KNH NEWSLINE ED 14 2021

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NEWSLINE We Listen, We Care

Issue 14.

16/7/2021

KNH cares for street families

On average 10 street family cases present themselves at KNH for treatment daily. By Luke Kung’u

C

hristine Miller (Not her real name), has been an urban destitute living in Nairobi’s central business district since the year 2001. She has been on the streets all her life and does not recall ever having a home. In a counseling session at Kenyatta National Hospital while seeking social intervention to be observed for chest pain, she says and I quote, “…all I lacked was an opportunity, I could have been a doctor just like you”.

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She goes on to narrate how she feels abandoned and forgotten since the onset of Covid-19. The support she received on the street from wellwishers is no longer forthcoming and she feels if a miracle does not happen soon she is afraid she might not make it through the cold season. On a good day she would pay for her accommodation which costs KES 250 (around USD.2) and afford a meal for herself. Lately, probably due to the ripple effect COVID-19 has imposed on the economy, Miller has been forced to sleep on the streets.

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Miller’s case is one of the many street family cases received at KNH for health care and treatment. KNH Newsline team sat down with Petrovic Kaiga, Senior Assistant Medical Social Worker 1 and this is what he had to say. Do street people have information on the ever emerging communicable and noncommunicable diseases? Social investigations reveal that most street people have little or no information on emerging communicable

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http://www.knh.or.ke A street boy refreshing himself at a public water source in the city

and non-communicable disease. They receive information from community health workers and hospital medical team when they visit but circumstances force them to partially implement medical advice or totally ignore it. Street families that survive on garbage collection or any other form of casual labor would rather be out working than attend a sensitization session because every minute counts for them. Being away from labor simply translates to no meals and no accommodation. Others are hooked on drugs and substance abuse therefore passing information to them is limited due to the constant state of intoxication. People do not change their health behavior unless they believe they are at risk as dictates perceived susceptibility in the health belief model. Majority of the street families perceive hunger and homelessness as a real risk compared to COVID-19. As a means of transport to KNH, they usually use handcarts (mkokoteni) as their ’ambulance’ when bringing a sick colleague to the hospital. In show of comradeship, they raise funds to hire a mkokoteni and accompany their sick one to the hospital. They are a family Have you interacted with educated persons who end up in the streets and if so what do they state as a major contributor to their status? According to a national census of street children and families carried out in 2018, Kenya has a total of 46,639 street families and street children out of this figure 72.45 percent are male and an additional 27.65 percent are female. Some of the factors identified by the ministry of labor and social work as causes for an increased number of street families include mistreatment by relatives, lack of school fees, domestic violence, and death of parents among others. 76 per cent of the street persons had reached primary school level of education (77 per cent females and 75 per cent males) while 14 per cent reached secondary level of education. More often than not the leader of the street families is either the strongest physically or the one with some formal education. He will mostly assist the other street people in the hospital set up communicate and ultimately receive treatment. Do they have access to any health care system and if so, do they regularly get checked or follow up clinics? Street families have access to health care systems from sub county level all the way to national referral health care. They receive consultation whenever they require treatment through waiver systems initiated by

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Kenya has a total of

46,639

street families and street children out of this figure 72.45% are male and an additional 27.65 are female.

%

- National Census of street children and families 2018. the government targeting vulnerable and marginalized groups of people. Clinics are available for them as well and notably TB, comprehensive care clinics for HIV victims and antenatal clinics are some of the many followup outpatient services street people benefit from. That notwithstanding the few challenges noted in appointment adherence include: challenges in transport, unavailability of a care giver to escort them to hospital (orthopedic clients) and disinterest to continue with clinic as condition resolves. Who caters for their medical bills once admitted in healthcare facilities? Approximately how many present to KNH for medical checkups? Medical bills accrued by street families are catered for by hospital waivers issued by the hospital management through medical social work office. On average 10 street cases present at KNH for medical intervention in various divisions on a daily basis. That loosely translated to 300 street patients in a month and well over 3,000 cases annually. With the emergence of covid-19 what has been done to ensure

