Gerties News Issue 67 | July 2023

WORD FROM THE CEO

From the CEO’s Desk…

Dr. Robert Nyarango CEO

Dear readers,

I am pleased to present the most recent issue of our newsletter, which provides our readers with updates from Gertrude's Children's Hospital as well as our Foundation and the impact we continue to make in line with our mission to improve the health of children and adolescents in Eastern Africa through high-quality healthcare, education, research, and advocacy.

This issue also coincides with the end of our financial year, which has been very successful despite the extraordinary operating environment. In the year, more children had access to high quality preventive and curative care and the depth and scope of our services also increased. During the year we opened our second medical centre outside the Nairobi Metropolitan after Mombasa in Kisumu, and we are on course to open another facility in Meru.

Towards the end of last year, we celebrated our 75th anniversary since our inception in 1947. We look back with great satisfaction at the milestones we have attained over that period. We have reached and impacted millions of children in the past 75 years and in the immediate past 20 years we have provided care directly to over 5 million children. Over the same period, we have expanded our specialist centres of excellence by increasing capacity and infrastructure.

In the last financial year, key highlights included the purposeful expansion of our cardiac surgery program with some surgeries including AV canal repair, Truncus arteriosus repair and Mitral valve repair with a tissue implant done successfully in Kenya for the very first time. Our flagship telemedicine program, DaktariSmart, done in partnership with Mpesa Foundation and Getrude’s Hospital Foundation made significant strides in providing specialist care to children in the counties of Baringo, Lamu, Homa Bay, and Samburu. We are course to onboard Narok county. Through the program, thousands of children have accessed high quality life-saving care enabled by technology.

We are optimistic about the future and have laid down solid plans to impact five million children over the next five years through a comprehensive preventive and curative approach, covering the entire continuum of paediatric and adolescent care and increased our reach to the Eastern Africa region. We will also keenly focus on expanding access to care to more children in Kenya through our access initiatives.

We owe a debt of gratitude to our dedicated Board of Trustees, management, employees, and partners, who all work collaboratively to bring our mission to life and to continually service the community.

Robert.

Editorial

Martin Mulwa - DCL

Chief Editors

Bernard Mpara - CCO

Diana Gachugi - CAL

Executive Producer

Dr Robert Nyarango - CEO

YEARS

1947-2022 OF TRUSTED PAEDIATRIC CARE

Gertrude’s Children’s Hospital on Track with New Five-year Growth Plan

Since its inception as a children's convalescent facility in 1947, Gertrude’s Children’s Hospital has evolved and expanded to become a Level 5 Tertiary Referral, Teaching, and Research Children's Hospital. Today, the non-profit Children's Hospital is the most recognized paediatric hospital in Eastern and Central Africa, and it is globally accredited for quality and safety by the Joint Commission International USA. The hospital serves over 400,000 children and adolescents annually.

In the next five-year phase, the hospital has outlined an ambitious strategy to contribute to the improvement of the health of five million ( 5M) children. The strategy, whose main thrust is to significantly expand access to primary healthcare through two primary care networks, while increasing access to high quality tertiary care at the hospital hub, was finalized last year and in the first year of implementation.

In order to increase access to quality healthcare to more children in the region, the hospital will expand its network of facilities to select counties in Kenya and deploy an access model network of facilities, both of which will be highly technology enabled to achieve service integration, continuity of care, and access to specialist care. The hospital is also in the process of establishing centres of excellence in select paediatric sub-specialties at the main campus in Muthaiga that will integrate care delivery, paediatric specialists training and research. The hospital has also embarked on a progressive process to establish a training and research hub focused on child health and adolescent care, to complement similar hubs in the North and South of the continent.

The current strategy dedicates significant resources to build on the existing quality and safety systems to further enhance clinical outcomes and service quality aimed at continually achieving internationally recognised world-class standards.

Delivery of the strategy will heavily depend on effective partnerships which both the Hospital and Hospital Foundation will help foster and grow.

Gertrude’s Hospital Foundation’s Annual Cancer Walk is Back and Bigger

In May, thousands of people gathered at Nairobi’s Uhuru Gardens in a display of solidarity and to raise funds for childhood cancer diagnosis and treatment during the 2nd annual Cancer Walk organised by Gertrude’s Hospital Foundation.

