The Gundua Health Centre, improving the standard of health in Ex-Lewa.

The Health Centre was officially opened on 12 November 2011. The Centre offers high medical standard with modern equipment and well-educated staff. The Centre provides a broad spectrum of medical services including primary care, dental care, HIV prevention, childbirth services and maternity care, vaccinations, basic surgery, lab tests, diagnoses as well as preventive care and education in health-related matters and a pharmacy.

The health situation in Kenya is slowly but surely improving. At the same time, there are differences between cities and countryside when it comes to availability of healthcare, with a doctor-density outside the big cities corresponding to around one percent of the Swedish level.

Gundua Health Centre collaborates with Rotary’s medical bank, which means that primarily dentists from the Nordic countries contribute with their know how and experience to the clinic. Apotek Hjärtat supports the centre with important pharmaceutical competence and is the main sponsor of the health centre.

Even if care and medication are important, there is a lot to gain from preventive care. The long-term ambition of Gundua Health Centre is to increase the standard of living in the region by battling problems such as malnutrition, resistance to antibiotics, alcoholism, sexually transmitted diseases and unplanned pregnancies. The main challenge is to increase the inhabitants’ generally low knowledge of hygiene and health. And the first step to generate change is to educate the children. Sexual information and family planning is neglected and many students at Gundua Secondary School are forced to interrupt their studies because they get pregnant.

The Kenyan state runs information campaigns about HIV, and HIV drugs are subsidised. Despite these efforts, there remains a flippant attitude, especially among men. It’s a common view that if a man is infected by a woman he can “return” the illness to another woman – something that has led to an increase in the transmission of HIV, syphilis and other venereal diseases. Another misunderstanding shared among both patients and pharmacy and healthcare employees is that all illnesses can be cured with antibiotics and malaria vaccine. Malaria is not even present in the area.

Today the health centre offers well functioning primary care services with a pharmacy and an expanded laboratory for qualified medical testing. Education and information meetings in preventive aim, help to self-help, are offered continuously. Both maternal care as well as follow-up of newborns are handled by our competent staff. It’s all about building trust with the local community and make them understand that Gundua Health Centre offers them qualified medical care compared to other services in the area. Great results have been achieved. Since the start the centre has seen more than 20,000 patients visits, 16,500 completed lab tests, nearly 200 childbirths, 1,100 HIV-tests, 2,500 child vaccinations and hundreds of educational meetings. Thanks to the agreement with Apotek Hjärtat, the Gundua Foundation has secured both financial and knowledge-based support for a long time in the future.

Information, education and health care

Vaccination of children

One of the most important programs implemented years ago with the support of our sponsors is the vaccination plan for children below five years of age. The Gundua Health Centre follows the national vaccination programs and conducts ongoing campaigns in order to convince parents to vaccinate their children. Many local parents now bring their children in for regular follow-ups, and the center has vaccinated nearly 2500 children since 2011.

Planned parenthood and HIV

The Gundua Health Centre has done extensive work in the area of planned parenthood. As in many poor areas worldwide, the lack of knowledge regarding family planning is a serious problem in the Ex-Lewa area. Problems related to family planning include inability to plan the number of children that one family can support, the spread of sexually transmitted diseases and a general ignorance regarding how to protect oneself during sexual intercourse. Every month, several information meetings are held by experienced nurses, both at the center and in the local communities. The health centre has conducted several campaigns targeting women, where they have offered free contraception in the form of implants as well as free access to condoms. When it comes to HIV, the centre tests patients daily and also invites locals to recurring HIV information days. HIV is still a highly sensitive topic in the area, and the population often has a difficult time accepting the disease, which means that many patients are reluctant to get tested at all.

The rights of girls and young women

Another important ongoing project is to lead the conversation with girls at secondary schools regarding their rights, especially their rights to their own bodies. Many girls leave school every year due to unplanned pregnancies, and many experience sexual debuts that include violence. There are very few natural opportunities, neither at school nor at home, for girls to talk openly about their experiences. These meetings are therefore very important, and are led by experienced professionals from the health center.

Basic hygiene and self-care

The Gundua Health Centre is located in a poor and often dirty agricultural society where the humans often live together with their animals in crowded, dark and smoke-laden sheds without access to toilets and clean water. The level of knowledge regarding the importance of personal hygiene in order to reduce the risk of gastrointestinal diseases is very low. Each month, several educational meetings are held where the locals are taught basic hygiene and personal care. The health centre has also carried out recurrent practical training courses for all the school children in the area on how and why to wash their hands so that the students can pass on the knowledge to their parents and relatives.