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that the preventive measures are adhered to by the street families? Sensitization exercise at community and hospital level has been the primary source of dissemination of information to street families on covid-19 preventive measures. The county administration has also provided public lavatories that provide clean water for street persons hence ensuring they are able to maintain hygiene. Community based organizations have supported street families with masks and hand sanitizers as donations to promote wellbeing and preventive therapy. Do we have hand washing points for all the streets/public places, do we give them masks and sanitizers, are they getting the COVID-19 vaccine? Hand washing points are available not only for the street but all general public visiting the facility. Masks are also issued to patients and relatives visiting the institution while sanitizers are available at various designated areas around the hospital for public use. Sensitization on the availability of the aforementioned items has been communicated on notice boards and health workers also furnish each and every individual at KNH on the availability and necessity of these items. COVID-19 vaccine is in the initial phase of issuance to the general public however street families being a vulnerable group in the community are yet to be vaccinated. The government through the Ministry of Health began vaccinating frontline health workers, the elderly above 58 years of age, uniformed security forces and teachers. Through social interventions such as advocacy, the department of social work is rooting for street families to receive the jab as soon as vaccination for the general public is rolled out. What policies do we have to safeguard their wellbeing? The needs of the street families are well safe guarded by all hospital policies; from admission to discharge policy and even the credit policy is well tailored to suit the needs of street persons in the healthcare continuum. They receive care and treatment, discharged and issued clinic dates if there is need for follow up through hospital waivers. Is ‘Sheng’ spoken by the street family a barrier to communication? Street people from different localities have a coded language/slang (sheng) which at times may be difficult to decode and thus present as a language barrier. For instance, sheng spoken in Dandora is different from Sheng spoken

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http://www.knh.or.ke in Kibera therefore it may be difficult to have an in-depth understanding of a particular slang. Sheng also mutates with time and may pose communication challenges. The key here is to make the street person feel accepted by the healthcare system; create an environment of safety and care. Once they feel

accepted, they then open up and share meanings of particular words, when to use them and when not to use them. An interpreter may not be useful due to the dynamic and informal nature of street language; it actually changes consistently to protect information important to them. In subsequent visits receiving them with their ‘sheng’

makes an entire session interactive and friendly for everyone. Availing youthful medics and other health workers as interpreters sends a message of hope to other street families outside the hospital set-up and improves the general perception by the street families towards the institution.

Unmasking The History Of Masks

Covid -19 Modern Day Mask

Influenza Mask 1918 By Godfrey Ekisa Osangi’r A mask is form of an object normally worn on the face, typically for protection, disguise, performance or entertainment. The earliest well documented masks come from the arid Judean Desert in the Middle East about 9,000 years ago. Older masks were made of perishable materials, such as leather, feathers, pigments, or plant remains, all materials that do not preserve well in the archeological record. The first masks were in the form of branches, mud and leaves strategically placed on the face to provide camouflage during a hunt or skirmish. There were also masks in the form

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of red or yellow ochre, or another pigment, used to highlight or hide facial attributes in order to enhance beauty. The idea for masks may have been born also during an early game; “peekaboo”, in which a parent or other adult surprises a child into laughter by hiding behind a tree or a pair of hands. It is therefore indisputable that masks have been an important c u l t u r a l phenomenon since antiquity and that all cultures m a d e them.

Dr. Rosa Chemwey Ndiema Former KNH Head of Unit (HoU) Infection Prevention and Control

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Plague Mask - 1619 Many different influences affected how masks were made and used. There are many popular masks around the world that can be categorized according to their use and material. In ancient times, masks were used in rituals, ceremonies, hunting, feasts, wars, performances as well as in ornamentation. The world has evolved too hence the use of masks. They are used in theatres, fashion, sports, movies, as well as in medical, protective or occupational purposes. The ancient Egyptians made funerary masks to hide the face of deceased and prepare them for the afterlife. Similarly, the Kwakwaka’wakw of British Columbia make and use transformation masks, which transform the wearer from one being to another during ritual ceremonies. When the pandemic started, and masks became a necessity. The face mask has become a symbol of our time, a clothing accessory that is worn every day and everywhere.

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A variety of shapes, forms and materials are being used and advertised to the point that in the year 2020, the business of producing face masks was born due to the Covid-19 pandemic. The small cloth at first felt like an inconvenience, a subjective feeling of strained, constricted breathing and labored conversation. It must be appreciated that humans adopt very fast and now cannot go anywhere without a face mask. Perhaps more profound is the fact that it has become a fashion accessory and an important part of our wardrobe. Today, face masks come in an assortment of on-trend colours and designs. In the human population, social contacts are a key for transmission of bacteria and viruses and the use of masks has proved to be critical and necessary to prevent the transmission of Covid-19 in which therapeutic interventions are lacking. Face masks have been therefore considered a first step to prevent and contain the spread of the disease. Simple masks covering mouth and nose are primarily used to prevent transmission by holding back droplets and this can only be more effective when the recommended minimum distance of 1.5 meter is not feasible. According to the former Head of Unit (HoU) Infection Prevention and ControlKNH, Dr. Rosa Chemwey Ndiema, there is an instinctive perception of obstruction when wearing a mask resulting to an individual having a subjective feeling of strained breathing. “When wearing very dense masks without valves, breathing occurs against an air flow resistance. Similarly, an increase in work of breathing can occur especially during physical exertion and depending on the design, masks can increase the lungs’ dead

