Help protect 1000 health workers in Western Kenya

Help protect 1000 health workers in Western Kenya

Introduction

Safe Water and AIDS Project (SWAP) has been operating in Western Kenya since 2005 with public health programs, research and emergency response. SWAP's mission is to provide innovative solutions for improved health and economic status of communities. SWAP has joined the Ministry of Health COVID 19 rapid response teams to help prevent the spread and mitigate the impact. The Founder and Technical Advisor of SWAP was appointed as member of the COVID-19 Advisory Committee of Lake Region Economic Bloc, providing advisory services to the Governors of 14 Counties in the region.

The scope of the problem

Healthcare facilities in resource-limited settings lack essential WASH and health care waste services.

• 50% Lack access to piped water
• 33% Lack improved Sanitation
• 39% Lack soap for hand washing or alcohol based hand rub
• 39% Lack adequate infectious waste disposal

The period under review was very challenging due a National Health Workers strike protesting against delayed salaries and insufficient protective personal equipment, which saw most of the public health facilities closed or with reduced activities. In March 2021 this ended following negotiations with the county governments and health workers resumed duties.

Some COVID-19 statistics

Since 13 March 2020 when the first case was confirmed in Kenya, a total of 106,470 confirmed cases and 1,863 have died giving a case fatality rate of 1.7% have been line-listed. Of these, 105,136 cases (99%) were local transmissions and 1,334 (1%) are imported cases. (2^nd March 2021)

Besides, the COVID-19 outbreak has so far spread to 100% of the counties in the country. Risk communication, laboratory testing, and contact tracing have been identified as key challenges. One hundred and five thousand one hundred and thirty-six – 105,136 (99%) of the 106,470 confirmed cases are local transmissions. The government is seeking at least 24 million doses of COVID 19 vaccine in the first instance, through the GAVI COVAX facility, to cover at least 20% of its population. The most vulnerable (Health Workers, Elderly, and Individuals with comorbid conditions) will be prioritized.

The South African COVID-19 variant (B.1.351/501Y.V2) of concern has now been detected in two persons in the coastal region of Kenya from samples collected in Mid-December 2020.The country continues to strengthen its routine surveillance to track COVID-19 Variants. WHO recommends that one of the indicators that the pandemic is under control, is when < 5% of samples tested are positive for COVID-19 for the past 2 weeks, assuming that surveillance for suspected cases is comprehensive and testing rate of suspect cases, is optimum at least 1/1000 population/week.

The past two weeks Kenya experienced a positivity rate of 8.1%. Among the cases who had their occupation filled in, a cumulative of 3,207 health professionals (4 new cases) and 32 mortalities (No new deaths) have been reported in all the 47 counties.

Production and Distribution of Alcohol Based Hand Rub to health facilities

Following the needs of improved hand hygiene for infection control and prevention of hospital acquired infections including COVID-19, SWAP sought funding from loyal donors to produce its own alcohol based rub to supplement the already provided hand washing stations.

We received technical support to produce Alcohol Based Hand Rub (ABHR) from the Centers for Diseases Control and Prevention (CDC). For the production we used the WHO formulae to make the ABHR and received approval from the Kenya Bureau of Standards. The ABHR was produced in SWAPs lab by a team of lab technicians and following approvals we started the distribution to 42 public health care facilities in Nyando and Nyakach Sub County to all patient care areas. Monthly rounds of distribution and monitoring of use continued though on a reduced scale due to the National Health Workers strike which affected many health facilities. Other facilities remained functional through partners. However,this activity will be scaled again in March 2021 now that the industrial strike has been called off.

The distribution procedure included;  

• Brief interview with nurses
• highlights on appropriate usage
• Sticking of the Standard operating procedures on walls of all patient care areas where the ABHR is distributed.

Mapping was also done to identify other hot spots and high risk areas to support with Alcohol Based Hand Rub moving forward. SWAP for sustainability is selling this product to stakeholders, partner organizations individuals and through door to door sales by community health volunteers.

WE THANK YOU FOR YOUR ONGOING SUPPORT AND DONATIONS

• Global Giving March 2021 Report with photo's (PDF)
  
• Annual Report SWAP 2020 (PDF)
  

GLOBAL GIVING REPORT NOVEMBER 2020

Help protect 1000 health workers in Western Kenya

Introduction

Safe Water and AIDS Project (SWAP) has been operating in Western Kenya since 2005 with public health programs, research and emergency response. SWAP's mission is to provide innovative solutions for improved health and economic status of communities. SWAP has joined the Ministry of Health COVID 19 rapid response teams to help prevent the spread and mitigate the impact. The Founder and Technical Advisor of SWAP was appointed as member of the COVID-19 Advisory Committee of Lake Region Economic Bloc, providing advisory services to the Governors of 14 Counties in the region. So far we have been reaching out to remote public health facilities with hand washing stations, soap, water treatment and hygiene promotion. The area was further affected by flood which made communities more vulnerable and at risk. SWAP also started the production of sodium hypochlorite and alcohol based rub hand rub to be issued to the health facilities.

