ANOTHER BUSY WEEK AT ARROW WEB HOSPITAL

Treating an outbreak in a local orphanage

Apart from the usual services we provide, last week was particularly busy as there was an outbreak of diarrhoea at a local orphanage. So it was "all hands on deck" for our doctors and nurses. As treatment for these children is not covered by the funds we receive from the government we have set up a Comprehensive Care Program for them and other poorer children to make sure they can receive the immunisations and drug treatment they need when they need it. Our board has always funded this program, but this year we are applyng for funds to extend it to help more of our most vulnerable children in our community.

Next in line for an injection

And the girls too

Our senior Doctor Ishmael Onyango gives advice to a young girl

Government report

Bram has been busy completing a very lengthy government report. Although we submit information to the District Health Authority every month, for the first time we are now being asked to complete forms about all our activity related to the government's health indicators. We are also being asked to complete detailed plans to show how we are working towards government targets. Fortunately Arrow Kenya board has already drawn up a plan for this year, taking into account these targets.

The government is expecting us to add the protection of children, adolescents and the elderly to our plans so we will be making it a priority this year.

PLANS FOR 2011

Arrow Kenya board plans

In January, Arrow Kenya board finalised the organisation's plan for this year. Our strategy for 2010- 2012 is to improve the quality and scope of our services and to try to reach more communities in our area of Embakasi District.

We are also trying to focus on the Embakasi District Health Authority Annual Operational Plan priorities and targets and achieve a higher level of accreditation from the National Hospital Insurance Fund (NHIF) by gradually meeting more of their criteria.

See our plan and the Kenyan and Embakasi District Health Authority priorities.

Bram and our senior doctor and board member Dr Onyango discuss the plans

Our board chairman Nicodemus Kipruto approves the plans

Another volunteer from the UK

We are really pleased to let you know that Jacq Goldthorp is coming to work with us in March. She is from Moray in Scotland and is a colleague of Dr Jamie Hogg and Liz Tait who visited us last year. Jacq will be helping us improve our data collection and financial management systems. She will also be helping us review the way we record the activity and achievements of our Community Outreach Team. This work is really important to us as it will help us with funding applications. In the future we hope that we will get paid for the out patient and community services we provide. Currently we only receive payment from the government for the inpatients we treat and the babies we deliver at Arrow Web Hospital.

The board and staff really look forward to meeting Jacq and showing her around Arrow Web Hospital and the local community.

LOOKING BACK AT OUR ACHIEVEMENTS IN 2010

A VERY HAPPY NEW YEAR TO EVERYONE !

As we look back at 2010 at so many successes (as well as a few disappointments), we realise that we could not have achieved so much without the dedication and commitment of our Board and staff as well as the support, generosity and advice from all our many friends, volunteers and partners at home and abroad.

2010 has been a year for building foundations for the future, strengthening existing partnerships and developing new ones; to enable us to improve the quality and scope of the services we provide to more patients and communities in the Nairobi slums.

Arrow Kenya, with its Arrow Web Hospital and Community Outreach Team continues to go from strength to strength and this is most clearly demonstrated by the increasing numbers of babies, children and adults we have treated and cared for over the years. We increased our total annual numbers by over 25% this year and since 2005 we have provided health education, treatment and care to over 76,000.

Link to activity data and our achievements in 2010

One of our nurses caring for one of the babies born at the end of 2010

Healthy and contented

One of our doctors with a proud new mother

Another very busy immunisation clinic at Arrow Web Hospital

Women and children queuing outside the hospital

Volunteers from Australia

At the end of 2010 we were so pleased to welcome two volunteers from Australia - James, a medical student and Dominique a nurse. This was arranged through a contact of our great friend and supporter Alison Lowndes whose innovative UK charity AVIF (http://www.avif.org.uk/), which assists online and onsite volunteering, is now working with projects in Nepal, Tibet and the Amazon as well as Kenya.

James, a medical student from Australia one of the last volunteers of 2010

The container of medical equipment

Many of you have been eagerly awaiting news of the container of recycled medical equipment which has been accessed for us by Aid to Hospitals Worldwide (A2HW) - a UK charity. We had all hoped that once the necessary Tax Exemption Certificate was provided by the Kenyan Revenue Authority, the shipment would leave the UK in November, arriving at Arrow Web Hospital by the end of 2010. Unfortunately new regulations require approval by the Minister of Health who has to personally sign a Memorandum of Understanding with us. So Bram has been very busy getting this organised. The Permanent Secretary at the Ministry has been very helpful and having heard about all the work done at the hospital and in the community, has said she would like to visit us.