space”, said Dr. Chemwey. Conversely, a mask has more to offer than just protection against Covid-19. It has worked well for introverts and those who suffer from anxiety in social settings since it offers some level of anonymity. Many of the folk have or will blame the mask in the instance an individual has recognized someone and does not feel like socializing; he or she pretends not to have recognized the other party. When the government declared wearing of the mask a must, businesses, especially the beauty industry registered a reduction in make-up production. Most of the women folk do wear make-up, but the introduction of the compulsory use of the mask conceals the ever admirable lips which normally come in different colours according to the wearer’s choice. More often, the make- up ends up in the mask. The little garb has brought about authenticity, you do not have to fake a

smile in those dreadful social meetings or conjure one up in situations that are made more comfortable by the appeasing gesture. A covered face has an expression of subtle meanings, loaded with mystery, and therefore to guess or figure out whether one is harmless or not becomes hard and this works better for women who bear the brunt of being taunted with cat-calls by men who make sexually loaded comments to passing women. While noting the key aspect of infection prevention by wearing a mask, people with hearing impairment rely on lip reading to understand others. This is not possible when wearing a mask. The garb with the splendor of antiquity has become a safety tool in hospitals and the society at large and has greatly contributed to the fashion industry.

African mask

Korean mask

Egyptian mask

Gas masks used in world war 2.

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Ancient traditional masks across the world

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Modern Masks as fashion accessories

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Are You Having Post-Traumatic Stress Disorder? By Priscah Angwenyi In the recent past, Kenya has started sensitizing the public on Mental Health illnesses through various organizations using different platform. Post-traumatic stress disorder (PTSD) is a disorder characterized by failure to recover from shock, terrifying, or a dangerous event. It has been categorized as a mental health illness/ problem. Anyone can develop PTSD at any age with people prone to the condition such as soldiers coming out of war, children, post–election violence victims, sexually assaulted victims, accident victims and many others. Women are likely to develop PTSD than men. Genes play a role in making some people develop PTSD more than others Recovery from fear after experiencing or witnessing a terrifying event varies from person to person. Some recover naturally while others continue feeling stressed or frightened even when they are not in danger Newsline had a sit down with Dr. G.M. Mareko who gave some insights on its possible causes, signs and how the condition can be managed. Q. How can you identify the symptoms of PTSD A. A psychiatrist or psychologist mostly does the diagnosis. Symptoms usually begin within three months of the traumatic incident, sometimes much later. In order to be considered as PTSD, symptoms must last a month and be severe enough to interfere with relationships or work. Some people recover within six months, while others have symptoms that last much longer. In some people, the condition becomes chronic. The strong indicators that someone might suffer from PTSD include: re-experiencing symptoms like bad dreams or frightening thoughts, avoidance symptoms like staying away from the place you experienced a bad incident, arousal and reactivity symptoms like insomnia and anger management issues. Cognition and mood symptoms include: ⁃ Trouble remembering key features of the traumatic event ⁃ Distorted feelings like guilt or blame ⁃ Loss of interest in enjoyable activities ⁃ Negative thoughts about oneself

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or the world Children react differently than adults which sometimes can have adverse effects. In very young children, the symptoms include:⁃ Performing scary events during playtime ⁃ Being very clingy with a parent or another adult ⁃ Forgetting how to or being unable to talk ⁃ Wetting the bed after having learned to use the toilet Teenagers also tend to portray symptoms similar to those seen in adults. The condition may also make them disruptive, disrespectful and even destructive. Thoughts of revenging on incidents often come to their mind. Older children and teens may feel guilty for not preventing injury or deaths. Q. What are some factors that increase risk of PTSD? A. ⁃ Perpetual experiences with dangerous events and traumas ⁃ Sights of dead bodies ⁃ Childhood trauma ⁃ Being hurt or seeing other people hurting ⁃ Feeling horror ,helplessness or extreme fear ⁃ Having a history of mental illness or substance abuse ⁃ Having little or no social support after the event ⁃ Dealing with extra stress after the event such as loss of a loved one, pain and injury, or loss of a job or home The whole PTSD experience may impact and create a negative shift from the normal functioning of one’s daily life. The way you think about

