Day 7 & 8: Cross-Discipline Health Agenda for Fluorspar Community

After a quick flight, we have arrived at Fluorspar, our other sister clinic in Kenya. 

We have a packed agenda for the week including:

  • cataract surgeries
  • cervical cancer screening
  • community health worker evaluation
  • chronic disease program review
  • didactic training on requested topics
  • nutrition counseling
  • women’s health
  • eye health
  • outreach
  • peadiatrics
 Rahema, a clinical officer at the clinic, during our first day of rounds. 

Rahema, a clinical officer at the clinic, during our first day of rounds. 

Yesterday we arrived at the clinic to a warm welcome from the staff.  It was so good to see them again and hear all that has been happening in their community.  We quickly reviewed the itinerary for the week and Alex gave an overview of nutrition and how she planned to support the doctors throughout the next few days.  We then immediately saw patients for the next hour that provided excellent teaching points for the clinicians.  Nothing like getting right back in there and wasting no time.

 The Fluorspar clinic team presenting a case to Naweza doctors. 

The Fluorspar clinic team presenting a case to Naweza doctors. 

Patient Rounds
So today we began with rounds as always at Fluorspar.  Different from Lewa, Fluorspar is an in-patient clinic and always seems to have patients who have stayed the night.  Since yesterday, we’ve seen several patients including type 1 and 2 diabetics, a pregnant woman with abdominal cramps, a woman who just delivered a healthy baby as well as a 9-day old baby with neo-natal sepsis.  Neo-natal sepsis is a life threatening infection in a baby occurring within the first month of life.

 This baby is 9 days old and suffering from neo-natal sepsis. Dr. Michael is providing training on prevention, diagnosis and treatment for this life threatening condition. 

This baby is 9 days old and suffering from neo-natal sepsis. Dr. Michael is providing training on prevention, diagnosis and treatment for this life threatening condition. 

The mother was holding vigil over her baby when we came in and seemed to be intently listening to everything Dr. Michael was saying in hopes that he could help.  Although the baby seems to be improving with the intravenous antibiotic, there’s a risk of delayed development, seizure disorder and hearing loss.

Cataract Surgeries

 Dr. Sidiqa, Jemimah and Noah discussing how the cataract surgeries will work tomorrow. It was also an opportunity to review how the weekly vision clinic is going. 

Dr. Sidiqa, Jemimah and Noah discussing how the cataract surgeries will work tomorrow. It was also an opportunity to review how the weekly vision clinic is going. 

The optometry team had a debrief yesterday in anticipation for the cataract surgeries scheduled for today and tomorrow. We’ve sponsored 2 surgeons and 2 assistants to do the screening and the actual cataract surgeries.  Last week they screened 327 people and found 50 who are eligible for the procedure.  Today they did 30 surgeries and tomorrow another 20.  It’s the first time cataract surgeries have been done at Fluorspar and the staff seems very excited. 

 Cataract surgeries being conducted at the Fluorspar Clinic. They will perform 40 surgeries in 2 days. 

Cataract surgeries being conducted at the Fluorspar Clinic. They will perform 40 surgeries in 2 days. 

I had the opportunity to observe an actual surgery today.  Really incredible.  And remarkable they are able to do this here.  The surgeons are working side by side while the assistants are prepping the patients in an adjacent room.  They are extremely professional and super cool under pressure.  The staff at the clinic are assisting with the surgeries which is an amazing opportunity for them.  They will also learn about post-op follow-up which is crucial to the success of the surgery.

 The cataract patients lined up waiting to be prepped for the procedure. 

The cataract patients lined up waiting to be prepped for the procedure. 

Cervical Cancer Screenings  

Dr. Sue is working with Samuel and Rahema doing cervical cancer screening.  They’ve seen 21 women and luckily all had normal results.  Usually you would expect to see about 10% of abnormalities but this group is luckily healthy. 

 Two members of the Fluorspar staff prepare supplies for the cervical cancer screening. 

Two members of the Fluorspar staff prepare supplies for the cervical cancer screening. 

It actually proved to be a good opportunity to discuss how certain “normals” can look abnormal and knowing how to distinguish between the two so that you don’t treat the lesion unnecessarily.

Nutrition Awareness
Alex had an opportunity to speak with several patients about their diets and give her recommendations.  She also met with the chef of the clinic to better understand the food that is served at the clinic.  She asked what his recipes were but he said that he doesn’t follow any.  So she has decided to work alongside him tomorrow so that she can see how and what he prepares.

 Helen and Faith, two of the three community health workers we've hired at Fluorspar Clinic in order to support the chronic disease program. 

Helen and Faith, two of the three community health workers we've hired at Fluorspar Clinic in order to support the chronic disease program. 

Chronic Disease Program
e also had the opportunity to meet with 2 of the 3 community health workers we’ve hired for the chronic disease program.  Helen was the original hire who did an incredible job organizing a strategy on how to collect data on all of the people in her community who are over 40.  She has almost collected data on 450 people, which represents about 90% of her community. 

 Helen's notes on who to follow up with for the chronic disease program. 

Helen's notes on who to follow up with for the chronic disease program. 

Helen's work went way beyond our expectations.  So we’ve decided to continue the relationship and she will now train all of the new health workers.  We’ve already had her train Faith who has collected data on about 200 people.  And we just hired a male health worker named Alan.  Helen will train him as well. 

 Helen and Faith share their record books on their chronic disease patients with Dr. James and Dr. Michael. 

Helen and Faith share their record books on their chronic disease patients with Dr. James and Dr. Michael. 

The cost of a health worker is about 10,000 ksh/month or about $100 USD.  If you get a good one, like Helen, they are worth their weight in gold.    Her next step after she has collected the data is to follow-up with all of the patients who scored non-green.  The ultimate goal is to find those people at risk of chronic disease and provide the treatment to them before a cardiac event occurs.  Again, these are patients who are asymptomatic and have no idea they are at an elevated risk.

Highly Productive First Day

It was a highly productive first day and tomorrow will be much of the same with more cataract surgeries and cervical cancer screening.  The patients who had their surgeries today are actually sleeping at the clinic to be checked first thing in the morning.  It will be very exciting taking their patches off tomorrow and seeing their reactions when they are hopefully able to see again!

That’s all for now….thanks for reading!

- Stacy