This week, Sagam Community Hospital (SCH) took their outreach team to Kambare, roughly 40 minutes from Sagam. There was a great turn out where 185 community members sought preventative care. After over 6 hours of seeing patients, our team was ready to head home.
There were 165 blood pressure screens with 47 referrals to SCH, 88 HIV tests, 42 cervical cancer screens with 3 SCH referral, and 15 Vitamin A tablets distributed. This week, we would like to highlight Dr. Mindy Sherman, an Emergency Pediatrics specialist, and Hanna Haiver, a 4th year American medical student for seeing 100 patients during outreach!
One of our newest developments with outreach is providing eyeglasses at a low cost for the community, thanks to Vision 2.5. We are increasing our efforts in helping those with limited or poor eyesight!As always, we would like to thank our partners, KMET, CHAK, Jhpiego, M-Tiba and Visions 2.5 for their efforts in making these outreaches possible. Let’s see if next week we can see over 200 community members on outreach!
This week Sagam Community Hospital (SCH) traveled to Asembo for community outreach, approximately one hour from SCH. Asembo is a rural town that consists of primarily farmers and fishermen from lake Victoria. The village was very welcoming to Sagam as the day started with prayer and hymns inside their local church.
The turnout was fantastic as 221 community members were registered in total. 128 people tested for blood pressure, 37 examined for HIV, 32 were consulted on family planning, and 35 women took part in cervical cancer screenings. Clinical officers saw 96 total patients throughout the outreach, ranging from small children to elderly parents.
SCH was thrilled with the warm reception in Asembo and is looking to come back in the near future to continue to provide quality care to the community members. SCH looks forward to expanding the Community Outreach program with our partners Jhpiego, M-Tiba, Vision 2.5, and the Kenyan CDC.
“Every person has the right to the highest attainable standard of health, which includes the right to health care services, including reproductive health care… A person shall not be denied emergency medical treatment… The State shall provide appropriate social security to persons who are unable to support themselves and their dependents.” – Article 43 of the Kenyan Constitution 
Do Kenyans have a right to healthcare? Yes, the people of Kenya maintain a statement of solidarity to their fellow citizen in providing high benchmarks in quality and access to care. A new constitution has put Kenya on a path to improving the equity of medical attention provided to its citizens. While the foundations of Kenya’s government recognize the inherent right of each citizen, many institutional and societal challenges face the growing nation on its mission to empower all Kenyans with healthcare.
In a historic 2010 vote, 67 percent of the Kenyan people ratified a new constitution that enhanced their individual rights and autonomy . The constitution states that both rural and urban inhabitants of Kenya have a right to the highest attainable standard of health, including the right to reproductive care . In articles 53-57, the constitution enumerates the rights of specific peoples including children, individuals with disabilities, and other marginalized citizens . Another key element of the Kenyan Constitution is devolution of power to 47 counties, each overseen by a governor. Under the belief that a more accountable and personal decision-making process will improve healthcare, the Kenyan government has empowered these county governments to service their communities with medical services, pharmacies, ambulances, and the promotion of primary health care .
The majority of Kenyan’s derive their right to healthcare by financing care via the National Hospital Insurance Fund (NHIF). Formed in the 1960s, the NHIF is the oldest government medical scheme in Africa . The NHIF is a mandatory tax for those in formal employment, and is an optional fee of 500 Shilling per month for those in informal employment; in 2016, 25 million Kenyans are benefitting from the program ,. The government has also undertaken initiatives to specifically focus on child and maternal care by guaranteeing a child’s right to hospital admission and the new Linda Mama platform. For all children under the age of five, the government has ensured their right to free healthcare through all public hospitals; consequently, the mortality rate for children has drastically improved . Launched in 2016, Linda Mama will provide expecting mothers with postnatal and antenatal clinics, as well as yearlong child health services in public and private hospitals; the program aims to serve 400,000 women .
