IMANI REHABILITATION AGENCY HEALTH PROGRAM
INTRODUCTION Health is a primary focus everywhere in the world. It is an area that touches on each and every human being and it has become a major concern in all nations. Every aspect in health becomes a challenge if it is not attended to with much concern. We in Imani value and respect the ethics of health and we put all health matters in the forefront. As it is said “a working nation is one that is healthy” We believe that children are a part of the working nation and so we in Imani strive to make sure that the children we have are attended to properly in regards to health: In Imani baby house we take care for abandoned and/or neglected babies.
When they are admitted to Imani they are often malnourished and some suffer from internal injuries. Their immune systems are weak and the babies need medical attention. 5% of the children are HIV infected and they grow up in Imani 5% of the children are handicapped and for this reason abandoned by their
parents in hospitals and on the streets.
We have a rescue center for approximate 45 sexually and physically abused children.
The large majority of children grow up healthy in the different Imani houses.
Imani has the availability of three clinics in our homes. We have three permanent nurses and doctors visit on regular basis our homes.
Our daily, weekly and monthly health activities are described in chapter 2.2 To limit the expenses for the hospitals Imani children are members of National Hospital Insurance Fund. The yearly expenses for the Imani Health program are around 3 Million KSH; 30.000 Euro a year. It is expected by getting assistance on medical support our children will grow up in good health. Secondly, when children are in good health their performance in school will be better. Thirdly, we will be able to manage primary infections before they become complex and in other case we will curb some diseases like diarrhea, typhoid and cholera.
1.1 IMANI BABY HOUSE Imani is so far accommodating an average of 350 children, which are day old babies to 18 years. Our major objective is in the area of child protection. Most of our babies are salvaged from unhealthy environs like the pit latrines, waste bins and some stay out the whole night before they are rescued. On average, we receive at most 5 babies a month who mostly come from Soweto slums either by being abandoned or neglected. Once these children are abandoned, they are denied the right to breastfeed hence making them prone to diseases. Their immune systems become very weak hence they require medical attention. We rescue children who are malnourished as a result of mothers who suffer from post pregnancy depression. The babies are either underfed or denied the nutrients they require for growth. Child care being our major objective, Imani takes upon itself to bring these babies back to health and it becomes quite costly as they require special attention and food supplements that are rich in nutrients. Some of the children that we rescue from the situation surrounding their abandonment is not clear during the admission, but after a thorough check up in the hospital, we are able to find out that they suffer from internal injuries. It now becomes our duty to cater for the medical expenses of these children which is very expensive. It is not every ailment we are able to treat in our first aid clinic; we therefore make necessary referrals to other specialized hospitals where we meet the cost of treatment and medicines. The medicines are very expensive and most hospitals are shying away from waiving the amount as they also suffer the cost of buying the medicines.
1.2 HIV The lacking support in the community in cases of HIV drives mothers to delay in testing, preventing them from taking early action towards PMTCT (Prevention of Mother to Child Transmission). Discrimination and stigma further enhances neglect and forces the mother and the community to abandon the already sick babies. On admission, the babies are tested of their status and after the results are out, we then act depending on the results. For children who are found to be positive, they are taken to Coptic hospital for screening and then put on medication. Currently we have 16 children who are HIV positive and they get their medicine from Coptic hospital. After every two months they are taken to Coptic hospital for checkups on their nutrition and also to collect their medicines. Their blood is tested after every six months to check their CD4 count. At the home, the nurses are in charge of administering the medicines to these children. The nurses make sure that the children take the medicines at 6.30am and 6.30pm everyday without fail. The ARV drugs are offered free of charge in the hospital. The other children are checked on admission and after three months they are given vitamin A capsules to boost their immunity and multi vitamin syrups to improve their appetite. We do not offer medical services to mothers or other people unless it is an emergency, where we only offer first aid to the patient and afterwards the patient will decide where to go for proper treatment.
1.3 HANDICAPPED CHILDREN Imani also receives children with disabilities of different kinds ranging from vision and hearing impairment, congenital disability, and bladder entropy, osteogeresis imperfect of limbs, seizersâ€™ disorder, hirschsprungs disease and burns. These children are normally taken to the hospital for special treatment where a lot of money is used. Since they are children with disabilities, their medication is constant and on a regular basis.
