It is more than the beautiful game (football). It is about our community and how we can support each other. Much gratitude and appreciation to our ‘rivals’, Marenyo Football Club (FC), who took time to conduct a free clean up in our compound at the hospital.
Many thanks to the Marenyo FC officials, Edward Achola (Chairman), Lucas Omollo (Team Manager), Noah Otenda (Assistant Team Manager), Allan Pudo (C0ach), George Obare (Assistant Coach) and Michael Otieno (Secretary), for helping to lead their players. Also many thanks to our Sagam Community Hospital (SCH) FC officials in Javan Ogoch and David Masiime (Nyayo) for the coordination.
Tuko pamoja (we are together).
The African Institute for Health Transformation (AIHT) at Sagam Community Hospital (SCH) was a significant participant when Siaya County held its first Health Scientific Conference from 18th to 20th of September, 2018 at Jaramogi Oginga Odinga University of Science and Technology (JOOUST) in Bondo. This was also the very first such conference by any County since the devolved system of governance was established in Kenya.
The well attended conference was officially opened by His Excellency (H.E.) Governor Mohamed Kuti of Isiolo County, the Current Chair of the Council of Governors Health Caucus. The opening ceremony was also graced by Siaya County’s Deputy Governor, Dr. James Okumbe, Siaya County’s Minister for Health, Dorothy Owino, the Siaya County Chief Officer for Health, Dr Omondi Owino, Siaya County’s Director for Health, Dr. Kennedy Oruenjo, Senior Health Sector Directors, JOOUST administration, Development Partners and Heads of NGOs active in the County. SCH’s founder, Prof. Khama Rogo, also provided a guest address during the opening ceremony. Prof. Pankaj Jani, President of the College of Surgeons in Eastern, Central and Southern Africa (COSECSA), gave a guest address on the prospects for decentralized Collegiate training of Surgeons in the Counties.
AIHT was active and visible: Prof Khama Rogo gave the key note address reminding the County of its historically large skilled human resource base in the health sector and its inverse proportion to the poor heath indices. He urged the County leadership to adopt innovative ways of involving this group, as they had a lot to contribute and were willing and ready to do so at no cost.
AIHT also presented six scientific papers and sponsored a well attended 2 hour plenary symposium on its research and innovation, ably facilitated by Debora Rogo, Sagam Hospital Manager and AIHT Board Member. The symposium was a collaboration of its founding organizations (SCH, the Kisumu Medical and Education Trust (KMET) and Massachusetts General Hospital (MGH)) and various other partners such as Medtronic Labs and Pharmaccess Foundation. The papers presented at the symposium included the following:
- Ketamine anesthesia package to support OB-GYN operative procedures when no anesthetist is available (presented by Dr. Mary Anne Nyamogo of SCH);
- Scaling and Sustaining Maternal Health Innovations: A Systems Analysis of The Uterine Balloon Tamponade (UBT) program in Kenya (presented by Brenda Ochieng’ of KMET);
- Diagnoses from an Emergency Care Center in Rural Kenya (presented by Dr. Richard Luate of SCH);
- Feasibility of a Rapid Response Team in a Resourced-Limited Setting in Rural Kenya (presented by Dr. Charles Ochola of SCH);
- Using Innovative Mobile-Based Technology to Bridge the Gaps in Chronic Disease Management (presented by Washington Dinga of Medtronic Labs); and
- Feasibility of an Online Interactive Platform for Continuous Professional Development for Healthcare Providers in Kenya and beyond (presented by Debora Rogo of SCH).
In addition, AIHT also presented 3 other abstracts in other sessions during the conference. These included the following:
- Behavioral and contextual barriers to optimal UBT use among skilled birth attendants in Kenya (presented by KMET);
- The Innovative Health Exchange Platform M-TIBA can help leapfrog access to better care on Western Kenya (presented by Millicent Olulo of Pharmaccess Foundation); and
- Assessing Wearables for Monitoring of Pregnant Patients with Hypertension in Siaya County (presented by Molly Guy of Medtronic Labs).
