Day 2: Afternoon - We return to Lewa for the first time in 2018, our 8th time since we started

After a beautiful lunch the team headed to the clinic for the first time on this trip.  We saw many familiar faces and a few new ones.  It was a warm welcome, especially from one of my favourite people, Rosaline, the clinic “go to” person for just about everything.  She came barrelling down the walkway with the biggest smile giving us all big bear hugs.  She even hugged Tania who is new to the team.  So lovely.

We quickly got started with Dr. James’ CME regarding Diabetes and Hypertension.  The doctors have found an interactive approach works the best and pose questions and scenarios to the clinic staff.  It is a good strategy and keeps them engaged.  They have many opportunities to use cases they have encountered at the clinic to get the opinions of our doctors in how they would approach the treatment strategies.  It was a rich conversation and I think everyone found it super helpful.

Emily our Community Health Worker who is screening the community for chronic disease risk was working with Benard, our research representative.  He is auditing our M-Health study, Afya Chat and ensuring that Emily is adhering to the study guidelines.  Emily is actually a new mother of a 3-month old little baby named Leon.  Absolutely beautiful.  However a bit of a challenge for her when she’s trying to focus with Benard.  So I happily stepped in to hold this little doll while she worked with him.  Honestly the sweetest baby.  And we are so grateful (and impressed!) that Emily has continued to work and meet all of her Naweza responsibilities despite the fact that she is a new mother.  A testament to the strength of character of the Kenyan people.

The second CME was spent presenting a first draft of our EMR software program to the clinic staff by Danet.  The purpose of the EMR is to manage the patients that we identify through our SMS technology as at risk of chronic disease. The EMR will enable us to monitor what drugs are prescribed, compliance and improvement in health indicators.  We wanted the clinic staff to be part of this iterative process of constructing the software so that the final package will meet their needs and wishes.  They had a lot of useful feedback that Danet is going to incorporate into the program. He will present the second draft in 1 month and we will again provide more feedback.  We are really excited about the prospect of managing these patients and hopefully ensuring more positive health outcomes than if they continued on with no intervention.

We ended with an 80-year old man who came in complaining of a severe cough for the last 3 days.  He presented with crackling in his lungs and wasting.   Dr. Michael, a communicable disease specialist, was worried that it was in fact TB and warned everyone to that it would be prudent to leave the room as it is highly contagious.  The patient will be tested tomorrow to rule it out and the diagnostic investigation will continue (Update: a blood test ruled out TB). 

Tomorrow’s agenda includes a meeting with Dr. Butt, Lewa’s doctor who comes to the clinic every 2 weeks.  We met Dr. Butt in 2012 when we were on our first trip here.  So after 7 trips we thought it would be a good idea to visit with him again and review our program and plans going forward.

Dr. Sidiqa will meet with the optometrist that Naweza sponsors to come once a month to hold a vision clinic for the community.  He is able to provide prescriptions for glasses utilizing the autorefractor that Naweza donated last year.  He is also able to provide education and counseling on eye health to both the patients as well as Lydia, the clinical officer who is in charge of optometry at Lewa.  His cost is $50USD per month.  A small investment in the eye health of the community.

We will also have 3 CME’s by Dr. Sue as well as Benard who will present findings from the Chronic Disease Program.  Our thought is to maintain a healthy line of communication with the clinic staff on all of our programs and include them in our discussions.  They have the best insight into their patients and and will be our best tool to ensure we are making the most impact with our initiatives.

I'll leave you with a 20 second video filmed in the clinic's courtyard around dusk today as the doctors were wrapping up their consults. Until tomorrow, thanks for reading and lala salama! :)