Kajire Village
As related to:
Robert C. Smithwick, DDS
(Amateur Radio W6CS)
29 September, 1991
Kajire Village, Kenya
Kajire is a village in south-east Kenya (click here for map) approximately 100 miles inland west of Mombasa and about 50 km from Voi, on marginal land at the foot of Sagala Hills. The village itself has a population of about 5000 people. The actual catchment area of the dispensary is difficult to assess in terms of population but could be as much as 15 to 20,000 residents.
|
|
Kajire Village |
The foundations for the clinic were laid in August, 1990, and I am pleased to report that the clinic building is complete as is the staff house. The clinic has running water with sinks in the relevant rooms and the staff house itself is quite unique in this village as it also has running water and a shower. There is no electricity. The nearest hospital facility is in Voi and prior to the opening of the clinic any patients in this village or surrounding villages had to make the trip to Voi either on foot or in a "mutatu", which is a small bus. The cost however, of a return journey in a "mutatu" is 40 shillings which is nearly a British pound which is a great deal of money to these people. The need for a clinic here was clearer to me and was endorsed by the local M.O.H. (Medical Officer Health) some years ago.
I delivered the final consignment of medical equipment to the village on my arrival - some 100 kilos in all. The transport of this was made available by British Airways at no charge. Fifteen different pharmaceutical companies in Kenya based in Nairobi had donated drugs so that we have a good supply of most drugs and very few deficiencies.
Currently, the clinic is staffed by a volunteer English nurse, Rachel Burke, who will be staying for another three months, and we also have our BHF (Bush Hospital Foundation) field worker, Jane Barham, here and a small jeep is available for their use which was donated, and is owned, by the BHF.
The government, that is to say, the local Medical Officer Health (M.O.H.) have agreed to supply a government community nurse to be resident in the village. Hopefully this nurse will arrive next week but certainly it will be essential that he or she is in place before Rachel Burke returns to "England." (The nurse arrived on October 1).
Rachel and Jane had serious problems negotiating the arrangements for the opening of this clinic. However, after much negotiation with regional government officials, the problem was overcome.
AMREF (African Medial Research Foundation) has also been a great help in arranging for the importation of all the medical supplies without any tax having to be paid but they were unable to provide the staff as was originally agreed upon.
The compromise arrangement that I have made with M.O.H. and with endorsement of the District Commissioner is that the BHF will undertake to continue to support the clinic financially for at least two years subject to annual review and will take direct responsibility for the project. The Government will supply a resident community nurse and we have applied for a basic drug kit from the Government and we will supplement the drugs either by donation from drug companies or by purchasing.
The clinic was opened officially by the District Commissioner yesterday, 28 September, 1991, with all the relevant regional and local officials present and major celebration took place lasting well into the night.
Future Plans: the World Health Team have agreed to come to the village on an expenses paid basis to train community health workers amongst the women of the village. The British High Commission (Kenya) has donated a refrigerator worth 4000£, which is solar powered and it should be installed within the month. This will enable us to commence a vaccination campaign because currently very few children or adults are vaccinated here. Outreach clinics from Voi, including family planning, mother and child health care and ante-natal care and a physiotherapy unit for treating the disabled children and adults in the village will commence visiting the clinic. We are going to install a solar electric light system. We are going to build an additional wing on to the clinic to act as a store room. Possibly at a later date, this could be used as an in-patient ward for treating dehydrated children who can be rehydrated by the use of nasogastric intubation.
Since I have been here I have been seeing as many as 60 patients a day in the clinic so the need is very clear. Most of the illnesses I have seen have been relatively minor, particularly respiratory infections, a lot of pneumonia, some tuberculosis, a lot of skin diseases particularly ring-worm and minor injuries mostly self-inflicted, and a lot of malaria. This is a major problem here. One or two cases have been Chloroquine resistant, at the moment we do not have any alternative so that the patients who do not respond have to be sent to the little hospital in Voi.
Patients are being charged for attending the clinic, this is partly due to discourage their obvious enthusiasm to see the doctor or nurse, even if they have nothing wrong with them, but also because it is necessary to finance watchmen as the grounds are some 5 acres. We also need somebody for the upkeep of the gardens that are to be established and to clean the building on a daily basis.
The wages of these two individuals is 300 shillings a month and in the first week here we earned 1000 shillings so I see little problem in paying wages to ancillary staff, as the community health workers will be volunteers. The only wage that has to be paid is the resident community nurse and this will be paid by the government.
Jane Barham will continue to supervise the clinic and deal with the inevitable problems that arise, particularly with the local office of the extremely bureaucratic Ministry of Health .
In summary, the Kajire Clinic is now open and operating and I am satisfied that the project is worthy for our continued support.
Mike Marks, MD
Ken Kirk-Bayley
Jersey Island, UK
December, 1991