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yourself and others tend s to change because of trauma. Possible signs of this phase includes:⁃ Becoming jittery, or always alert and on the lookout for danger ⁃ Difficulty in sleeping ⁃ Trouble concentrating ⁃ Being startled by a loud noise or surprise ⁃ Tendency of forgetting about parts of a traumatic event or not being able to talk about them ⁃ Thinking the world is a dangerous place to live in ⁃ Feeling hyper arousal ⁃ Not having positive or loving feelings toward other people and staying away from relationships Q. What are the most effective management practices in treating PTSD? A. ⁃ Avoiding crowds if they feel dangerous ⁃ Keep off driving if you were involved in a car accident or if you were in a military convoy that was bombed. ⁃ Avoiding situations that remind you of the event. ⁃ If you were in an earthquake, you may avoid watching movies about earthquake Mental Health expert advice Since people tend to behave differently, treatment that works for one person may not necessarily work for another. If a person has PTSD, it is important that a mental health practitioner who is experienced with that condition treat them. This is because some patients will need to try different modes of treatment to find out what works for them. Treatment for people with PTSD includes medication and physiotherapy

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KNH-Othaya ICU renovation and equipping to state-of-the-art CCU

KNH-Othaya team led by DCNS. Ms. J.Tisnanga & HOD Administration Mr. Mundia during the handing over of ICU to the contractor to start construction. BY JULIUS ITA Kenyatta National Hospital-Othaya has embarked on yet a new project of renovating and equipping the Intensive Care Unit (ICU) from its current 7 bed to a 20-bed state-ofthe-art CCU. “There is a high demand for ICU services in this region which the upcoming ICU will be able to cater for and the entire catchment area that the KNH-Othaya covers,’ said Herman Kairu Head ICU KNH Othaya. He added, “There will be none if any referrals to outside once this unit is complete and we are grateful to the Kenyatta National Othaya Management for this upgrade.” The Contractor has 6 weeks to transform this unit to its intended status,” It’s a major renovation and we are planning to work around the clock to realize the timelines we have been given,” said Mr. John Koigi Technical Manager TIFF East Africa Limited, the contractor tasked with the renovations. “We are happy and honored to have been given this opportunity to be the ones to transform this unit from the current 6-bed unit to a 20-bed modern CCU”. On their part, the KNH-Othaya management is full steam ahead on their promise of making this facility, above all others, a Center of Excellence in the provision of

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HOD Administration Mr .Mundia handing over the blue prints of the new ICU to TIFF East Africa Limited contractor Mr. John Koigi who will be carrying out the renovations. specialised healthcare in the region. The Director Clinical & Nursing Service Ms Juliana Tisnanga had this to say, “This is a time-consuming process and might even take longer than projected, but we are committed to see that eventually we have the best modern state-of-the-art ICU at KNH Othaya”. Kenyatta National Hospital Othaya

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has in the past one year launched many projects such as an oxygen plant, a modern farewell home (mortuary) among others that will elevate this facility to the status of a Level 6 hospital capable to serve the hospitals in the entire catchment area. Many of these projects are in their final stages to completion, awaiting the commissioning of the KNH Othaya- Hospital.

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OUR STORY IN PICTURES

CEO, Dr. Evanson Kamuri & KNH-OTHAYA Management during a random visit of the ongoing projects.

Dr. Rose Nyabanda, KNH Director for Diagnostic Services (middle) received the PPE donation on behalf of the CEO from Thomas Wimmer, the Acting Ambassador (2nd left) and Deputy Head of Mission at the German Embassy and the GiZ Country Director for Kenya Gabriela Vihuto (2nd right).

Honorable Members having alight moment after a friendly match between Bunge FC & Marafiki FC where KNH OTHAYA was carrying out basic free screening services to members of public.

KNH received 350 copies of books named; “Jesus Only” by Dr. Desmond Ford from Good News Unlimited based in Australia. The donation was received by Rev. Miriti Kanamba - Chaplaincy Department.

KNH FC Striker Pato Patrick (Left) in a game where they won 2-0 against Kibera Soccer.

Transport Department capture the moment infront of the new Hospital bus recently acquired so as to enhance service delivery.

