Working Visit to the Matata Hospital in Oyugis Kenya February-March 2014, by Beer Peters, construction consultant, and Jacqueline van Hoorn, chairwoman. February 22, 2014, after two long flights, we arrive at Jomo Kenyatta Airport in Nairobi. Since the great fire, the airport looks like battered although a new arrivals hall already is under construction. Tom Ogeda, the driver of the Matata Hospital, picks us up and takes us to the hotel. Nairobi is as always full of cars and traffic jams! The next day we drive to Oyugis, a day's ride; the traffic is quieter outside of Nairobi. At first we see mountains and the Ngong Hills, then green tea plantations and then we drive through the Rift Valley, this famous trench in the earth. We have lunch in Narok, the famous city which is the gateway to the Masai Mara and Serengeti National Park. We see the famous Masai and learn the meaning of their colours. Masai love red. This colour symbolizes life and blood and would scare wild animals such as lions. The landscape is still beautiful and diverse. Then we turn to Nyanza Province. The landscape is barren and it s clear immediately that it hasn t rained long times. Here almost nothing grows longer. It reminds of a desert. We cross the Mara River and see children fetching water in jerry cans. Mara looks polluted! Then we reach Rachuonyo district, the area where Dr John Malago, CEO of the Matata Hospital, provides health care and sanitation. Suddenly we see in the distance the hills of Kericho and lots of green: the famous Kenyan tea cultures - Douwe Egberts and Lipton. Eventually, we arrive at Oyugis. Dr John Malago and his wife Benta are already waiting for us and urge to dine at their place. The food consists of vegetable Sumaweki - a kind of endives - which literally means: how do you get through the week, Lake Victoria fish and rice. At breakfast porridge made from corn. The reunion is very warm. Telling, talking. Much to say. We stay in a hotel near Kishi. Oyugis is nowadays among the Homa Bay County, near Lake Victoria. The Constituency is Kabondo. The coming days we visit the 2013 and previous projects. Gamba Health Centre Gamba Health Centre, a medical clinic, is far inland and being operational since December 19th last year, Gamba community has gained access to Primary Health Care Services. This means a sustainable development in health care for the local community, mostly mothers and their children. Malaria, typhus, Cholera, HIV / AIDS, and tuberculosis are common diseases in this region. Children are vaccinated and mothers can now give birth in Gamba Health Centre. The Kenyan government has appointed qualified nurses, pay their salaries and provide vaccines and medicines to the patients. We are welcomed and patients tell us how happy they are with the advent of this clinic. We speak with Moses, Gloria Jane and James. They tell us about their often difficult lives. The village communities depend on agriculture. Regular drought often fails the crops, such as corn. And corn is the main food. We see that eye tests are done, and the patients who need it, get glasses awarded
by Dr Malago. 10 CHW's - Community Health Workers - are trained to help in Gamba Health Centre also important to provide immediate medical first aid to the villagers. Further on, the Wasweta well is under construction. As there are problems with the pumping up of water the currently are digging deeper. Gamba Health Centre was established by financial support from the Netherlands Impulsis and another anonymous donor. There are about 90 patients per day. It's good to see Gamba Health Centre operational. Kimonge Health Centre Kimonge Health Centre was formally opened in October 2009 and quickly upgraded by the Ministry of Health from a Dispensary to a Health Centre. In Kimonge Health Centre patients are waiting patiently to be treated. We see the tree which a donor donated to the clinic and planted during the opening. The tree has grown and surprising maintained well in this tropical climate. The donor unfortunately has deceased. Outside on the premises, we see a lot of waste; inside, it looks not very clean. All kind of stuff like wood and plastic containers is stored here. At our remarks, the staff looks surprised: what are they going to do with all the material? With Dr Malago and his staff we evaluate these visits and present positively our recommendations. However, we also understand that Kenyans should do it in their own way: who are we to interfere? Each day, 70 patients visit Kimonge Health Centre for medical care and treatment: family planning, VCT, testing for HIV / AIDS and testing for malaria infection; deliveries also. A huge improvement in medical care to the village community. Ongamo Dispensary We are warmly welcomed and it is very busy with patients. Children waiting for vaccination, or for malaria medicines. These medications - Artemether and Lumefantrine - consist of a three-day course. These medications act directly and the children feel quickly healthy again. Then they can go to school. Happy again. The staff works hard and is excited about their Ongamo Dispensary. They also inform on prevention in the area of HIV / AIDS and family planning. 30 to 80 patients per day are treated. Every week deliveries take place. Ongamo Dispensary was officially opened in October 2012. The donor has indicated to remain anonymous. The Staff House was funded by Cordaid. Ojwando Dispensary This medical clinic became operational in September 2013. For the first time a new combination was applied: the construction and realization of a Dispensary and a water well next to Ojwando School. This works very well in practice: health care, education and clean drinking water, a golden formula. Everything looked good, and especially clean. Many children, mostly from Ojwando School, were treated for malaria with Artemether and Lumefantrine. Mother-child care, education and prevention of HIV / AIDS and family planning. Malaria nets were distributed to pregnant women and children under 1 year, and the have been instructed about the use of these nets Malaria, which are so
important in the fight against malaria. Again, we met a highly motivated Medical Staff. The clinic was financed by two anonymous donors. Nyawango Dispensary This medical clinic is far away into the inland. There is only one nurse working. Judith Raywahi, she is the District Public Health Nurse. Judith reports the lack of malaria drugs, blankets and malaria nets. Matata Foundation cannot do a lot for her since the board of Nyawango village community is responsible for the management of this dispensary in collaboration with the Kenyan government, the Department of Health in Nairobi. We discuss the issue with Mr. Joseph Oyugi Magwanga, Member of Parliament and he promised to solve this. We have been working with him for years now and are confident he will keep word. In Nyawango Dispensary we have a detailed discussion with the board of the Village Community. We talk to the patients, especially the mothers and their children. We ask them how it is to be treated here and all show happy with the establishment of Nyawango Dispensary. Nyawango Dispensary is now on the list for upgrade to Health Centre by the Kenyan government. However, it appears to be unclear where exactly it is waiting for... We also have a meeting with the Community Health Workers. They are busy in providing assistance in the clinic and cleaning Nyawango Dispensary on a daily basis. They pray that we may travel safely back to the Netherlands. Suddenly, at our leaving, a lady brings two bags of roasted nuts, as a present. There you are - two bags of nuts in your hands: we thank the lady very much for her very sweet gift. It is so important for this village community that they now receive medical care and primary health care services, 24 hours a day, as well as delivery assistance. We drive back to the Matata Hospital. Our impressions are overwhelming and our head is full... It is important for the Matata Foundation and the donors the clinics are supervised by the Kenyan government in the areas of: 1) managing the clinic, and paying of salaries of the nurses; 2) providing the necessary drugs; 3) providing malaria nets; 4) offering of training courses for nurses; 5) providing vaccines to the children.
