Rehabilitation Project
Summary: In cooperation with Community Development Fund in Kenya, The Water Project is funding a new well and water distribution system at a medical clinic in Western Kenya serving tens of thousands of people.
History
The clinic at Bushiri came into being as a community led facility in the late 1960s, and was run as a community led organization until it was taken over by the Kenyan Government in 1989. At that point, the clinic consisted of a single nurse and a casual cleaner serving approximately 20 local people every week. 20 years on, and the clinic is staffed by nine nurses, two Registered Clinical Officers, seven support staff and a team of 50 Community Health Workers (CHWs). The current Nursing Officer in Charge (NOC), Mrs Janerose Nasambu Juma estimates that the clinic now sees between 180 and 200 patients per day. Acute cases are treated in the wards, which consist of 12 beds, four cots as well as four maternity suites. In addition to front line services, the clinic now also boasts a working laboratory, allowing for efficient diagnosis of common diseases.
Areas of Work
Malaria is the greatest concern in this area of Western Kenya. With this in mind the clinic provides free medication to under 5s and pregnant women. HIV/AIDS is also prevalent. In addition the clinic also sees a great number of water related disease, including typhoid, diarrhea, amoebic dysentery, scabies (skin disease) and cholera.
Community Work
As well as patients seen at the clinic, the CHWs are responsible for promoting good health, hygiene and sanitation practices in the surrounding communities, and as such continue to reach out to the broader population of some 47,000 people.
Current Supply
Since the time of government intervention in 1989, the center has anticipated the arrival of piped potable water, to the extent that the buildings are already fitted with pipes, taps and sinks, flush toilets and bathing areas. The compound boasts a water tower. However, due to a lack of funding water has never flowed through the pipes.
Currently the clinic pays local water carriers to fetch water in jerry cans from the nearby community hand pump, some 250 meters away. This is a considerable burden on the finances of the facility, and restricts investment, particularly in terms of maintenance of the buildings. Staff estimate that the clinic spends approximately US$16 per day on water, a considerable sum for a rural clinic in Kenya.
Hygiene and Sanitation
The lack of adequate supply impacts greatly on service provision. Basic hygiene standards are almost impossible to uphold. Cleaning bedding, washing equipment and sterilizing medical tools are daily tasks greatly complicated by the relative lack of water. Staff have identified cross infection as a real concern, particularly given the lack of hand washing between patients. This, coupled with a scarcity of disposable gloves appears to be a highly dangerous practice.
Sanitation is also impacted upon by the water scarcity. During the day in patients use the flush toilets in the wards which are then flushed manually, whilst out patients use the vertical pit latrines in the compound. At night, however, in patients use the flush toilets without water to flush. This is a particular problem with cases of diarrhea and dysentery, and greatly compromises the environmental sanitation standards of the facility.
Impact of proposed scheme
The provision of water by the Bridge Water Project with the support of The Water Project and in conjunction with the Community Development Fund in Kenya will have a visible and measurable impact on the capacity of the clinic to provide high quality health care services. Particular benefits in the areas of infection prevention, sterilization of instruments, hand washing, and overall cleanliness were cited by staff at the facility. In addition, financial savings (see above), a reduction in dust from the nearby road (especially in the dry season) and an increase in efficiency through time-savings are anticipated. All such savings will then be channeled into infrastructure repair, with replacing the aging and ineffective asbestos roof the next priority.