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Men’s Health Awareness Month. By. Abigael Lunani and Vincent Mutua The tale of men and health has always been an elusive one, with only one in every four men undergoing regular check-ups. This is even though men have historically suffered from more diseases than women. But is mens’ health only about medical alertness. “Mens’ health refers to a state of complete physical, mental and social well-being experienced by men and not merely the absence of disease.” Notes Dr Juma Kitaa, a Medical Officer at KNH - Othaya. The month of June presented men all over the world with a chance to take charge of their overall health by adopting and maintaining desirable lifestyles. In as much as men are historically at a higher risk of contracting terminal ailments, they have perpetually kept doctors at bay and while at it indulging in risky lifestyles unless they encounter a really serious complication. “It took me about seven years to master the courage of seeing a doctor. It was not until a close associate of mine exhibited signs of fragility I realised the importance of having thorough checks regularly.” explains Mr Maina Karaya, an IT officer at KNH Othaya. This is primarily due to the societal stereotyping of men as tough and invincible individuals. This has shaped programmed men to suppress any signs of weakness or frailty, thus the lack of regular hospital visits to

“Men’s health refers to a state of complete physical, mental and social well-being experienced by men and not merely the absence of disease.”

maintain their masculinity. The importance of Mens’ health awareness is to counter health difficulties that often go unnoticed or neglected. To commemorate this month, KNH Othaya took the opportunity to encourage boys and men to prioritise their health by observing healthy living decisions considering we are facing the COVID-19 pandemic, the male fraternity must get regular checks up and seek necessary medical treatment. Worldwide, men pay less attention to their health than women. Additionally, men are more likely to drink alcohol and use tobacco, make risky choices and not visiting a doctor for regular check-ups compared to women. Many of the major health risks that men face can be prevented with a healthy lifestyle: regular exercise, a healthy diet, not smoking, stress reduction and alcohol consumption in moderation. Regular check-ups and screening tests can spot disease early when it is easiest to treat. Bottom line, as a man take charge of your health by getting regular tests, exercising regularly and watching your lifestyle. Better together.w

- Dr Juma Kitaa, a Medical Officer at KNH Othaya.

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BOOST IN THE FIGHT AGAINST COVID-19

By Jacqueline Ngure Kenyatta National Hospital has received a donation of assorted Personal Protective Equipment (PPE), valued at KES 7.7 Million from German Development Agency, GIZ. The donation which includes respiratory masks, disposable gowns, disposable lab coats, wide vision safety glasses and oxygen masks was handed over by Thomas Wimmer, the Acting Ambassador and Deputy Head of Mission at the German Embassy and the GiZ Country Director for Kenya Gabriela Vihuta. Dr. Rose Nyabanda, KNH Director for Diagnostic Services received the donation on behalf of KNH CEO, Dr. Evanson Kamuri with much appreciation, noting that it is a timely and much needed gesture, as the Hospital continues to battle the pandemic.

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Partnership in planting “Trees for life” By Julius Gitonga Ita Trees can teach us a lot about life, both professional and personal. After all, mother nature has taken about four hundred million years to perfect these incredible beings. Theodore Roosevelt once said, “To exist as a nation, to prosper as a state, to live as a people, we must have trees”. If this powerful words are anything to go by, then Kenyatta National Hospital Othaya is on the road to prosperity. Through a joint effort of World Wildlife Fund, LOTTO & AHADI Kenya Trust CEO and KNH Board Member, Dr. Stanley Kamau, Kenyatta National Hospital Othaya launched a tree planting program dubbed “Trees for life” which saw 2,907 trees of various types donated to the hospital. “I have been doing this all over the country, but for KNH-Othaya I wanted to start a Conservancy program that can be emulated by other institutions,” Said Dr. Stanley Kamau. He added,” KNH Othaya has set the pace, its time others followed suite” It was further decided that for every child born in our maternity ward, they’d go home with a tree, a trend that has now seen over 100 trees already handed out to parents who to say the least are at a loss of words to the hospital, having received quality services and in addition a gift for their new borns. “I am very grateful to Kenyatta Othaya Hospital, not only did they see me have my baby without any issues but they gifted me a tree,” said Mary Wambui who delivered

Dr. Stanley Kamau, CS health Hon. Mutahi Kagwe MP Othaya, Hon. Gichuki Mugambi among other guest during the launch of “Trees for life” campaign in May 2020

at the hospital’s maternity ward recently. She went on to add “I have planted this tree, and will take care of it with love such that one day when my daughter is old enough I will hand over the tree to her”. On their end the maternity ward team lead by their head had this to say “We are grateful to the KNH Othaya Administration for the trees, every mother is guaranteed a tree as they go home to serve as a reminder of the day they became mothers” Head nurse Maternity ward Evance Oduor said. Through his stewardship the Maternity team has recorded 147 deliveries in the month of June the, highest number so far recorded at the ward. Due to the environmental degradation that has happened to pave way for the construction of new units at the hospital, this trees couldn’t have come at a better time to help rehabilitate the land to

Members of KNH - Othaya Management lead by the Senior Director Dr. Peter Muiruri presenting trees to new born babies at the maternity ward in Othaya.