The highlight of AIHT participation was the display kiosk, shared between SCH and KMET. KMET displayed their highly acclaimed ESM – Uterine Balloon Tamponade (ESM-UBT) for management of Post partum hemorrhage. Sagam Hospital displayed the ESM=Ketamine innovation for use where there is no anesthetist. This technology is already in use in ten Counties, following provider trainings at Sagam and full endorsed by KOGS. The Province of Saskatchewan in Canada has also recognized the technology and has sent two clinical groups for training in at Sagam. Another innovation on display was ESM- NRB, a simple technology for newborn resuscitation, and the Empower Health app by Medtronic Labs that is being implemented at SCH towards management of hypertension. Medtronic Labs also included information on the new Maisha Mapya pilot program, which they are implementing with SCH to assess whether technology can be used to monitor blood pressure in hypertensive pregnant women. The displays kiosk was always inundated by curious health workers and managers, anxious to learn more about the new technologies and their applications.
Another popular attraction was information on the weekly free outreach services that Sagam Hospital runs on request from local community groups. Tens of participants were anxious to make use of this facility and were advised on how to apply.
Additionally, Prof. Jani and Jaymie Henry joined Prof Rogo in a meeting with Health CEC to discuss surgical training in the County. They agreed to sign an MOU to support training of Surgeons and Gynecologists using the joint resources of Sagam Hospital and the Siaya County Referral Hospital Hospital. The parties will raise additional resources to invest in this endeavor.
The three days of the conference felt like a whole month due to the heavy workload. AIHT flag flew high and attracted many new fans and admirers.
All this could not have happened without the hard and untiring efforts of the Sagam and MGH team. Many thanks to Benson Sewe, Javan Imbamba, Dr. Richard Luate, Dr. Charles Ochola, Dr. Khama Rogo, Dr. Mary Anne Nyamogo, Juddy Odhiambo, Fredrick Owino, Sebastian Suarez, Brenda Ochieng’, Molly Guy, Washington Dinga, Eric Angula, Chemuttaai Lang’at, Millicent Olulo, Leslie Ojeaburu and Sebastian Karlson. We also with to thank the Medronic Labs team and Pharmaccess Foundation, who were part of the AIHT team. AIHT owes them sincere gratitude. Special thanks also go the County health leadership, the conference organizers, Prof Jani and Jaymie Henry for making time to participate.
We all look forward to next year’s conference- better and bigger. AIHT will be there!
On any graduation day, graduates are made to believe that all of them have the same level of knowledge and skills. Soon after, however there is a rapid divergence and you may be lagging far behind your graduating class, even your best friend.
CPD is important because it ensures you are competent in your profession. It is a continuous process, throughout your professional carrier. The ultimate outcome of a well-executed and effective CPD is to safeguard the PUBLIC, the EMPLOYER, the PROFFESSION, the PROFESSIONAL and his carrier.
CPD can be mandated by law or regulation but, at the core, it is a personal responsibility of every professional to maintain optimum levels of current knowledge and skills that enable them to deliver the highest quality of services, that safeguards the public and meets the expectations of clients and requirements of the profession.
CPD should be engaging and fun to do. CPD must be relevant.
That is why the African Institute for Health Transformation at SCH (AIHTSagam), in collaboration with Machealth, the Division of E-Learning Innovation at McMaster University and Kenya Medical Practitioners and Dentists Board (KMPDB) launched its online CPD platform for Kenyan doctors on Friday, September 21, 2018, at the KMPDB Centre, Nairobi. The grand occasion was video-linked live with McMaster University, Hamilton Canada, with Prof. Anthony Levinson and Rosa Kovalski in Ottawa. There was a full house in Nairobi, led by the CEO of KMPDB, Dr. Daniel Yumbya and Chair of the Kenya Medical Association, Dr Jackie Kitulu. All the ten national health regulatory councils and associations were present as we plan on expanding the online CPD platform to other cadres of healthcare workers such as laboratory technicians, nutritionists and clinical officers. Prof. John Adwok, Chair of the South Sudan Medical Council urged AIHT to extend the online CPD service to SS health professionals immediately after the launch.