Dr Robert Nyarango, the Gertrude’s Hospital CEO, said the walk was intended to raise awareness about childhood cancers and assist the hospital in accelerating early diagnosis of the disease.

“For the thousands of children who are not diagnosed with cancer every year, early detection is key to starting them on treatment in good time and to achieve good outcomes. This is especially important given that 80% of childhood cancers are curable, but only two (2) out of 10 Kenyan children with the disease achieve full remission. The funds raised from the walk will help us extend the services cancer treatment centre to even the most vulnerable communities across the country,” said Dr. Nyarango.

On his part, the hospital’s head of Clinical Services, Dr. Thomas Ngwiri, underscored the value of early detection in helping improve treatment outcomes, while stating that the hospital has established a program to step up diagnosis and treatment of paediatric cancer nationwide. “We initiated the Kenya Childhood Cancer Program in 2019 and intend for it to run in perpetuity to advance childhood cancer diagnosis and treatment, build the capacity of health workers to detect childhood cancer, and provide timely interventions to children diagnosed with cancer. By the end of the first five-year period of the program, we aim to have treated at least 1,000 children,” said Dr Ngwiri.

The Gertrude’s Hospital Kenya Childhood Cancer Program is working with County governments to establish a diagnosis and referral system and is already engaging healthcare workers to improve their capacity in providing quality and holistic cancer treatment.

“We are grateful to all the partners who donated, and to everyone who participated in the walk. By lacing their shoes and joining us, they not only managed to raise funds for paediatric cancer treatment but also promote the importance of healthy living while spending quality time with family. The walk allowed us to increase awareness of childhood cancer while helping to build a stronger support system for all the brave children that are facing the disease,” added Dr Ngwiri.

The World Health Organization (WHO) estimates that 400,000 children under the age of 19 worldwide are diagnosed with cancer each year, making it one of the top three causes of mortality for children. There were 3,000 new cases of childhood cancer in Kenya in 2020, according to the Global Cancer Observatory (GLOBOCAN), a WHO-run online database of cancer statistics.

The Gertrude's Hospital’s Cancer Walk event was first held in 2020 and took a break during the COVID-19 pandemic.

2nd Annual Cancer Walk 2nd Annual Cancer Walk

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Henry’s Courageous Cancer Journey: The Pain, the Tears and the Triumph

Henry had a joyful, regular upbringing until the age of 15 when he became unwell and became too weak to attend school. His condition deteriorated, and with no definitive diagnosis from the hospitals in his hometown, he was referred to the Gertrude’s Children’s Hospital medical centre at Doonholm. It was on this day that his life would take an unforeseen turn, and Henry has allowed us to share here his story of pain, resilience, determination, and triumph.

Henry was referred for further evaluation at the Gertrude’s Children’s Hospital at Muthaiga because he had symptoms of Congestive Cardiac Failure (CCF), and his haemoglobin was extremely low. Tests indicate that his bone marrow was not functioning properly or was not producing normal cells. His kidneys were on the verge of failing. All of this pointed to something other than a heart problem, prompting additional tests.

Further tests unfortunately confirmed that Henry had a form of cancer called Acute Promyelocytic Leukaemia, which requires patients to begin treatment as soon as possible to avoid the risk of bleeding and death.

"I spent two months in the hospital after receiving my diagnosis and all this time, they treated me as if I were their own child even though I was in a lot of pain to the point of thinking about death,” Henry narrates.

"I was son after started on chemotherapy, which resulted in severe headaches, cracked lips, and my hair started falling out. I would look at myself in disbelief. Apart from headaches, other adverse effects include vomiting and loss of appetite...I remember going for 8 days skipping meals. The good thing is that I began to gain some weight despite my circumstances, which made me very happy.”

Henry soon became withdrawn and stopped talking to everyone, not even to him mother. With the help of the hospital counsellors and psychologists Henry and his family were provided the requisite psychosocial support to cope with the reality of the diagnosis, the challenges of treatment side effects and the emotional drain that comes with a cancer diagnosis. The hospital team of nutritionists, physiotherapists, chaplains, and indeed other disciplines ensure Henry received comprehensive round the clock care.

At fifteen years of age, Henry had the typical challenges that teenagers have when diagnosed with a chronic of potentially terminal illness. “ I was lucky that I was in a hospital very well equipped to provide care to teenagers, and with comprehensive programs to care for teenagers with catastrophic illnesses”, says Henry.

