Oct 10, 2017

Under One Roof: HIV Care and Salsa Dancing

This weekend was truly magical . Key stakeholders (about 8 in total) from across North America and Kenya came together to discuss the infrastructure of care in the adolescent clinic: areas of strengths, areas of improvement, and short and long term goals. This meeting demonstrated deep rooted committment and momentum among those who advocate for our clinic. 

Here are a few of the issues we discussed:

Strengths:

  • Integrated into the hospital system with the majority of staff from the hospital 
  • Provides a model for outlying sites 
  • Draws both HIV negative and positive to clinic
  • Provides free reproductive health care
  • Committed staff
  • Engages youth beyond their medical illness- Yes, thats right: daily salsa dancing, bead works, and spoken word

Areas of Improvement:

  • People who are not known to be living with HIV are coming to the clinic, but not seeing the clinician. 
  • Working closer with schools which will help with ART adherence
  • Uptake of reproductive health care

To start to address the above, we plan to increase adolescent friendly educational and health related signage to attract the usage of our services to non HIV positive youth, start working on establishing connections with administrators in school, and ensure clinic staff are well versed in counseling  reproductive health issues. A training is in the works (which will be a refresher for some). 

The clinic is the love, sweat and tears of all of us. Those areas of improvement will come with perservence and passion (which we all have) to provide adolescents the best health possible. We have an amazing and powerful set of assets, which leds itself to sustainability, resilience, and delivering the best care to our teens for a long time to come. 

 

Best, 

Sep 26, 2017

Responding to Urgent Needs: Charles Oteino's Story

Charles Oteino (changed name) is a 19 year old who was referred to me by a social worker in Khunyangu, one of our busier clinics in Busia County. When I saw Charles at our Mosoriot clinic he was a frail skeleton, clearly near the end of his painful journey.

Charles was infected with HIV at birth and as is too often the case became an orphan when first his father died with the disease and then his mother. Charles was ultimately sent to live with an Aunt in Siaya. Unfortunately, the Aunt had no interest in Charles and simply wished he would go ahead and die. She would throw out his antiretroviral drugs and refuse to give him transport money to attend our clinic in Khunyangu. Even though he had reached high school, the Aunt refused to support his school fees as well.

Charles was determined to try to survive and began walking over three hours to keep his clinic appointments in Khunyangu and then walk back home. The social worker in Khunyangu realized that Charles would not survive much longer and sent him to our shelter in Mosoriot where I saw him the next day. All of our initial attention was focused on treating opportunistic infections, changing him to second line antiretroviral drugs and food, food, food. Before long a new Charles began to appear----a fine young late teenager needing love and some hope for a future. It was clear to all of us that Charles could not return to Siaya and any meaningful plan would demand a new beginning.

Thanks to the generosity of those who have donated to my humanitarian fund, Charles has a modest wardrobe a smart school uniform, all of the books/supplies he needs and tuition paid in a nearby boarding high school.

During school breaks Charles returns to the Mosoriot shelter as “home” and helps with the chickens and gardens that feed the guests in the shelter. Over the weekend, Sarah Ellen and I love having him over for a meal in town. His favorite has become the Chinese restaurant where he loves the food while struggling with chopsticks. 

Dr. Joe Mamlin shared this update with us at AMPATH, as an example of how your contributions are used. Asante Sana! 

Jul 31, 2017

Continued Progress!

Jambo!

Welcome to our third report for the Providing Palliative Care in Kenya project. This is a partnership between the dedicated palliative care physicians, clinical officers, nurses and social workers in Eldoret Kenya and the Indiana Institute for Global Health.

 The team’s efforts have been needed more than ever. There has been a nation-wide nursing strike throughout government hospitals in Kenya. The reasons are complicated but the impact on patient care is significant. The palliative care physician, clinical officers and social workers have all stepped up to do what they can to insure patients pain and symptoms are identified and treated.

In our last update, I mentioned that we received a small grant to pilot the use of telephone monitoring as a means of delivering hospice care for patients who do not have access to home hospice services. That study is underway and we are preparing a second study in collaboration with the wonderful team at the Kimbilio Hospice in Kenya to use a similar approach for patients that are cared for in their inpatient hospice and then discharged home. Your donations are helping us bring pain and symptom management into the most rural parts of Western Kenya.

In June, Phanice, the palliative care nurse on our team, received a grant from the hospital in Kenya to visit the US. She spent three weeks with the palliative care teams in Indianapolis and Bloomington, Indiana. Phanice’s time included a week with Andrea the wound care nurse at Eskenazi Hospital. Andrea was kind enough to provide both education, as well as hosted Phanice in her home. Phanice’s time with Andrea was important since she is the primary nurse providing colostomy care for Moi Teaching and Referral Hospital in Kenya, as well as providing palliative care services to both inpatients and outpatients. Phanice spent a week with me at Bloomington Hospital and we concentrated on pain and symptom management. Overall, she found the experience invaluable and looks forward to implementing what she learned back in Kenya. We all learned from Phanice as well, she asks very insightful questions and her novel perspective helps us expand our views and our approach to medicine. 

As always, thank you for your support! The Palliative Care Team takes patients who present with unimaginable suffering and provides them with pain relief, hope, and most importantly dignity. I have seen it and your donations really have direct impact on people in need.

Sincerely

Ken Cornetta and the Palliative Care Team

 
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