As part of the presentation, AIHT Sagam was able to demonstrate how the platform works in real-time. We wish to thank Dr. Walter Obita, Mr. Duncan Mwai, Mr. Crispus Muthiani and Mr. Isaiah Opondo (together with Ms. Kovalski, Prof. Levinson, Dr. Khama Rogo and Dr. Lucie Rogo) for their support in getting the hub and the launch up and running.
The new online service offers intensive courses written by professionals for professionals and opportunity for thoughtful interaction with peers, both in Kenya, the region and beyond.
To sign up or find out more, please visit the AIHT Sagam website or copying and pasting the following url into your browser: www.aihtsagamhub.com
The following AIHT updates were shared with us by courtesy of SCH founder, Professor Khama Rogo.
AIHT shares innovations with Zimbabwe
The AIHT experience was recently presented at Victoria Falls during the annual conference of the Association of Health Funders of Zimbabwe (AHFOZ). The photos below aptly represent the determination of AIHT to share the PP in health experience and innovations with like minded networks across Africa, from Lake Victoria to Victoria Falls!
AIHT Sagam at the 6th Quadrilinial conference of ECSACON
Nearly 1000 nurses from 16 African countries and beyond, recently gathered in Nairobi for the East Central and Southern African college of Nursing (ECSACON) Conference. All global and regional nursing royalty were there, including the current President (Kennedy from Ireland) and Past President (Judith Sharman from Canada) of International Council of Nurses (ICN), the President of ECSACON (Susan Otieno), and President of JHPIEGO (L. Mancusso). Near Kiereini, the first and only black president of ICN, former Chief Nursing Officer in Kenya. They both graced the occasions together hinders of senior nurses from the country and region.
The ‘Nightingale’ procession and candle lighting were events to behold.
Professor Khama Rogo chaired a special two hour stimulating Presidential round table at the plenary before the official opening by Kenya’s Deputy President. Both Siaya and Kisumu counties were well represented by strong delegations, led by the first lady of Kisumu County, H.E. Dorothy Nyong’o. Mrs. Nyong’o comes a historically formidable nursing family. Both, her mother and aunt were pioneer nurses at Kenyatta National Hospital. AIHT was at hand to attend to accompany the County delegations and display our UBT innovations through the well visited KMET stand.
The pictures below help to tell the story.
After a two-week hiatus SCH’s community outreach program will continue this Wednesday, the 19th, at Ulumbi. During our outreaches we strive to provide health services to rural areas that may not have the same access that many others have. We will set up at the church in Ulumbi (near Yala town) and are kindly asking for people or organizations to join us as partners on the day. If you are interested, please contact Javan Ogoch at 0719893544. Thank you in advanced.
Every Second Matters for Mothers and Babies Ketamine (ESM-Ketamine)™ Anesthesia Training Program: The training program for this life-saving, award-winning safe anesthesia solution in areas of Kenya with limited access to anesthesia services is housed at the African Institute for Health Transformation (AIHT). AIHT at Sagam Community Hospital (SCH) was excited to host trainees from Kisumu County for September’s Ketamine Week. The team from Kombewa (in Kisumu County) consisted of three registered nurses, a Clinical Officer (also trained as an anesthetist) and a medical officer.
This month’s Ketamine week started with a slight hiccup as there were some logistical issues on Monday (the traditional start of Ketamine Week). Because of that, only one member of the Kombewa team was able to start training then, with the rest all arriving on Tuesday morning. Despite the shorter week than usual, the trainees got some excellent hands on experience in administering Ketamine. There were 21 surgeries performed last week including four successful emergency cesarean sections.