Some of the children in Imani with disabilities These children need special equipments like wheelchairs, hearing aid, walking stick, special shoes, glasses, skin protection oil. They also need to be taken to special schools with children of their kind where they will get special education and attention.
1.4 SEXUALLY AND PHYSICALLY ABUSED CHILDREN We have a rescue center for the sexually and physically abused children in Ngong. On admission, these children undergo physiotherapy as they come with broken limbs and even burns. Sometimes we are forced to call for a psychiatrist to offer counseling for these children. Our home counselor offers counseling sessions to boost the previous sessions handled by the psychiatrist. It requires a lot of sessions for these children and it takes time to adjust to the new life around them. Some of these children take long to heal from the trauma they underwent when being abused hence they require more time and special attention. At times the social worker steps in to offer the children with counseling sessions. There are times when we rescue children who are still very young and after a few months of growth, we realize that they have medical complications that require medical attention and sometimes further referrals. Since this child is under our care, it is upon us to ensure that the child lives a normal life.
1.5 THE HEALTHY CHILDREN Apart from the children who are HIV positive, there are those who are healthy. They at times suffer from common illnesses like heacahes, malaria, common cold, chest aches and other treatable illnesses. The children have their checkup yearly which is conducted by specialized team of doctors and nurses form different organizations who volunteer. Whenever the children get ill, they are treated within our home clinics but if it is a serious case then a referral is made by the nurse to a major hospital under the instruction of the home doctor. The young babies who are still on immunizations are regularly taken to a heath center for their injections. The injections are monitored using the clinic cards and so the nurses at the health center know which injection to give to which child and at what age. The other children get injections when it is necessary and are also put for IVs if need be there. The injections and IVs are administered by the nurses. In the home there are older girls who undergo a lot of counseling and teachings concerning their body changes. The girls have not been put on any form of birth control but they are tested on pregnancy each and every month.
2.1 NURSES AND FACILITIES Imani has a total of 3 nurses, 2 nurses operate in Imani A, B, Kasarani and Baby house. There is 1 nurse in Malindi who works in the home. Imani Ngong does not have a nurse but the board chairman who lives in Ngong owns a clinic and so he volunteers on Tuesdays and Saturday to treat and check on the children in Ngong. DUTIES OF THE NURSES IN THE HOME
Dispensing of medication and injections
Taking the young children for clinics
Taking temperatures of the children
Giving first aid to the children
Ensuring that the children are checked by the doctor weekly
Writing of the medical reports.
Establish IVs or other medications
Provides small procedures i.e. change a dressing
Triage i.e. taking health information on admission and prioritizing according to the need.
Inside view of Imani A and babies unit clinic.
Inside view of Imani B and Kasarani clinic.
Inside view of Imani Malindi clinic
2.2 DAILY, WEEKLY AND MONTHLY HEALTH ACTIVITIES Since we have very young babies in the center, extra attention is given to them.On a daily basis, our nurses take the temperatures of these children aged 1 day old to 5 years old. This enables us to know the health of each child as they wake up in the morning and in case of any emergency, the situation can be rescued much earlier. The nurses also check on their chests to make sure that there breathing is normal. The weight of the children is taken monthly and recorded in their clinic books. The chart is then monitored closely by the nurse and in case of any drop in weight then the child is given special attention and care.
A sample of the weight chart used by the nurse.