Jackie, our contact at A2HW has been really patient, having to cope with the delays which have been outside our control. As A2HW can only book one shipment per week, we will now have to wait until the beginning of May before our equipment can be sent to Mombasa and then on to us in Nairobi. If there are any cancellations A2HW will be able to ship the container sooner.

So, thank you once again to everyone who has supported us with this project which will bring urgently needed medical equipment and supplies worth over £58,000 or 6,000,000 Ksh to Arrow Web Hospital.

Developments for 2011

We are now finalising our plans for 2011, with a lot of hard work ahead of us and many exciting opportunities. We will post them on the website and look forward to hearing from anyone who feels they can help us meet our objectives. Please do not hesitate to get in touch if you would like more information about the services we provide.

Our new website

We are very pleased to let you know that our new website at http://www.arrowkenya.org/ is proving to be very popular. We have had nearly 500 "hits" since it was launched at the end of October.

If you click on the link below you can see where in the world the "hits" come from: http://arrowkenya.org/vmap.php

Please let us know if you have any comments or suggestions via the "Contact Us" section on the site menu.

Arrow Kenya is asked to give a presentation at a British Council workshop

Last week we were asked to give a presentation at a British Council workshop in Nairobi. The workshop was to inform health service providers from across Kenya of the UK International Health Links Funding Scheme.

As you know we are currently working with NHS Grampian in the UK, writing an application for funding, which if successful will provide training and development opportunities for our staff and some colleagues from Embakasi next year.

Answering questions about our plans for a link with NHS Grampian

Making sure the equipment works before we start

WORLD AIDS DAY - DECEMBER 1st 2010

Started on December 1st 1988, World AIDS Day is about raising money, increasing awareness, fighting prejudice and improving education. The World AIDS Day theme for 2010 is "Universal Access and Human Rights".

World AIDS Day is also an opportunity for us to remember people we have known who have died of AIDS.

According to UNAIDS estimates, there are now 33.3 million people living with HIV including 2.5 million children. During 2009 2.6 million people became infected with the virus and an estimated 1.8 million died of AIDS.

In Kenya 1.5 million people out of a population of over 39 million are living with HIV/AIDS; around 1.2 million children have been orphaned by AIDS; and in 2009 around 80,000 people died of an AIDS related illness.

For more information about HIV/AIDS in Kenya : http://www.avert.org/hiv-aids-kenya.htm

Arrow Web Hospital and HIV/AIDS

The staff at Arrow Web Hospital and the Community Outreach Team are making a real contribution to the prevention of the spread of HIV in the Embakasi District of Nairobi.

We offer confidential counselling to people of all ages before and after HIV testing at Arrow Web Hospital. If a patient tests HIV positive we then refer them for Anti Retroviral Therapy (ART) from a local NGO.

Our Community Outreach Team raises awareness about HIV transmission and the importance of using condoms, with individuals and groups in the community, encouraging people to go to Arrow Web Hospital for testing if they have been at risk.

Patients who become ill with AIDS related illness are given "first aid" treatment at Arrow Web Hospital and then referred to Kenyatta National Hospital for specialist treatment. We help many patients by providing transport to take them there, as it is 34 kms away.

Our main contribution to the reduction of the spread of HIV is PMTCT or the prevention of mother to child transmission. An HIV infected mother can pass on HIV to her baby during pregnancy, labour and delivery or through breastfeeding. Without treatment up to 30% of babies born to HIV positive mothers will be infected during pregnancy and delivery and up to 20% will become infected through breastfeeding.

The rates of transmision from mother to baby can be greatly reduced if they are given the appropriate ART as soon as possible. It is therefore really important that we encourage pregnant women to find out their HIV status so that we can give them counselling, start their treatment and encourage then to come to Arrow Web Hospital for the delivery. Many women are reluctant to find out their HIV status and very afraid of their husband's reaction when they find out they are HIV positive. So we also offer HIV positive women support after their baby is born.

Last year we provided ante natal care for over 1400 women and over 1300 women came to Arrow Web Hospital to deliver their babies.

For information about how HIV is transmitted:http://www.avert.org/can-you-get-hiv-aids.htm

Here is a link to three posters in different languages: World AIDS Day Posters 2010

Avert World AIDS Day 2010 Video:

Open Clinic for Baby Immunisations

Every Saturday, mothers whose babies were delivered at Arrow Web Hospital are invited to bring their babies back to see us for their immunisations.

Arrow Web Hospital also provides extra open clinics for women who chose to have their babies at home. Our Community Outreach Team works with local communities to raise awareness about many health issues and they explain the importance of protecting babies against many illnesses which can be disabling or even fatal. In the first year of life we offer immunisation against illnesses such as diptheria, polio, tetanus, measles and tuberculosis. We also give the babies a much needed vitamin boost.

