By Alie Eleveld | Founder SWAP and Technical Advisor
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.
Health care workers are overstretched and fatigued and lack health insurance. Medical supplies including protective gear and vaccines are short in supply. The region has a shortage of skilled personnel, ICU beds, oxygen, testing kits and limited surveillance and contact tracing. Mortuaries are lacking enough space. There is insufficient adherence to precautionary measures likes. Proper mask wearing, hand washing and social distancing.
The recent erratic rain and back flow of the lake in the area caused yet again flooding and this affected also the road infrastructure. In Nyando Sub County, over 200 households were evacuated and living in temporary shelters after their houses got submerged by water. They also lost their crops which for some was their only source of livelihood and left them more vulnerable and impoverished. This is one of the areas we had to intervene together with members of the local disaster management committee due to the high risk of COVID-19 spread. Providing hand washing stations, water treatment, soap and reusable masks together with food items were some of the interventions we had to take to mitigate the impact and avoid more patients visiting the already overstretched health facilities.
COVID-19 Current Status in Kisumu and its surrounding Counties
In June 2021, a major national public holiday (independence day) was celebrated in Kisumu. The President of Kenya visited several projects in the region and was escorted by various politicians which pulled various massive crowds during their rallies. This was despite the fact that Coronavirus infections were spiking, hospital isolation units were filling up and the highly contagious Delta virus has been first found in Kisumu among factory workers returning from India. In the weeks since all reports show an alarming surge in infections and deaths, with now also affecting young people. Medical supplies have depleted, vaccines are scarce, health workers fatigued and overstretched and hospitals are turning patients away for lack of beds and lack of oxygen. The current third wave has affected mostly the lake region in Western Kenya and with more transmittable variants. Fewer than 1% of the population have been vaccinated. To forestall the ongoing crisis, Kenya Ministry of Health imposed a restriction on gatherings and extended a dusk to dawn curfew, however this has come too late. In this region, the human toll of the virus is cuting across all segments of society. In rural parts there has been a surge in deaths with no causes recorded, indicating that the toll of COVID-19 far exceeds the official tallies.
Production and Distribution of Alcohol Based Hand Rub to public health facilities
Alcohol based hand rub
Following the needs of improved hand hygiene for infection prevention and control 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 and since January 2021 started the monthly distribution to 47 public health care facilities in Nyando and Nyakach Sub Counties in all patient care areas. Currently this activity is scaled up with funding from Washington State University, whereby SWAP will extend this to hot spot areas in the region as well. SWAP regular communicates with the in charges who inform SWAP when there is need for replenishing the stock. This initiative is very much appreciated since Alcohol Based Hand Rub is essential in patient care and even more important to protect patients and healthcare workers from transmission of the current Coronavirus pandemic.
The distribution procedure included;
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 for sustainability.
Distribution of reusable Masks and Hand washing soap
Surgical masks are short in supply and should be reserved for the front line health workers. SWAP with income from GlobalGiving procured reusable masks which are distributed to all the 47 public health facilities during the distribution of alcohol based hand rub. They will be used by support staff, community health volunteers and casual workers. They are environment friendly and offer sufficient protection in their line of duty.
Another observation was during our frequent visits to the health facilities that the hand washing stations previously donated by SWAP had mostly water but were often lacking soap.
There is lack of and delay in supply from the County Government of some of these essential items and health facilities lack the funds to procure or are in very remote areas where they do not have access.
Muhoroni County Hospital Support
SWAP has worked in collaboration with Muhoroni County Hospital in a chronic kidney disease study among sugar cane cutters. The Hospital is situated within the sugar cane belt in Kisumu County. SWAP targeted 1,000 sugar cane cutters for the research and worked in close collaboration with the lab team of the Hospital.
The Medical Officer in Charge has reached out to us on several occasion requesting for support with gloves. The supply they receive from the County Government is insufficient and not consistent. He reported to have no stock left for the past 3 weeks. The hospital is serving many patients and with increased COVID 19 cases is getting very busy, however no additional supplies have been allocated. SWAP handed over boxes of powdered gloves and 5 liters of alcohol based hand rub to help protect the health workers and patients.
WE THANK YOU FOR YOUR ONGOING SUPPORT AND DONATIONS
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