Long story short, Henry is currently in his third year of treatment and is doing exceptionally well. The disease has nearly been eradicated. Recent laboratory tests indicate that his kidneys are healed, and his bone marrow is generating heathy blood cells. His cancer is in remission. However, because he is still a child, he will require regular monitoring and follow-up after completing his treatment.

"God has been gracious to me, and through it all, I discovered that I am funny and that I can act. I have a YouTube channel, which has been a turning point and a place for me to better understand myself. Through the platform, I can reach out to parents whose children are going through the same thing and encourage them. Being there for them is enough, and if you are a teenager going through the same thing, I want to encourage you that things will be fine," he says.

The Paediatric and Congenital Cardiac Surgery Program at Gertrude’s Children’s Hospital

Background

Congenital heart disease (CHD) is a term that refers to congenital abnormalities that affect the heart and major vessels. It is believed that one in every hundred children born alive (1%) has CHD. In Kenya, it is projected that approximately 13,000 children are born with CHD each year. CHD is usually corrected through surgery. Most of the time the heart surgery requires that the patient is hooked up to a 'Heart-Lung machine' (HLM) to enables the surgeon to halt the patient's heart and fix the heart defect.

Progress

The first open heart surgery at Gertrude’s Children’s Hospital was conducted at GCH in October 2013. We are currently on track to complete 50 surgeries every year. Our team has operated on 183 patients in total, 118 (64.5%) on-pump (open heart) and 65 (35.5%) off-pump (closed heart).

The heart defects listed below will benefit either from open heart surgery of closed heart surgery.

Open heart surgery (OHS)

1. Atrial septal defect (ASD)

2. Ventricular septal defect (VSD)

3. Tetralogy of Fallot (TET)

4. Complete Atrioventricular canal defect (CAVCD)

5. Ebstein’s anomaly (tricuspid valve replacement)

6. Single ventricle (Bi-directional Glenn Shunt)

7. Mitral valve repair

8. Aortic valve replacement

9. Truncus repair (contegra)

Closed heart surgery (CHS)

1. Patent ductus arteriosus (PDA)

2. Pulmonary artery banding

3. Blalock-Taussig-Thomas shunt

4. Coarctation of aorta repair

The cardiac surgery program is part of the hospital’s Paediatric Cardiology and Cardiothoracic surgery Centre that provides comprehensive diagnosis and treatment for conditions affecting the heart and related organs. Care at the centre is provided through a multi-disciplinary team of highly skilled staff including paediatric cardiologist, paediatric cardiothoracic surgeons, paediatric anaesthesiologists, paediatric intensivists, paediatric critical care nurses, clinical pharmacists, clinical pathologists, child psychologists/counsellors. Their persistent efforts and steadfast dedication to quality have resulted in great outcomes for these brave young patients, enabling them to live healthy and vibrant lives.

Gertrude's Children's Hospital remains devoted to developing paediatric cardiac care and expanding access to life-saving operations. The Hospital continues to invest in cutting-edge technologies and research to improve treatment outcomes, with the goal of creating a world where every child with a heart problem may receive the care they deserve.

Cardiac Surgery Sessions

Our Success Story: More Than 183 Little Hearts Healed Since 2014

Gertrude's Children's Hospital is proud to have performed 16 successful lifesaving heart operations on children. These extraordinary treatments signal an important step forward in the hospital's ongoing dedication to improving the lives of children in need.

These young children had complicated procedures to address congenital heart abnormalities and other severe cardiac diseases under the competent hands of Gertrude's renowned team of paediatric cardiac surgeons. The surgeries were performed with extraordinary experience, cutting-edge technology, and loving care, resulting in restored health and renewed hope for these children and their families.

The incredible devotion and ability of Gertrude's Children's Hospital staff, including surgeons, nurses, anesthesiologists, and support teams, is exemplified by each child's individual journey to healing. Their persistent efforts and steadfast dedication to quality have resulted in great outcomes for these brave young patients, enabling them to live healthy and vibrant lives.

The families of these 16 youngsters have expressed their great thanks to Gertrude's Children’s Hospital for the exceptional care they have received. Families have seen a remarkable turnaround in their children's lives as a result of the Hospital's comprehensive approach to treatment, which includes preoperative counselling, rigorous medical exams, and continued postoperative care.

