interesting discussion with the CHWs where they openly talked about the issues in their community.  A big challenge is motivating the children to go to school when they have friends who have already completed school but are not able to find a job.  They wonder why would they burden their family with paying for school fees when they won’t be able to be employed afterwards.  It’s a never-ending cycle perpetuating itself.

One funny story the CHW shared with us was when he went to a home of a community member who he was going to examine for the chronic disease program.  Apparently a popular yet illegal local brew is called Busaa.  The house in particular actually brews Busaa and sells it, an unofficial local bar of sorts.  In fact that is one of the reason the CHW went there as it would be full of people who may be at risk for chronic disease, exactly his target market!  As he was taking the blood pressure of one of the “customers” the police raided the house, and the woman whom he was measuring ran off with the blood pressure cuff still on her arm!  So he ran a ½ a kilometer to catch up to her to get his cuff back.  He had to convince her that the police weren’t chasing her anymore so that she’d stop running.

This particular CHW, Alan, is quite a resourceful guy and his community has nicknamed him “Google” as they are constantly asking him questions and he researches them and comes back with an answer.

It will be good citizens like him that will be critical to the success of our initiatives.  We’ve learned very quickly that we must go to the community and not wait for them to come to us in order to make an impact.

The next project will involve having the CHWs go door to door to identify HIV positive patients via a point of care diagnostic which reveals whether a person is positive within 20 minutes.  Alan has already tested 450 residents of his designated villages with 6 testing positive and 2 who were reconfirmed positive.

These patients will now be put on the life saving drugs that are provided for free by the Kenyan government.

Tomorrow, Dr. Paul our dermatologist arrives and will be working alongside Dr. Michael conducting a scabies clinic for children.  And the first of 2 days of cataract surgeries will begin.  A full day with lots more to report and stories to share.

Thanks for reading.