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what is fast becoming a Center of Excellence. Mr. Paul Mwangi, Senior Superintendent at KNH has been giving the much needed technical expertise on ground to a team of gardeners on a mentorship program at KNH-Othaya, “This is a great program that was started and the benefits are many”, Said Mr. Mwangi. He added: “One benefit that stands out other than purification of air and beautification is the stoppage of soil erosion. The Hospital sits on a sloppy piece of land and the trees will ensure we protect the soil.” Mr. Mwangi was also quick to point out that to ensure the continuity of this program, the hospital is in the process of setting up a nursery which is key for this program to live on. On their part KNH Othaya directorship is proud to champion this conservancy program that is quickly getting notoriety, “From the get go Kenyatta National Hospital Othaya has been all about setting new trends and impacting our patients positively and the community at large”, said Ms’ Juliana Tisnanga, Director Clinical & Nursing Services. She went on to add,” The management is committed to see the trees for life program through, this is part of our legacy in Othaya.” Kenyatta National Hospital Othaya in the last one year has brought about transformation in Othaya and the nearby towns both social and economic. And if the trees for life keeps the current pace, soon KNHothaya will be a pace setter and the hospital of choice to all.

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KNH-Othaya Hospital graces a local derby By Julius Gitonga Ita

which saw a cue of people at the KNH tent. All the buzz of activity at the tent didn’t go unnoticed, where a Member of Parliament for Kieni Constituency Hon. Kanini Kega who is the official goal keeper for Bunge FC, joined the KNH Othaya team after the match for a courtesy call and shared a meal that was courtesy of KNH-Othaya Hospital. Kenyatta National Hospital Othaya has diarized to attend such and many more events in the County to raise awareness of the provision of specialized health in KNH Othaya and support the community at large.

They say all work and no play makes Jack a dull boy, and so the Kenyatta National Hospital Othaya team were invited to attend a local derby between Mashariki FC & Bunge FC at Kinunga Stadium Nyeri. The event that was put together as a curtain raiser for a fundraising event, saw people from all walks of life brave the cold to catch a glimpse of our Members of Parliament and the local boys lock horns on the field. After the dust settled the scores were a tie which left many requesting for a rematch. KNH Othaya on their end were the medical team on ground with an ambulance and a team of health care givers. Moreover, there were screening services being offered

Nurse Stella Langat of KNH - Othaya screening a patient at a recent football friendly match between Bunge FC & Marafiki FC at Kinunga Stadium Nyeri County.

OUR VISION A world class patient-centered specialized care hospital OUR MISSION To optimize patient experience through innovative healthcare; facilitate training and research; and participate in national health policy formulation OUR MOTTO We Listen, We Care

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“Change will not come if we wait for some other person or some other time. We are the ones we’ve been waiting for. We are the change that we seek.” - Barak Obama “People often say that motivation doesn’t last. Well, neither does bathing -- that’s why we recommend it daily.” - Zig Ziglar “If you cannot do great things, do small things in a great way.” - Napoleon Hill “Move out of your comfort zone. You can only grow if you are willing to feel awkward and uncomfortable when you try something new.” - Brian Tracy “Challenges are what make life interesting and overcoming them is what makes life meaningful.” - Joshua J. Marine “Don’t let the fear of losing be greater than the excitement of winning.” - Robert Kiyosaki

To contribute or report on newsworthy items, please contact the Editorial team; Marketing & Communication Department Editorial Team: .Dave Opiyo, Hezekiel Gikambi ,Luke G. Gathura & Edel Q. Mwende Stories: Luke G. Gathura , Godfrey Ekisa Osangi’r, Priscah Angwenyi , Jacqueline Ngure , Julius G. Ita, Abigael Lunani and Vincent Mutua Design By: Collins Cheruiyot Photos: Nicholas Wamalwa , Julius Ita & Chris Mwiti

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Tel: +254 20 2726300-9 Ext. 43121 or 43969 Fax: +254 20 272572 Email: caffairs@knh.or.ke knh.caffairs@gmail.com

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