The scope of the problem

Healthcare facilities in resource-limited settings lack essential WASH and health care waste services.

• 50% Lack access to piped water
• 33% Lack improved Sanitation
• 39% Lack soap for hand washing or alcohol based hand rub
• 39% Lack adequate infectious waste disposal

Without appropriate WASH infrastructure and services, patients, healthcare workers, and communities are at increased risk of disease. For example, if patients or staff drink unsafe water when they are thirsty, or when taking oral medications, they could get sick with a waterborne disease. WASH infrastructure and services are also essential to allow healthcare workers to perform appropriate infection prevention and control practices.

For example, both healthcare workers and patients need access to hand hygiene supplies to reduce the risk of spreading infections through unwashed hands. This has become more essential during the current COVID 19 community spread.

In Kenya the first case was reported and confirmed on March 13, 2020  and currently there is very fast community spread with over 57,000 cases and more than 1000 deaths. We have seen an increased number of health workers getting sick, which shows that they are insufficient protected. Health facilities in rural areas are ill prepared and the health workers at risk. There are limited testing facilities and contact tracing is no longer effective due to the large numbers of confirmed cases who get infected through community spread. Community members are often not complying to the rules of frequent hand washing, social distancing and wearing of masks. Cultural practices such as funerals and political rallies have caused the rapid spread. Some health facilities were further challenged due to the massive floods in the region with as a results some health facilities were hard to reach and others were submerged under water with collapsed toilets. Quite a number of health facilities do not have reliable water supply.

Activities

Distribution of supplies to health facilities

SWAP completed an assessment of all 43 health facilities in two sub counties (Nyando and Nyakach) which have been affected by flood and which are underserved due to poor road infrastructure. We were evaluating to see if these facilities meet the Joint Monitoring Program WASH and Waste Management standards. The aim was to identify gaps and to do resource mobilization and advocacy to get more support from the County Government. SWAP also continued with mentorship of the health workers to promote hygiene and hand washing and ensure they improve their WASH standards and prevent hospital acquired infections.

The GlobalGiving Fund supported additional health facilities with the following supplies; hand washing soap and waterguard (chlorine solution). The focus was on the remote health facilities affected by flood and who were targeting to support the families displaced.

Water Tank for Health Facilities

During the assessment we identified one facility, Gari Dispensary in Nyakach Sub County with an unreliable water source, which made them struggle to adhere to the COVID-19 rules and regulation of regular hand washing. County Governments are currently overwhelmed with the increasing cases and the need for testing and contact tracing as well and the limited spaces in isolation rooms. We therefore felt the need to support and procure a water tank to enable them to harvest rain water to supplement the piped water. SWAP procured a water tank and this was installed in order to harvest rain water.

There was cost sharing with the facility, SWAP with funds from GlobalGiving paid for the tank and its delivery and the facility supported preparing the base, gutters and piping.

Production of alcohol based hand rub

SWAP started the production of alcohol based hand rub which is prepared in our lab by the lab technologist and is currently going through the approval of the Kenya Bureau of Standards for quality control. Once this is approved SWAP will do distribution to the 43 health care facilities where we have done the assessment to support health workers with practicing hand hygiene.

Production of Sodium Hypochlorite

SWAP started the production of Sodium Hypochlorite (Chlorine) with the STREAM community water disinfection system, which will be installed at two larger facilities in Nyando and Nyakach Sub County Hospitals. The chlorine can be used for treating of water and cleaning purposes, contributing to the infection prevention and control. It is a user friendly device which uses water and salt to generate the sodium hypochlorite. The in charges of the two selected facilities in collaboration with the Sub County Health Management teams will be trained on the production of sodium hypochlorite and its use. The generated chlorine will be used in the patient care areas, labor ward, and to treat the water for drinking and hand washing. Currently SWAP is still doing experiments testing the levels of degradation to ensure we produce a quality product which can be used in the prevention of COVID-19 spread and to protect the health workers.

WE THANK YOU FOR YOUR ONGOING SUPPORT AND DONATIONS

• Global Giving November 2020 report with photos (PDF)