"It is with great joy that we celebrate the successful cardiac surgeries performed at Gertrude's Children's Hospital," said Ms Caroline Ayilo, Chief Nursing Officer. "The collaboration and dedication of our multidisciplinary team have enabled us to provide life-saving interventions and give these children a second chance at life. We are immensely proud of their resilience and strength, and we are grateful for the trust placed in us by their families."

Gertrude's Children's Hospital remains devoted to developing paediatric cardiac care and expanding access to life-saving operations. The Hospital continues to invest in cutting-edge technologies and research to improve treatment outcomes, with the goal of creating a world where every child with a heart problem may receive the care they deserve.

The successful operation of more than 183 young hearts fixed since 2014 is a great achievement and a testament to the Hospital's dedication to promoting the health and well-being of Kenyan children. The operation was made possible via collaborations with a variety of organizations and donors who support the Hospital's objectives.

Meet the Team

Cardiothoracic Surgeons

Dr.Mark Awori

Dr.Nikita Mehta

Leon Ondieki

Cardiologists

Dr. Martin Mbiata

Dr. Sean Del Rossi

Anesthesiologists

Dr.Jimmie Kabugi

Dr.Alphonce Mwendwa

Dr.Hypheginia Mbithe

Perfusionists

Alex Kentyatta

Boniface Muturi

Theatre Manager

Leah Asami

Theatre Nurses

Pamela Laleyo, Nicholas Miriti, Phyllis Ngige, Diana Njeru

Pediatric Intensivist

Dr. Wangui Manguyu

ICU Doctors

Dr. Anne Metto

Dr. Magarette Odoyo

Dr. Aspagreen Mola

Dr. Nicolas Mosoba

Dr. Ismail Ahmed

Dr. Kabui Kaguongo

Dr. Agnes Mwilu

Dr. Lizz Kinyua

Dr. Beatrice Tole

Laboratory Team

David Kimani

John Kamau

Brian Akombo

Clement Ndungu

Samuel Sande

Emily Simiyu

Daniel Kibe

ICU Support Staff

Emma Chebus, Hannah Kamau, Rosemary Wangari, Judy, Mokeira, Matilda Isambo, Godfrey Oketch

Surgical Ward Manager

Alice Cheruiyot

Nurses

Tracey Allindi, Jane Kamau, Loice Mbiti, Duke Ogoti, Leah Kinuthia, Ann Kajuju, Linet Barasa Susan Thuo, Richard Timondo, Evangeline Bulimu, Janet Muithya, Mary Joel, Peter Wamweya, Simon Kanguru, Joash Ngeno, Winnie Nyabuto, Dorcus Mugure, Judith Kigen, Ruth Nzomo, Emily Ntinyari, Topista Nangira, Magdalene Nambuye, Faith Wangechi, Felix Kirema, Ann Oyaro, Domtilla Kegehi, Thecla Tibenda, Jane Mary Gichuru, Ruby Ojode, Lilian Tirra, Josephine Indimuli, Alice Githuka, Grace Muiruru, Molly Mutula, Hilda Mbuya, Melisa Kwendo, Stephen Kamunya, Newleen Boyani, Betty Mutembei, Amos Simiyu, Irene Kariuki, John Nangaira

Biomedical Team

Antony Murithi

Elijah Limo

Frederick Nyanduso

Moses Mwangi

Cardiac Surgery Beneficiaries

Grayton Knox Truncus Arteriosus (TA)

Angela Mwihaki

Atrial and Ventricular Septal Defects (ASD/VSD)

Blessing Masakati Ventricular Septal defect (VSD)

Brian Kipkoech Korir Tetralogy of Fallot (TOF)

Precious Waridi Atrial and Ventricular Septal Defects (ASD/VSD)

Hadija Ali Patent Ductus Arteriosus (PDA)

Children Treated 16

Mylar Mueni Atrioventricular Septal Defect (AVSD)

Ladasha Queen Njeri Tetralogy of Fallot (TOF)

Lucy Mukhambe Khamisi Tetralogy of Fallot (TOF)

Chepoghisho Thomas Rheumatic Heart Disease

Josephat Sila ASD/SUPERIOR RIM

Opinion: Tackling That Persistent ‘Homa’ This Cold Season Starts With You

By Dr Winnie Akoth

We are well into Kenya's cold season, which has seen us experience extremely low temperatures as well as a fair share of rainfall. Sweater and space heater stores see a significant increase in sales each year as more people look for ways to keep warm during this season.