In Siaya County, Sagam Community Hospital (SCH) is evidence of success at the local level. By undergoing infrastructure and community investment SCH is able to provide its patients with their right to efficient and quality care. SCH upholds an expert staff of trained clinical officers, an efficient acute response service, and frequently host’s trainings and foreign doctors dedicated to providing care in a rural setting. Recently, from June 1-3, doctors from Nairobi traveled to SCH in an effort to conduct Laparoscopic surgery training. Furthermore, SCH is partnered with Massachusetts General Hospital in the United States to conduct research and exercise best practices to improve the public health of Siaya.
In concert with the excellent care provided at SCH, the hospital frequently ventures into neighboring communities as a part of an initiative known as Community Outreach. The program often sees over 200 patients in one outing, offering services that include cervical cancer screenings, HIV testing, blood pressure assessments, and eye examinations. The Community Outreach enriches the knowledge and overall health of surrounding villages; subsequently, saving many lives.
While Kenya has taken significant strides to improve the lives of its citizens, significant barriers prevent the country from realizing basic healthcare standards. A key barrier to a successful system that plagues all of sub-Saharan Africa is endemic corruption. Corruption strangles the growth of Kenya as it prevents the distribution of healthcare services from reaching the target population. Currently, Kenya is ranked 145 of 176 nations in terms of corruption . Without responsible politicians and institutions, Kenyans will continue to struggle to receive proper care afforded to them in their constitution.
Further barriers to healthcare success in Kenya include access to trained medical professionals and proper infrastructure. The stock of medical professionals in Kenya continues to limit the access citizens have to quality care. For example, Kenya has only two doctors for every 10,000 people, leaving their healthcare system compromised by significant delays; the World Health Organization recommends 23 per 10,000 . Compounding the problem is weak infrastructure throughout Kenya. Often times medical professionals in Kenya are unable to provide high standards of care to their patients due to weak infrastructure. Currently, 17 million people lack access to clean water, 33 million people lack access to improved sanitation, and 40 percent of the population lack access to electricity ,. Without proper infrastructure, Kenya’s healthcare system will not be able to achieve the high benchmarks set by the constitution.
More systemic obstacles to a healthy Kenyan population are severe poverty and deeply rooted cultural norms. Extreme poverty is prevalent in all of sub-Saharan Africa as it debilitates the native population’s ability to access basic human needs, including food, safe drinking water, sanitation, shelter, and education. Poverty will impede a patient’s ability to pay the services associated with healthcare visits, and can even stop patients from traveling to hospitals due to high transportation costs. In addition, cultural challenges persist into the 21st century, as some traditional groups do not believe that new medical technology can be applied in a rural setting. Societal forces can also prevent individuals from seeking medical testing, mitigating the advancements made in HIV and other communicable diseases .
For Kenya to fulfill its promise of a right to healthcare, the national and county governments must end corruption, further invest in the density of medical professionals, and partake in cultural education of health literacy. The 2010 constitution is very clear in its healthcare objectives and outlining the rights of citizens, the next step is for the government to dispense its healthcare resources effectively. Kenya must continue to lead sub-Saharan Africa by overcoming the barriers to quality healthcare; doing so would mean capitalizing on its robust economy and wealth of natural resources to benefit the least well off. It is time for Kenya to follow-through on its constitutional commitments in providing high quality care to all its citizens, regardless of age, ethnicity, disability, or geography.