After a busy week full of lectures, surgeries, a pretest and a posttest, all of the team members from Kombewa were successfully trained as Ketamine providers. In celebration of this we held our traditional graduation ceremony on Friday evening to conclude another successful Ketamine Week. In this ceremony we presented the former trainees with their Ketamine certificates, danced, and enjoyed some cake.
We would like the SCH staff for working so hard during this Ketamine Week. Also thank you to the Kombewa team who were able to come on short notice and were excellent students. SCH is very proud to have accomplished our goal that we were given earlier last month. We intend to build on this successful Ketamine Week with more in the future.
Javan Imbamba, Clinical Officer, Ketamine Champion (SCH)
Wenslaus Adenya, Clinical Officer, Ketamine Champion (SCH)
Juma Jaqtone, Anaesthetist (SCH)
Our surgical staff
Dr. Taha Yusufali, Chief of Surgery (SCH)
Dr. Nyamogo, OB/GYN consultant and Assistant Team Leader for the ESM-Ketamine Project
Lucy Atieno, Surgical Tech
Samuel Orondo, Surgical Registered Nurse
Kashmir Owino, Surgical Tech
Grace Sawanda, Surgical Nurse
Additional staff members;
Debora Rogo, General Manager
Juddy Odhiambo, Administrative Manager
Leslie Ojeaburu, Program Coordinator
Phoebe Kelleher, Program Coordinator
Sebastian Karlson, Assistant Program Coordinator
Dr. Solomon Orero, Team Leader for the ESM-Ketamine Project
For more information on AIHT please visit our website by clicking here.
This article was written by Sebastian Karlson.
Everyone is aware that some days can get off to a rough start, but it’s important to not let that dictate how the rest of your day goes. Last Wednesday the SCH outreach team had a bit of rough start in the morning when our ambulance got stuck on the side of the road right in front of the hospital. It put the team a bit behind schedule but knowing that we had patients waiting on us in Ugunja, our main driver, Fred Owino, promptly towed the ambulance out and we were soon on our way.
Last week’s outreach was special for several reasons. Firstly, we were joined by a team from Metronics, one of our spongsors that help make outreach a possibility. Secondly it was Elizabeth Ogada’s (our Matron) last ever outreach. You can read more about her by clicking here. In addition to both of those things we were also joined by Kathy Tate-Bradish, a Rotarian from Evanston Lighthouse Rotary Club.
Despite the morning’s delays we arrived to Ugunja at around 10:00 AM and found a place that we could park our trailer before swiftly setting up to make up for lost time.
Although we had a bit of a stuttered start in the morning the rest of the day went rather well for our outreach team. We were fully prepped and seeing patients by 10:15 AM. Throughout the day we were able to register 151 new patients. 110 of them were screened for high blood pressure while 49 more were tested for HIV. 12 patients received family planning services while 20 women were screened for cervical cancer. 52 patients were also seen personally by a nurse and we even referred one patient back to SCH to receive surgery for free during this week’s Ketamine week.
A big shout out to the Metronics for helping out with this week’s community outreach. Also, a huge thank you to Matron for all her countless contributions on outreach days, it will be difficult to find another outreach leader like her. We would also like to thank the rest of our sponsors that help make days like this feasible (Jhpeigo, Mtiba, HHA, KMET, Odit, Esslor).
This article was written by Sebastian Karlson
“Nurses are the heart of healthcare” – Donna Wilk Cardill
The sun has barely peeked out from behind the horizon as Elizabeth brushes her hands down her blue and white nursing uniform. She exits her home and makes her way down the long winding path leading to Sagam Community Hospital. She stops only to wave and talk to neighbors she has known for years.
Maybe it is her warm smile or her soft yet firm voice, but from the moment you talk to Elizabeth Ogada, you feel the comfort and care that only a good nurse can provide. Elizabeth, or Matron as she is called by the hospital staff, has had plenty of practice in this role – nearly 30 years to be exact. Currently she serves as Sagam Community Hospital’s head nursing director, helping to coordinate nursing services within the hospital and to ensure the cleanliness of the facilities.