Hospitals are also seeing an increase in the number of people seeking treatment for sniffles. As of now, no one is immune to the common cold, having either caught it or nursed sick family members back to health.

The common cold is distinguished by a runny or blocked nose, fever, sore throat, cough, watery eyes, and fatigue. Adults and children alike are frequently pushed to miss work and school depending on the severity of the symptoms.

Viruses such as influenza, rhinoviruses, and corona viruses, among others, are the most common cause of common cold infections. These viruses spread from person to person through contact with droplets produced when an infected person coughs or sneezes. Because of the mode of transmission, the common cold is one of the most contagious illnesses, especially among people who congregate in crowded places.

Schoolchildren are especially vulnerable because they are in close contact in classrooms and on school transportation, and they frequently participate in group activities that necessitate close physical proximity. It's no surprise, then, that when one child gets a cold, almost all their classmates catch it soon after.

Even though we are accustomed to the sniffles, sneezes, and coughs that accompany the common cold, it is still necessary to see a doctor to confirm the illness. What most people don't realize is that other, more serious illnesses, such as bronchitis, can masquerade as a simple cold.

The common cold, like other viral infections, has no cure. The reason for this is that there are so many different strains of the viruses that cause the common cold, making it difficult to develop a cure that works for all of them. However, cold symptoms will go away on their own.

Contrary to popular belief, antibiotics will, however, not help treat a viral infection. Antibiotics are only used to treat bacterial infections. The immune system takes seven to ten days to eliminate the virus, though symptoms can last up to 14 days. The belief that antibiotics help with colds stems from a combination of the body's natural disease-fighting abilities and a placebo effect.

Nasal decongestants like saline drops, antihistamines, and pain relievers can, however, be prescribed to help with the symptoms. Rest and rehydration to replenish fluids lost due to nasal secretions and coughing are also recommended to help with the illness.

Notably, the Center for Disease Control (CDC) does not recommend the use of over-the-counter cough and cold remedies in children under the age of four unless prescribed by a doctor.

As the saying goes, prevention is better than cure. When it comes to colds, the adage holds true. Annual flu vaccination is critical in preventing influenza-related infections. The good news is that vaccines are available for both children and adults.

Following the Covid-19 pandemic, we are now better equipped to deal with illnesses spread by aerosolized droplets. It goes without saying that the same measures used to reduce transmission during the pandemic can also be used to reduce common cold cases. Hand washing and sanitizing, for example, are critical in preventing the spread of viruses from surfaces. It is also a good idea to cough or sneeze into your elbow or to use a disposable tissue and throw it away right away.

Additionally, avoiding people who already have an active infection is the simplest way to avoid colds. Masks can help reduce the risk of infection in situations where isolation is not possible.

In conclusion, as we move deeper into the peak season for common colds, we must all take extra precautions to stay healthy. Like security, disease prevention begins with you.

Tembo Talents hosted their fourth inter-school speed skating championship on June 10, 2023. Every year, Gertrude's Children's Hospital collaborates with Tembo Talents to provide First Aid Services for minor injuries as well as ambulance services.

The team treated 130 children and adults for minor injuries such as scrapes, headaches, minor cuts, soft tissue injuries, and nose bleeding. The hospital also welcomed Sisimua Mascots to entertain the pupils and parents at the event.

The Tembo Talents Team appreciates Gertrude's Children's Hospital's presence on-site to assist students and parents during the event. Gertrude's Team wishes to thank the Sisimua Mascots and Alpha Ambulance for their assistance in making the Tembo Talents skating event a success.

Gertrude's Rongai Medical Centre nursing team visited Banda School for HPV education and vaccine on May 29, 2023. The team was able to successfully administer the Gardasil-9 HPV vaccine to children at the school.

Athletics Kenya held their Inter-Regional Prisons Athletics, Darts, and Volleyball Championships on the 26th and 27th of May, 2023. Gertrude's Children's Hospital was one of the key event sponsors, donating Dart Boards to the Kenya Prisons Dart Board Team as they prepare for the National Darts Championships, expecting to win the championship again this year. During the event, GCH also provided First Aid and Ambulance services.

The event was attended by teams from around Kenya, including the Rift Valley, Nyanza, Coast, Central, Eastern, and Nairobi, and was held at the Moi International Sports Centre in Kasarani.