The children are also given vitamin tablets after every 6 months to help in the vitamins supplement and they are dewormed after every 3 months. This is all done under the
supervision of the nurse. The young babies are also taken to the clinics to get their immunizations done. Usually they are taken by the care givers accompanied by the nurse. The immunizations are also recorded in the clinic books. As the babies are taken to the clinics the care givers are given training on nutrition and the kind of foods they are to be given. The everyday meal of these children is therefore monitored. Currently we do not have children
who are on special foods or diet. Every week a doctor comes to Imani A and B twice (on Tuesday and Thursday), to check on the health of the children and also to check for any special case that needs much attention. At
the end of it all a report is written by the nurse to indicate the findings of the month. As much as we take care of medical conditions that arise, we try to ensure that these babies with low immunity do not become sick hence we raise our standards of cleanliness. We ensure that each child maintains hygiene and so for the much older children they usually disinfect their bedding and clothes with dettol and antiseptic. The care givers to the young ones also use antiseptic to clean the rooms and clothes that the children use. The toilets are cleaned regularly with disinfectant soap. The cost of having to budget for all these materials is quite expensive and we cannot close our gates because we are financially crippled instead we open our hearts with an open heart to these children. In a day we have an average of 2 children visiting the hospitals due to one reason or another especially cases that we cannot treat in our first aid clinic. 3 NHIF CONTRIBUTION Children NHIF (National Hospital Insurance Fund) is a government initiated contribution made monthly to cater for any expense incurred on hospital admission. The contribution is made in groups of three, each group paying Kshs 160 per month through the authorized government centers. The program has been beneficial to our organization since in case of children admission, the government pays the entire bill invoiced without considering the amount of contribution made. As a home, we have benefited from the program for almost 2 years and the results have been commendable. Once a child joins the program, a membership number and card is issued to enhance easy administration of any arising hospital admission case. The program allows for new entries and exit from our home which are updated automatically in their system. The average amount paid per month from Imani childrenâ€™s home, for all the branches, has been Kshs. 16,000 which depends on the number of children present during a given month. Below find a sample of the receipts issued by the National Hospital Insurance Fund on payment.
4. PROJECT OBJECTIVES Primarily the objective of this project is to provide: a. Primary health care to our babies. Childhood is the most crucial developmental period
in an individualâ€™s lifetime, and in particular health issues. The earlier these diseases are detected the easier it is to control it as the child grows and the less expensive it is for us as an organization. b. Medicines and care to our HIV infected children from childhood up till they become
adults. c. Medicines, wheelchairs, hearing equipments, to our handicapped children. d. Medical and social attention for abused children. e. Medical care for every child in the event of sickness.
Secondly, we have learnt through experience that we can use preventive methods to curb some of these diseases like diarrhea. We have therefore maintained high standards of cleanliness be it in handling our babies, food and also general cleanliness in the compound.
Care givers taking babies to the clinic.
4.1 PROJECT OUTCOME It is expected by getting assistance on medical support our children will grow up in good health. Secondly when children are in good health their performance in school will be better. Thirdly, we will be able to manage primary infections before they become complex and in other case we will curb some diseases like diarrhea, typhoid and cholera. 4.2 CONCLUSION The philosophy and experience of Imani Childrenâ€™s Home is based on the reality that every human being is a unique individual and that we all have a right to good health and basic needs and should access means to a comfortable life in one way or another. Children are subsumed within the poverty categories most often referred to such as households, communities, people â€“ which means that there is a high tendency to focus on adult-related poverty while child problems are ignored, partly because children have little power and influence within a group that contains adults. Therefore it is in our best interest to provide parental care and guidance, provide primary health care, quality education, rehabilitate and reintegrate them into the society to address and alleviate factors leading to the phenomenon of their situation. We strive to give these children the best as their future depends on us hence we take it upon us to nurture them, shower them with love and guidance and provide basic needs so that they fit into our society and not feel left out. Imani childrenâ€™s home is humbly requesting for your support in our initiative to elevate the livelihood of this society by supporting our health and medical care bill that makes a meaningful difference in the lives of children. A contribution from you will give us the jumpstart we need while we continue to implement our set goals and objectives. We hope that you will find it in your hearts and budget to support our project. We look forward for your immense goodwill in necessitating the operation of our project.
5.0 PROJECT FINANCIAL BUDGET IMANI REHABILITATION AGENCY HEALTH PROGRAM BUDGET FOR ONE YEAR ITEMSSUB-ITEMS KSH Hygiene materials 600.000 Hospital charges 1.200.000 NHIF for children 200.000 Drugs/medicine 500.000 Salary doctor and nurses 432.600 Travelling 95.000 Special shoes (2people) 10.000 Hearing aids purchase 25.000 Hearing aids batteries 10.000 Special oil for special cases 5.000 TOTAL 3.077.600 We use for hygiene materials per month; • 10 jiks • 6 bags of omo • 10 boxes of jamaa soap • 20 tins of valon • 15 bottles of harpic • 10 litre bottle of dettol