FAQs - Health Care Services:

In the '60s, AIC owned three hospitals i.e. Kapsowar (90 beds), Kijabe (35 beds) & Lokori (24 beds).  These all served as referral centres for 'curative' care including surgical, medical, paediatric and maternity services.  In addition to these AIC had some dispensaries with in-patient facilities and some small dispensaries dispersed in many remote areas of the Republic, mainly where there were no other Health Care providers.  All these Health Units were essentially giving 'curative' health care

It soon emerged that in areas especially those inhabited by nomadic pastoral tribes, there was a great need for 'Ophthalmic' care, both preventive and curative. Many people were going blind as a result of trachoma caused by flies and unhygienic customs.  Blindness was also caused by lens cataracts.  As people became more literate there was a need for reading glasses.  Initially an AICHM Doctor commenced 'cataract' surgery at Litein and this has continued into a vigorous 'Eye' programme.  Due to the generosity of Christoffel Blinden Mission (CBM) in Germany, AIC was able to embark on a programme of 'Eye' care in other areas.  This included the training of Patient Attendants and later trained Nurses, in a six month course in the CBM Eye Unit in Tanzania and later in a three month course at Kikuyu Eye Unit, Kenya.   Several times per year, CBM funded visiting Eye Surgeons in performing many cataract operations, even in small dispensaries.  At Kijabe an eighteen bed Eye Ward was built, but later CBM developed Kikuyu Hospital, 50 kms away, as the referral centre.  However static & mobile clinics have continued at Kijabe and many other AIC Health Units throughout the country.

During the '60s many infants died of measles and whooping cough.  When a mother was giving her Antenatal history it was not unusual for her to report having given birth to many children and at least half of them having died mainly due to preventable diseases.  So in the late '60s Kijabe began to provide static and mobile services which included immunisation, infant development assessment & health education.  Initially the mobile clinics targeted the villages which had the highest incidence of children suffering from and dying from preventable diseases.  As time progressed and funding became available, integrated static and mobile Maternal Child Health (MCH) clinics were developed at Kijabe & at 16 centres in the surrounding area.  These are visited once per month.  With the excellent Kenya Expanded Programme for Immunisation (KEPI), which included the supply of basic vaccines and training in careful handling and administration of vaccines & maintenance of vaccine refrigerators, the communicable diseases mentioned above are now rarely seen at Kijabe Hospital and in the surrounding area. Other AIC Health Units endeavour to provided similar services.

With the survival of more infants by the '70s, parents were experiencing greater financial difficulty in bringing up their larger families!  Also Kenya had the highest birth rate in the world and the highest birth rate in Kenya was among the Kikuyu people.  Family Planning (FP) then became a major thrust.  The main obstacle to this programme was the attitude of husbands who were suspicious though the women were very eager for the service.  With special training of staff in FP, health education of the communities, and availability of contraceptive methods, including tubal ligation, an impact was made reducing the birth rate and subsequently improving the health status of families.  The AICHM Director, who was also a surgeon, frequently performed tubal ligation in the remote dispensaries during his administrative visits.  In '96, the Kenya Nursing Council approved the practice of qualified nurses in the insertion and removal of 'Norplant' capsules.  Apart from the Doctor training some of the Rural Health Unit staff in this procedure, the programme has not yet been fully developed (2003) in all AICHM Health Units.  Presently the subsidised supply of Norplant is greatly reduced.