“I was born right here in County,” (a subcounty of Siaya County) Matron tells me. Her eyes peering out over her low hanging glasses. Her hands rest gently on the desk in her office at the top of SCH. “This is my home – where I grew up”. I ask her about her family and she laughs. This is the same jovial laugh I have heard through the halls of Sagam in the morning while Matron checks in on the nurses in the wards.
“I was the oldest of eight children,” she continues. “From the start I have always been the role model in the family. The one everyone looks up to and the one who was responsible for making sure all the house work gets done”. This sounds almost exactly like the role of a matron – to be a role model to all of the nursing staff and to make sure essential nursing and sanitation activities run smoothly. I point this out to Matron and she laughs again. “I really didn’t connect it until now but that is what I have been doing all along, since childhood”.
Matron has wanted to be a nurse since standard E6 when she got sick and was cared for by several nurses in her local hospital. After she finished school, she enrolled in nursing school and received her nursing certificate. Later she would go back for her nursing diploma. For Matron, the hardest and most important part of being a diploma nurse is the critical thinking that is essential in every patient interaction. “You have to ask why you are doing things and sometimes you find yourself rubbing shoulders with others because you want to have more information”.
After nursing school, Matron rose through the ranks. She served as a registered community health nurse, then as a nursing officer in charge of the wards, before being promoted to a senior nursing officer in charge of many hospitals in the sub county she was working in at the time. Eventually she made her way back home to Gem, where she took on her current role at Sagam.
Being a nurse has changed Matron in many ways. Initially a very shy person, she has learned to build interpersonal relationships with her other nurses and patients. As a leader in the hospital, she has learned how to motivate her staff and evaluate their performance. She has developed a keen eye for identifying personal difficulties her nurses might face that negatively impact their work and has learned to handle those challenges in a caring and discreet manner.
During her time at Sagam, Matron has been essential in separating the role of the sanitation staff and the nursing staff. She has also been an active leader of the outreach team. With her guidance, SCH outreach has grown from just seeing a few patients every Wednesday, to caring for more than a hundred members of the local communities each week.
“The first time we started outreaches, we would just go somewhere and take outreaches there. But nobody would turn up. Eventually we talked to our community health volunteers and told them that each of them should invite outreaches to their homes. So, when we went to those locations for outreach we would find that these volunteers have mobilized people.” Matron continues, leaning back in her chair. “Through the family planning and the health screens at outreaches, I have seen women who thought they were sterile, give birth to children. We have managed to bring others who can’t afford care for our ketamine weeks.” It is clear that Matron takes great pride in Sagam Community Hospital and its dedication to communities around Siaya County. There is a lot to be proud of. In 2018, the SCH outreach team has already seen 2393 patients, given blood pressure screens for 2093 people, and seen over 800 patients for family planning services. All of this has been possible because of Matron’s leadership and that of the other members of the team.
We at Sagam Community Hospital thank Elizabeth “Matron” Ogada for her hard work and dedication to the Sagam community.
This article was written by Leslie Ojeaburu
At 12 pm, Friday, August 24th the AIHT classroom was filled with over 80 young women from around the community. This was the third installment of Sagam’s reproductive health talks. This talk, however, was unique. Not only would this event be led by a female sex educator from KMET, but the group would also be joined by the Siaya County Woman’s representative and members of the Sagam Rotary Club.
The event started with a demonstration from Cecilia, one of the outreach nurses, on how to use the sanitary pads donated by Skylark. This was followed by a presentation from Caroline Nendez, an educator on sexual reproductive health interventions. Caroline will be joining the outreach team in the coming months as they reach out to young girls in the community. She was an engaging speaker, interacting with the crowd of teenagers to young adults like an older, knowledgeable sister. She showed the girls various forms of contraception and birth control – highlighting the benefits and downsides associated with each intervention. In addition, she led a fascinating demonstration on the proper use of male and female condoms. Many in the crowd, both young and old, had never seen a female condom before and found her presentation to be truly eye opening. This demonstration, coupled with the free condom’s available through the Comprehensive Care Clinic at Sagam Community Hospital, will be crucial in preventing under-aged pregnancies.