Active work with pregnant women and newborns

The Gundua Health Centre has a basic but well-functioning maternity ward with associated health care for both mothers and children. The infant mortality rate is still high in the area, as well as the number of women who die in childbirth. One of the reasons for this is that women traditionally give birth in the home, which is often both dark and dirty, without the help of trained midwives. The Gundua Health Centre has worked extensively with various information campaigns to educate the local women. The health clinic explains and teaches them how important it is to allow the staff of the center to monitor their pregnancies, both before and after the birth, to ensure that both mother and baby are doing well. The work is successful, and over 200 children have now been born at the center. Many women have also started to show up for check-ups both before and after the birth of their children.

 

The Gundua health centre gains more and more patients

The health centre, with its great capacity and its qualified personnel, has since its opening in 2011 worked actively to increase the number of patients. In the first four years, over 20 000 patients visited the center. During the first year, 4500 patients were examined, and the number of patients have increased gradually since then. Much of the work is about gaining the trust of the local population, and to get them to understand that the quality of the health care that they are offered at the center is much better than the other health care options in the area.

The results speak for themselves

Long-term change does not happen overnight, and does not always match today’s requirements of instant results. The trust of the main sponsors of the foundation has been central in order to develop the Gundua Health Centre at a pace that works with the local environment, and the health center has achieved concrete results while the foundation has also been able to build a business that will work in the long term. The center has had over 20 000 patient visits, 16 500 completed lab tests, nearly 200 childbirths, 1100 HIV tests, 2500 child vaccinations and hundreds of educational efforts. The numbers speak for themselves, but what really matters is that children and young people in all the schools in the area have been taught the importance of self care and received help to examine and treat their teeth for the first time in their lives. What also matters is that girls and young women have been offered the chance to understand their rights as well as been strengthened in their self-esteem, and that boys and young men have been trained in how to respect women’s rights. Planned parenthood, in the form of information and protection, has improved the conditions for many families. Fewer children are now born at home, and more mothers and newborns get follow-up treatments and vaccines. Adults and children with chronic diseases have been taught how to care for themselves. The list goes on, and the work to support the local population of Ex-Lewa in Northern Kenya continues. And there is a lot of work left to be done.

Chief Nurse Brenda Florence Matete

She loves children, friends and cooking. And you can’t stop listening to what she has to say. Brenda Florence Matete, Gundua Health Centre’s Nurse Officer, has a warm and confidence-inspiring voice. She also had solid experience as district nurse and midwife in the Health Department as well as in the south of Sudan before she noticed a recruitment ad for the Gundua Foundation.

“My passion is to help the local community, and that is precisely what the Gundua Foundation is all about. As a midwife it is also my duty to work with health-promoting activities, like teaching mothers the importance of clean and safe childbirths. I decided to work for the Foundation because I knew my experience and know-how would do good here.”

The Gundua Health Centre differs from many other clinics that Brenda has worked for during her professional years. Or as she puts it: It will become a modern clinic with access to the right tools. With childbirth, aftercare, family planning, advisory services, lab and pharmacy, the ambition is very high indeed.

One of the issues close to Brenda’s heart is reaching out to women and children. She feels they are very responsive to the message. It is also these groups who are the most heavily hit by deficiencies. But, as she says, change doesn’t happen overnight. This is why she has a close cooperation with the Gundua schools; it’s important to start early. In 2010, Kenya passed a law prohibiting corporal punishment of children. Unfortunately, the law is not commonly known, and corporal punishment is still very much part of child rearing, both in homes and schools. Brenda and Jessica are therefore visiting also the other schools to inform about the law and children’s rights in society (and to their own bodies and senses). Their next step is to reach out to parents – and that will make a big difference in the community.

All children seeking help at Gundua Health Centre will also, according to common praxis in Kenya, be HIV tested. Should the test be positive, the rest of the family will also be tested, to make sure the infection is caught at an early stage, helping the individual to a proper life.

At the moment, two nurses, on administrator, one doctor (half time), a lab technician, a pharmacist are working at the centre.

“My wish is that we shall be able to offer the very best healthcare, that all small children will get vaccine, that no mothers will die during childbirth, and that the Health Department will eventually take over the responsibility for running the centre.