A large number of patients who attend 'curative' clinics suffer from diseases and conditions which could be preventable by simple measures, e.g. personal hygiene, safe fireplaces, pit latrines, safe water supply, grass cutting, etc.  In the mid '70s an AICHM Doctor at Kapsowar pioneered Promotive Health Care in Kenya by a programme of training and supporting Community Based Health Workers ( CBHW) to implement simple promotive measures in their own villages.  In the Kapsowar area, within 2 years, this programme had reduced the number of children attending the satellite dispensaries by 50%.  The success of the programme was probably due to the fact that the Doctor had the respect & credibility of the communities after providing 20 years of effective Hospital health care in the area.  Later Life Ministries developed a community based health programme incorporating Scripture teaching.  This was known as Community Health Evangelism (CHE).  This programme had limited success as it was an expensive programme and lost impetus when the Health Ministry staff handed over.  More recently in the '90s, at Litein an effective CHE programme has been in progress which puts the onus on the community and not on the staff who are doing the training & is self-sustainable.  This has also included the training of Traditional Birth Attendants (TBAs), who in Kenya still conduct about 80% of the deliveries of babies. In 1995 the Kenya MOH aided by WHO revised the TBA curriculum and the MOH Co-ordinator of the Programme facilitated a seminar for AICHM nurses. Due to lack of motivation and supervision, it has had minimal effect.  With the appointment (2003) of a CHE Co-ordinator it is hoped that the CHE & TBA programmes will be adopted by most of the AICHM Rural Health Units and so impact the health of community’s country wide.

In the '60s dental care consisted of dental extractions and some fillings provided by an AICHM Dentist who visited Kijabe once per week.  His main clinic was in Nairobi.  This service has extended to include daily clinics at Kijabe providing comprehensive dental care including extractions, fillings, root canal & capping, orthodontics and dental hygiene.  A Dental Unit has been built and is providing high quality care including the making of dentures.  Dental Students also obtain clinical experience at the Unit during their electives

In the mid '70s one of the Kijabe Surgeons caught the vision for reconstructive surgery for children with post-polio physical deformities.   He obtained specialist training in Korea in muscle and tendon transplants & implemented the services at Kijabe Hospital but now a small self-contained Hospital, Bethany Crippled Children’s' Centre, has been built and provides an excellent service to the post-polio children and children with many other deformities / disabilities.

In the early '60s, a Laboratory Department was initiated at Kijabe by an AICHM Laboratory Technologist.  The plan also included setting up simple Laboratory services at all AICHM Health Units.  She succeeded in both of these ventures and commenced training Laboratory Technicians to staff the Laboratories.  Subsequently it has been mainly Patient Attendants, trained in some basic laboratory tests, who have staffed the Laboratory services in many rural health units country wide as the Laboratory Technician training was phased out due to inadequate tutorial staff.

The Laboratory services at Kijabe received a significant boost in 1994, when "Pathology Overseas' established its Pathology Department at Kijabe.  It is the fourth Pathology Laboratory in the Republic.  At present (2003) it serves 80 hospitals.  At its inception during a 2 month period it detected 850 cases of cancer.  With the above discovery there are great implications for training staff in the early detection of cancer.  The ideal would be to provide oncology training and to establish cytology services in a number of larger remote health units, with routine 'pap' smear testing of larger numbers of women.  Also there may be implications for using the Department for the 'elective' experience of pathology students in the future.

 

With the advent of AIDS in the '80s, the AICHM has endeavoured to be involved in an AIDS Programme.  This has developed into the establishment of an AIDS Division within the AICHM.  Its main thrusts have been: a Church Programme where AIDS Awareness and Information has been taught at Regional level; a 'Why Wait?' Programme which targets upper Primary & Secondary school children with 'Life Style' training - it initially targets the teachers who subsequently teach the children; 'Mother to Child transmission of HIV' Programme; training AICHM staff in AIDS awareness, pre & post-test counselling and home care; & recently emerging are programmes for Home Care and care of Orphans in the community initiated locally.  It is estimated that about 50% of patients in hospitals are suffering from HIV / AIDS.  With proper support they could be taken care of at home thus relieving the blocking of hospital beds for acutely ill patients.  Medication for opportunistic infections and anti-retroviral drugs at subsidised, affordable prices would be a great asset in a Home Care programme.  Litein and Kijabe have opened VCT (Voluntary Counselling and Treatment) Centres.  Manuals have been developed for the Church AIDS & 'Why Wait?' programmes.

 

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