 Diallo, Mariama. “New Kenyan Constitution Ratified.” VOA. VOA, 05 Aug. 2010. Web. 02 June 2017. https://www.voanews.com/a/kenyas-new-constitution-ratified-100158209/123395.html
 International Journal Of Scientific Research And Innovative Technology, and Vol. 2 No. 1; January 2015. “HEALTH POLICIES IN KENYA AND THE NEW CONSTITUTION FOR VISION 2030.” 2.1 (2015): n. pag. International Journal of Scientific Research and Innovative Technology, Jan. 2015. Web. 2 June 2017. http://www.ijsrit.com/uploaded_all_files/2737275308_g12.pdf
 “Case Study: Kenya National Hospital Insurance Fund (NHIF).” USAID Health Finance & Governance, 9 June 2014. Web. 03 June 2017. http://healthmarketinnovations.org/sites/default/files/
Muema, Morris. “New NHIF Rates in Kenya Finally Take Effect.” Kenyan Business Review. N.p., 04 Nov. 2016. Web. 03 June 2017. http://www.kenyanbusinessreview.com/892/new-nhif-rates-kenya/
 “NHIF Operations.” National Hospital Insurance Fund, n.d. Web.
“Health Challenges Facing the Realization of Children’s Right to Health in Kenya.” United Nations Human Rights Office of the High Commisioner, n.d. Web. 6 June 2017. http://www.ohchr.org/Documents/Issues/Children/Study/RightHealth/
 Odhiambo, Rhoda. “State Launches ‘Linda Mama’ to Target 400,000 Women Delivering at Home.” The Star, 18 Oct. 2016. Web. 6 June 2017. http://www.the-star.co.ke/news/2016/10/18/state-launches-linda-mama-to-target-400000-women-delivering-at-home_c1440376
 “Corruption Percentage Index 2016.” Transparency International, 25 Jan. 2017. Web. 2 June 2017. https://www.transparency.org/news/feature/corruption_perceptions_index_2016#table
 Kushner, Jacob. “Kenya’s Doctors to End 100-day Strike.” USA Today, 14 Mar. 2017. Web. 6 June 2017. https://www.usatoday.com/story/news/world/2017/03/14/kenya-doctors-strike-over/99171746/
 Chumo, Ben. “Kenya’s Electricity Access Rate Now at a Historic 60 per Cent.” Daily Nation, 23 July 2016. Web. 6 June 2017. http://www.nation.co.ke/oped/Opinion/kenya-electricity-access-rate-now-at-a-historic-sixty-per-cent-/440808-3307998-p0whfa/index.html
On Tuesday, June 6th, 2017, SCH had the pleasure of hosting Mr. Frederic Corbasson, the President of the 2.5 New Vision Generation, an Essilor Group Initiative. He visited SCH as part of his tour of Kenya. He was joined by Mr. Raphael Okumu, the Business Developer-Eastern Africa for Essilor.
The purpose of their visit was to meet our community outreach team, who they had trained as Vision Ambassadors on May 23, 2017. Vision Ambassadors have been trained to assess vision and sell eye glasses to members of our community.
Essilor is expanding its services and support for eye care to Kenya and SCH is proud to host one of the first Vision Ambassadors in the country, joining other colleagues in China, Brazil and India.
During the meeting, the Vision Ambassadors were able to share their experience, both successes and challenges, in assessing eye care for the community and selling glasses. SCH’s In-Charge of its Ophthalmology Department, Mr. Martin Audi, also shared how the number of referrals by the community outreach team have increased and also encouraged the team on how their work is helping their community. In addition, we shared our needs for strengthening of our eye department, especially in increasing capacity for our opthalmology department to participate fully in SCH’s weekly outreaches in terms of equipment and staffing.
The Essilor team were also able to learn more about SCH and the African Institute for Health Transformation; their visit was concluded with a song and dance from the community outreach team and a tour of the hospital.
We are thankful for the visit and privileged to have hosted the Essilor team! Karibu tena!
Who is Essilor? Essilor is a french company focusing on eye care and has a corporate responsibility mission to improve eye care and eye sight for the 2.5 billion people across the globe that lack access.