At last week's busy open clinic we immunised 187 babies. All immunisations are carefully recorded and numbers are submitted to the District Health Authority on a monthly basis.

"Next please"

"I've brought my baby's record card along"

" Watching carefully before it's our turn"

"Good, not long to wait now"

More international partnerships for Arrow Web Hospital

Dundee medical students

In the last blog we told you about the three Dundee University medical students who were planning to spend six weeks with us for their medical elective. Well, now they are halfway through their time with us. They have become very involved in the hospital routine, admitting new patients to the hospital and treating them under the supervision of our doctors. They have been assisting at out patient clinics and one of the highlights for them has been seeing newborn babies and healthy mothers after safe deliveries at Arrow Web Hospital. They have also been out with the Community Outreach Team.

Having such enthusiastic and competent volunteers for six weeks has been a great support to our busy staff team.

It hasn't all been work for Sarah, Christine and Catriona as they have managed to do some sightseeing. Their visits have included Nairobi City and a few days in Mombasa.

Sarah, Christine, Catriona and Bram taking a well earned break

Proposal for a grant to fund a new hospital

We have been very busy over the last few weeks writing a proposal for funds to build a new 21 bedded hospital on land allocated to us by Nairobi City Council. Having successfully submitted an application to the Japanese Embassy in Nairobi in April, we were asked to draw up a very detailed proposal in July. Before a final decision is made the Embassy staff may ask to undertake another "site visit" this month.

A new building will not only provide a much better environment for patients to be treated in and for staff to work in, it will also help us develop our hospital and community based services. It will help us in our application for a higher level of National Health Insurance Fund accreditation. As you may know our main income is from the Ministry of Health for every registered patient we treat. A higher level of accreditation will increase this income helping us to sustain our services. We will also be able to take referrals from other health facilities in the area. (Poorer patients pay a small registration fee and then they can receive free treatment).

NHS Grampian

NHS Grampian is a health board (or health authority) in the north east of Scotland. A few months ago we approached a senior doctor and nurse from NHS Grampian to see if the organisation would like to develop a partnership with us. NHS Grampian provides services in hospitals and the community and has close links with the local medical school and medical research institutions.( http://www.nhsgrampian.org/ )

When they heard about the work that we do and the challenges we face, Dr Jamie Hogg and Liz Tait were really keen to work with us. Jamie is deputy medical director and a general practitioner (community doctor) and Liz is a nurse and clinical governance co-ordinator. Jamie worked in Nepal from 2006-8. This included working as a doctor in a small hospital. He is also a trustee of a charity Asha Nepal which re-integrates and supports HIV positive trafficked women and children (http://www.asha-nepal.org/) . For the past five years Liz has also been a team leader for various deployments to disaster zones on behalf of the UK Foreign Office.

With the support of the NHS Grampian medical director and Arrow Kenya Board we now have a formal partnership. I am so excited as we have also been successful in getting funding for a "start up" grant from the International Health Links Funding Scheme, to enable Jamie, Liz and me to visit Arrow Web Hospital at the end of September. The purpose of the visit is to agree how the two organisations can work together for mutual benefit. Further funding will need to be applied for, to enable professional links to be developed next year.( http://www.britishcouncil.org/learning-healthlinks.htm)

Dr Gray's Hospital in Elgin - one of NHS Grampian's hospitals

Jacaranda Health

Did you know that in the Nairobi slums 1 in 142 women die in childbirth, this compares to 1 in 178 for the rest of Kenya and 1 in 7300 in countries with well developed maternity services ?

Last week we were very privileged to receive a visit from six representatives from Jacaranda Health, from the UK, USA, Korea and Zambia. This is a new venture which aims "to provide affordable, high quality maternity care to low income women in urban Kenya". Using vans for mobile ante natal care and outreach, they also hope to set up special clinics to offer "women centred" maternity services. Initially they hope to start this service in the Nairobi slums. With common aims and shared values we had so much to discuss. We are very pleased to announce that Jacaranda Health has chosen to work with us in a special community healthcare partnership.

Bram says that currently about 70% of babies born in the communities around Arrow Web Hospital are delivered at home, with no midwife or medical assistance nearby to help the women if there are any complications.

A very warm welcome to Jacaranda Health from Arrow Web Hospital

Discussing how we can work together

A link to Jacaranda on You Tube with a video about women in the Nairobi Slums:

http://www.youtube.com/watch?v=A6qVqREcXb8

Our website

We have also been working on updating the website so that there is more information about the work we do and to acknowledge the generous support we receive from partners, friends, volunteers and donors both locally and nationally.