We visit realized water wells in Ojwando and Kabuor and see how children and parents come to pump water. We also visit the well in the grounds of St Joseph's School in Oyugis. During breaks and lunchtime, the children come to fetch clean water and thereby learn to wash their hands properly. So, infections by diarrhoea can be prevented. Very important, because clean water is scarce in the inlands of Kenya. Traditionally, water is taken from rivers which are not safe at all. Therefore, the construction of water well is vital for a village community, also near
a school. A school in the inland usually consists of 600 to 800 students! With the establishment of these wells, the village communities gets access to safe and clean drinking water and eventually far fewer diseases such as cholera and typhus, and fewer patients in the Matata Hospital. The wells are managed by the village community at the cost of Kshs 0.20 per month, which is reserved for maintenance. In this way, it really is their water well, which, as it shows in practice, is properly and adequately managed. A good and modern form of development. We visit Oyuma area - dry to very dry - near Lake Victoria. We see Ongalo School and Oyuma Dispensary. It doesn t reserve the name Dispensary as it is a very old building with only one bed and little or no resources to provide medical assistance. This policy is difficult to understand as there are two qualified nurses (in Nyawango only one, and many more patients to be treated)! Requested by Dr Malago and the Oyuma village community, we looked at the possibilities to build a new Dispensary. As the groundwater in the Victoria area is brackish or salt, Beer Peters advised not to go for a shallow well, but to use a borehole. You have to dig deeper but it s then possible to pump clean and safe water. Matata Hospital Every day we visit the hospital and all its departments. Currently, the hospital has 120 beds. The expansion of the maternity ward is almost ready, 30 extra beds! It's great to meet all friends again and especially to see the progress. Margaret, the head nurse, doctor Samson and John of the X-ray department, Elizabeth of the children's ward, and all the others. Everything looks good and neat. It is very busy and the kids even lay with mattresses on the floor. Many children suffer from malaria, which is unfortunately still a serious infection disease. There is a malaria peak currently. Malaria, Malaria, and Malaria again. The children are seriously ill, and some have a drip infusion. We look at the lab under a microscope to the red blood cells of a child that has 4 pluses and so very sick. Be it death, in the worst case.
Mother-child clinic In this new clinic mother-child care is given. Babies are weighed and given the necessary vaccinations or medications. Dr Malago is distributing the baby milk powder. Many mothers have hardly enough to breast-feed their babies, due to the meagre food during pregnancy. Laboratory The laboratory has been expanded with new equipment. Now, directly can be determined whether a child has malaria, and the extent to which the child is infected. Also, now can be tested directly on HIV / AIDS. Once the diagnosis has been established, medication can be given. Management There are daily meetings with Dr Malago and Staff on the policy for the day. We discuss the vision for the near and distant future. What are the expectations in terms of medical care, water supply, sanitation, and patient s administration, control of tropical diseases such as malaria, and prevention and education in the field of malaria nets, HIV / AIDS, TB and family planning. Doctor Malago finds it very important that the Staff also is trained in the field of hygiene. Due to the lack of rains, the water supply in Matata Hospital is a major problem. To this end, in addition to the water tanks, the construction of a borehole is absolutely necessary. Dr Malago would like to build a children s surgery to avoid the transfer to Kisumu hospital. In the Matata Hospital no operations are performed. Maternity Ward The new-born babies are beautiful, such a miracle, these little babies - and we wonder what their future will be like; will it be a better life than their parents have now? Oyugis and environment still is, unfortunately, a third world area. We concluded that the donated funds from the Dutch Matata Foundation are spent properly in the Matata Hospital: new beds and medical clinics and water wells. We thank Dr Malago and his team for their dedication and hard work which has been done to make all projects a success. At this point, we also would like to thank all the donors for having made this possible. At the end of the field and working visit to Matata Hospital and surroundings, we say goodbye to our Matata friends and fly from Kisumu to Nairobi. We stay a few days in Nairobi where we meet with Hon. Joseph Oyugi Magwanga about the current health policy of the Kenyan government and the medical policy in the Matata area.
It was an exciting and successful working visit. Jacqueline van Hoorn. March 2014.