Madaraka Day at SCH was a special one with the launch of our second Laparoscopic Surgery Camp that was supported by the Kenya Society for Endoscopic Specialities Kenya Society for Endoscopic Specialities – KESESand Massachusetts General Hospital (MGH). As a follow-up to the first camp held in September 2016, this camp not only provided much needed surgical intervention for the participating patients but also provided an opportunity for doctors and nurses at SCH and beyond to be exposed to laparoscopic surgery. We wish to to thank the KESES Executive Board Member, Dr. Francis Were, for spearheading the camp. We are proud to have hosted ob/gyn specialists, surgeons, nurses, residents and medical students from University of Nairobi, Kenyatta National Hospital, Moi Teaching and Referral Hospital, PGH Nakuru, Jaramogi Oginga Odinga Teaching and Referral Hospital, MP Shah Hospital, MGH, KESES, University of Massachusetts Medical School and Maseno University’s School of Medicine. The camp was supported by two CO anesthetists, Mr. Dan Kavole and Mr. Jackton Juma and our dedicated theatre staff led by Mr. Samwel Orondo and and Mr. Kashmir Owino, who were also assisted by the visiting nurses from PGH Nakuru, Ms. Veronicah Serem and Ms. Mary Wambui.
In addition, much appreciation to our clinical, theatre, nursing, pharmacy, laboratory, accounting and sanitation staff for their hard work throughout the duration of the camp. Patients and physicians came from far and wide to access and be trained in laparoscopic surgery. We believe creating access to laparoscopic surgery in this area will greatly improve patient experiences by reducing patient postoperative pain and hospital stay. Like last year, the cases were operated on in one of our new theaters built with funding from the Kletjian Foundation and relied on theatre equipment donated by the GE Foundation @GE and the Center for Public Health and Development (both of whom also provided maintenance support for the equipment before the camp began). During the 3- day camp, 8 laparoscopic cases were performed successfully. We would also like to thank KMET (Kmet Kenya) for their logistical support for our participants on the first day and the MGH Global Health Fellows for their participation in the planning of the camp. In addition, much appreciation to Mr. Charles Awiti and Mr. Nyaga Morris of Covidien/Medtronics for provision of the necessary supplies, which also included a donation of several items. We also wish to thank Victoria Comfort Inn in Kisumu and OASIS Hotel in Luanda for hosting our participants. As you can see, this camp is only possible through robust collaborations and partnerships as well as our dedicated staff to provide this important health intervention for the women in our community and beyond. We are planning a third camp in the coming weeks and will keep our Facebook family updated as we finalize plans. This level of surgery is now functioning at Sagam and fully covered for those with NHIF cover. Please visit Sagam Community Hospital or call Juddy at 0721 348 777 for more information about how to access this service or participate in future camps and trainings #laparoscopy#laparoscopicsurgery #surgery #health #healthforall
This week Sagam Community Hospital (SCH) traveled to Kodiaga Market Center as a part of the Community Outreach program. A total of 184 total people received comprehensive services that included : 111 for Blood Pressure, 17 for HIV testing, 17 for Cervical Cancer Screenings, 8 for family planning, 11 for Vitamin A deficiency, 7 registered for NHIF, and 16 registered for M-Tiba.
In addition, 5 glasses were sold and 30 pledges were made to receive a pair as a collaboration with 2.5 New Vision an Ellisor company. The Community Outreach program was made successful by a strong effort by the mobilization team in alerting the community of the servics Sagam Community Hospital had to offer. The expert nurses and medical professionals enjoyed discussing preventative care as the program looks to grow to service more members of the community.
In addition, Sagam Community Hospital welcomed fourth year medical student Hannah Haver and Mindy Sherman from Massachusetts General Hospital. While the doctors are here they will be helping and mentoring our medical interns and joining us for our community outreaches. Sagam Community Hospital is dedicated to providing the best quality care to the people of Sagam and the surrounding communities.
Sagam Community Hospital would like to sincerely thank its sponsors 2.5 New Vision an Ellisor company, M-Tiba, KMET, and Jhpiego for their continued support in providing expert care.
