Physical Health Kenya Project #46097

Help protect 1000 health workers in Western Kenya

by SAFE WATER & AIDS PROJECT

Project Report | Oct 15, 2021
GlobalGiving Report October 2021

By Alie Eleveld | Founder SWAP and Technical Advisor

GLOBAL GIVING REPORT

OCTOBER 2021

Help protect 1,000 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 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

COVID-19 Current Status in Kisumu and the Lake Region Economic Bloc (LREB)

Limited testing, slow vaccine rollout under COVAX, poor logistics, limited health system implementation capacity, and serious vaccine hesitancy are amongst the constraining issues to controlling COVID-19 in this region. While Europe and the USA are potentially moving towards ‘herd immunity’ through vaccination program, Africa is tremendously lagging (less than 3% of the population is vaccinated today). COVAX is seriously behind. Recent research prove that COVID-19 is in fact very much present, though more hidden, due to underreporting and less symptoms. This situation, with high COVID-19 presence at the population level, seriously risks the development of different COVID-19 mutants in the future that could (partly) escape from existing COVID-19 vaccines, creating potential health risks to Kenya. In Kenya’s Lake Region residents’ livelihoods have been significantly disrupted by COVID-19. A raft of measures including dusk to dawn curfew, cessation of movement, social distancing, among others have made subsistence trade difficult, causing widespread food insecurity.

The LREB region with 14 million inhabitants has 2,363 health facilities, 2,870 isolation beds, 137 ICU beds, 1,216 doctors, 8,866 nurses, 30,213 community health workers, 36,213 cases, 117 ambulances, and less than 300,000 and 50,000 have received the first and second doses of vaccine respectively.

From May 9 2021 onwards, starting in Kisumu, LREB region is experienced a sudden Delta Variant surge, which followed preceding Alpha and Beta surges. This further exacerbated the deteriorating socio-economic situation.

The unstable COVID-19 situation in LREB identified gaps in disease management, response, surveillance, and recovery. These gaps include, but are not limited to insufficient medical oxygen, inadequate testing capacity, need to accelerate COVID-19 testing, understaffed health facilities, little vaccination, waning cross-border disease surveillance, few multidisciplinary clinics to attend to long COVID-19 patients, and lack of social safety nets like health insurance schemes to cushion residents against ravages of the pandemic.

SWAP has a wealth of experience in public health interventions and has worked in collaboration with County Health Management Teams to respond to COVID-19 especially with focus on health care facilities supporting and protecting the frontline work force and the community at large from COVID-19 spread.

For that reason, the GlobalGiving platform was used to source for crowd funding from donors and well-wishers in our effort to protect health workers, reduce the COVID-19 spread and mitigate the impact.

Production and Distribution of Alcohol Based Hand Rub to public health facilities

Following the needs of improved hand hygiene for infection prevention and control of hospital acquired infections including COVID-19, SWAP supplemented the GlobalGiving funds and sought funding from loyal donors to produce its own alcohol based rub (ABHR) to supplement the distribution of hand washing stations and soap.

The ABHR was produced in SWAP’s water lab by a team of lab technicians and approval was granted in December 2020 by the Kenya bureau of standards for a period of two years. Since January 2021 the monthly distribution continued to 50 public health care facilities in Kisumu County for all patient care areas. Distribution is done on needs basis while regular monitoring and evaluation is done to observe use and hand hygiene practices. Alcohol Based Hand Rub is also sold to partner organizations.

In September 2021, SWAP extended the activities to 34 hot spot areas in the region. These are local markets, police stations, administrative offices among others. In these areas, hand washing stations and soap were donated and training was done on hand hygiene and social behavioral change communication. In collaboration with the Public Health Officers, ongoing monitoring of compliance and proper use is done.

STREAM disinfectant generation

SWAP imported 8 STREAM disinfectant generators and installed these following training at health care facilities. The STREAM Disinfectant Generator provides a continuous flow of disinfectant solution (0.5% sodium hypochlorite) from common salt and electricity. The chlorine-based solution generated by the STREAM System complies with national and international guidelines for disinfecting surfaces, medical devices, and instruments. The STREAM Disinfectant Generator is ideal for rural and urban hospitals. The STREAM system produces enough disinfectant to treat up to 240,000 liters (60,000 gallons) per day of water. The 8 facilities selected by Kisumu County Health Management Team now no longer rely on the mostly interrupted external supply but can produce enough chlorine for infection prevention and control.

COVID 19 Vaccine Outreach

Because of COVID-19 vaccine hesitancy and myths and misconceptions around COVID -19, Kisumu County Health Management Team reached out to partners seeking support of the County Expanded Immunization Officers with COVID-19 outreach. The target group was people living in informal settlements where there is in general overcrowding and poor compliance with COVID-19. Many people living here are not well educated and therefore have limited access to health services and have not taken the initiative to go for COVID-19 vaccinations. To reduce this barrier, mobilization was done prior and the COVID 19 vaccination outreach teams were brought to them in Nyalenda, Obunga and Manyatta informal settlements during a two day exercise on 13^th and 14^th October 2021. SWAP supported with the mobilization and allowances for the teams mobilizing, vaccinating and recording.

WE THANK YOU FOR YOUR ONGOING SUPPORT AND DONATIONS

Attachments:

Global Giving Report October 2021 with images (PDF)

1 Attachment

Permalink

Jun 29, 2021
GlobalGiving Report June 2021

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.

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

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;

Brief interview with nurses
Monitoring of use and compliance
Replenishing stock on demand
Hygiene promotion and social behavioral change communication.

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

Attachments:

Global Giving Report June 2021 with images (PDF)

1 Attachment

Permalink

Mar 3, 2021
GlobalGiving Report March 2021

By Alie Eleveld | Founder SWAP and Technical Advisor

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.

WE THANK YOU FOR YOUR ONGOING SUPPORT AND DONATIONS

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