The girls then had the opportunity to ask questions. Many of these young women were truly looking to understand and engage with the material. One girl asked about the effectiveness of each type of contraception at stopping pregnancy. Caroline answered in stride, categorizing contraception into the natural methods and therapeutic/mechanical methods. She highlighted the downsides of natural methods like withdrawal or calendar tracking, noting that extra vigilance and partner cooperation is needed for these to be effective.
Before any other questions could be asked, Christine Ombaka, the Women’s Representative of Siaya county entered the room. She was accompanied by Otieno Siguru (MCA of Gem Sub-county), members of the rotary club, and Dr. Khama Rogo (Sagam’s founder). After introductions, Dr. Rogo gave a brief address reminding the girls that they play an integral role in the future of Sagam community. He encouraged those present to strive for greater civic and community engagement. After this address, Elizabeth Ogada, Sagam’s matron gave a brief presentation on the Sagam outreach team. This was followed by a brief introduction on the origins and accomplishments of the Reproductive Health Talks by Javan Ogoch. The MCA of Gem sub-county also briefly highlighted how proud he was of the Sagam Outreach Team – noting the importance of continued community support for Sagam’s young women.
Christine Ombaka then took the stage. A previous visitor of Sagam, Ms. Ombaka commended the hospital for interacting closely with the local community and for driving cervical cancer and HIV screening around Siaya county. She also offered her knowledge and experience as a teacher and video producer to help with future reproductive health talks. Finally, Christine Ombaka summarized the various initiatives around Siaya that she has played an integral role in creating. Most relevant was the new legislature that limits marriages to individuals above the age of 18. This law helps to protect under-aged pregnant mothers from forced marriages, allowing many to finish their education. Finally, she encouraged the girls to join community groups and to continue offering ideas for community improvement. With those final remarks, the third Reproductive Health Talks ended with refreshments and mandazi.
Sagam Hospital sincerely thanks Christine Ombaka, Otieno Siguru, and Caroline Nendez from KMET for taking part in this important outreach effort. We look forward to continued partnership with the Siaya County government, Skylark, and KMET to drive improved sex education within Gem sub-county.
A day long ceremony attracted a large crowd of over 4000 at Diemo Primary School earlier this August on the 9th. The event was held as part of the National United Healthcare program (UHC). The National UHC is aimed at ensuring universal healthcare for all citizens of Kenya. This is also one of President Kenyatta’s ‘big four’ priority programs that he said the government would prioritize in 2018 during his reelection speech. The other programs include food security, affordable housing, and manufacturing.
His Excellency, Governor Peter Anyang’ Nyong’o of Kisumu led the ceremony along with the county cabinet and legislators. During the day, the Nation Hospital Insurance fund (NHIF) introduced their brand-new registration process with the help of Mbita technology, Pharmaccess Foundation, and Safaricom. Together they registered over 5000 households in only 5 days! The governor and his team also paid a visit to Kombewa Sub-County Hospital, which will be the service delivery hub in the area. The hospital’s OR is still under construction and many gaps were identified when evaluating the services the hospital could be expected to provide. Among the largest problems discussed were the lack of emergency and surgical services.
Currently, the hospital does not have an anesthetist available, so a temporary solution was identified involving Sagam Community Hospital. SCH agreed to help establish surgical care at the facility within four weeks. In addition, SCH was tasked with identifying an interim space within the hospital to serve as an operating room. SCH also intends to train Kombewa Sub-County Hospital staff members during the next ESM-Ketamine training week and will continue to coach the onsite resident doctor on basic surgeries, including cesarean section.
SCH is excited about this collaboration with Kombewa and looks forward to training Kombewa’s staff members in administering Ketamine during the first week of September.
This is a giant step for both SCH and ESM-Ketamine.
This article was written by Sebastian Karlson