On Thursday, May 25th, Sagam Community Hospital and AIHT hosted a training for their latest innovation to implement in Siaya County. The Every Second Matters New born Resuscitation Bundle (ESM-NRB), a contiunos positive airway pressure (CPAP) device that is commonly used in the rest of the world. However, what makes this device so special is that it costs about 15 USD to create, rather than hundreds or thousands of dollars. In addition, ESM-NRB kit does not require electricity. This was specifically designed to function in low resource setting where power is intermittent. This is essential because according to John Hopkins University, most of the 13 million children under 5 hospitalized for respiratory illnesses live in low and middle-income countries.
We had participants come from Bondo, Yala, Ambira, and Madiany Sub County Hosptials and Sagam Community Hospital to be trained in using the ESM NRB kit, also known as bubble continuous positive airway pressure (bCPAP). During this daylong session, the trainers focused on the practical and theory approach to using bCPAP. The next day, the trainers put their teaching to use in live action at each of their facilities.
We cannot wait to see the positive impact bCPAP has on Siaya County. Massachusetts General Hospital, a founder of AIHT, has also rolled out bCPAP in India and hopes to continue this project in Zambia.
We would like to thank all of those who helped make this training possible:
- Center for Public Heath and Development
- Massachusetts General Hospital
- Master trainers
- and Partners, for their work in engineering
This week, our community outreach team took us to Muhoho, roughly 20 minutes from Sagam Community Hospital (SCH). At this outreach, we were posted in a rural setting outside of a church, where we attended to the local residents.
Thanks to Sagam’s administration teams efforts at mobilization and posting signs for awareness, we had a large turnout this week!
In total, 177 people were seen in six hours. From this total, 112 were screened for high blood pressure and our star clinical officer, Jacqueline Chemem, saw 43 people.In addition, Juliet and Varisty, Sagam’s expert nurses at cervical cancer screening, saw 31 women. We look forward to continue reaching as many people possible during our outreaches, especially in our home county, Siaya. SCH strives to spread the message of how important preventative medicine and screening are! We would like to thank our partners, Jhpiego, CHAK, M-Tiba, and KMET for helping us spread this message!
Over the past 10 days, we have had the pleasure of hosting Dr. Chris Barrios and Dr. Megan Lundeberg from the University of California (UC), Irvine. As renowned trauma and critical care surgeons, they brought a great deal of insight and consultation expertise to Sagam Community Hospital. Recently, Dr. Lunderberg gave a riveting presentation on haemorrhagic shock and trauma. This medical education presentation provided critical information for our Sagam clinicians as we unfortunately see numerous road trauma due to matatus and boda bodas.
A couple of months ago, we hosted Dr. Dolich and Dr. Lekawa, co-workers of Dr. Barrios and Dr. Lunderberg from UC Irvine. The continuous visits from UC Irvine surgeons are for the potential to begin and rollout a surgical fellowship, a global health experience at Sagam. Here at Sagam, we have not only enjoyed their medical expertise but also their gregarious personalities. We look forward to the full implementation of this surgical fellowship at Sagam Community Hospital!
On Tuesday, May 23, 2017, Essilor came to Sagam to train SCH staff and community health workers (CHWs) as Vision Ambassadors.
The one-day training provides training on how to assess eye sight for members of our community and also be able to test for strength of eye glasses, which the CHWs and trained staff will be able to disperse and sell to community members at a subsidized cost. In addition, each trainee has received a full backpack that will include the necessary equipment and posters to assist in vision acuity to help with their work.
We expect this training to be the beginning of a robust partnership with Essilor as aim to strengthen our eye services, both at SCH and in our communities via our outreach programme. We are proud to join the Vision Ambassador programme which is being implemented across the globe from China to Brazil.
We wish to thank Mr. Raphael Okumu, the Business Developer – Eastern Africa at Essilor, for conducting the training.
Who is Essilor? Essilor is a french company focusing on eye care and has a corporate responsibility mission to improve eye care and eye sight for the 2.5 billion people across the globe that lack access.