KNH NEWSLINE ED 14 2022

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Newsline

1/7/2022

We Listen, We Care

1/7/2022 PHOTO | WELLBEINGOFWOMEN

Issue 14

Prostate Cancer: A disease of the aging male ISSUE 14 | Kenyatta National Hospital Newsline

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Contents

Editor’s note

ISSUE 14 Editor’s note p.2 Prostate Cancer: A disease of the aging male p.3-4 Phantom limb pain, phantom sensation, and residual limb pain p. 5-6 Disaster preparedness training for MMUH staff p.7 Nicholas Wesonga Wamalwa: The bubbly photographer. p. 8 A case for active TB case finding p.9-10 The first-ever bundle of gifts for MMUH p.10 MMUH opens Chaplaincy Hall p.10 March birthdays p.11 - 12 The KNH 4th Cohort Nursing process certification p.13 The first-ever Family Week at KNH p.14 - 15 Boost as KNH Security officers train on Security Certification Compliance Course p.15 Our story in pictures p.16 KNH participates in the first Damu-KE conference p.17 KNH School of Nursing holds tracheostomy care training for nurses p.17 Twins: A miracle unfolds at KPCC p.18 KPCC holds medical outreach at Royal Nairobi Golf Club p.19 Karate classes at KNH p.19 Comic zone p. 20

ON THE COVER Prostate Cancer: A disease of the aging male P. 3

Marketing & Communication Department Design Concept Team: Dave Opiyo, Edel Q. Mwende, Yvonne Gichuru & Collins Cheruiyot

Editorial Team: Dave Opiyo , Edel Q. Mwende, Luke Kung’u, Yvonne Gichuru, Priscah Angwenyi & Linnette Leyi

Dear Colleagues, COVID-19 keeps rearing its ugly head again and again leaving a trail of destruction, unfathomable devastation compounded by the untimely loss of lives and livelihoods. Like an enemy within, there is an incessant need to positively identify and deal with it as per the approved guidelines from either a personal, national or international level. We call upon all not to let the guard down lest we erode the gains achieved so far. Our commitment and resolve remain the same; to defeat the common enemy. To this end, we call upon all and sundry to: • • • •

Wear your mask appropriately Observe frequent hand hygiene Get vaccinated against COVID-19 ; AstraZeneca, Pfizer, Johnson & Johnson are all available at KNH Avoid overcrowded places

All the Newslines and Newsletters can be accessed online at: https://bit.ly/3uQGCcI

Stories: Verah Mugambi, Linnette Leyi, Edel Q. Mwende, Jacqueline Ngure, , Petterson Njogu, Luke Kung’u, Shiphrah Njeri, Cynthia Cherono, Dr. Tabitha Munyoki, Yvonne Gichuru, Peter Githua, Steven Arwa & Shawn Paul Omondi

Mr. Luke Kung’u CACAOII Marketing & Communication Kenyatta National Hospital

Design By: Collins Cheruiyot

Photos: Nicholas Wamalwa, Linnette Leyi, Shawn Paul Omondi, Petterson Njogu, Joan Macharia, Jacquline Ngure, Cynthia Cherono, Thellesi Co, Elijah Ng’ang’a, Steven Arwa & Nahashon Ogigi

Tel: +254 20 2726300-9 Ext. 43121 or 43969 Fax: +254 20 272572

Find us on Social Media Kenyatta National Hospital

Email: caffairs@knh.or.ke knh.caffairs@gmail.com To contribute or report on newsworthy items, please contact the Editorial team.

ISSUE 14 | Kenyatta National Hospital Newsline

Kenyatta National Hospital Official Page

@CeoKnh @KNH_hospital

www.knh.or.ke

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Prostate Cancer: A disease of the aging male By Verah Mugambi

T

he human body is made up of trillions of cells that over a lifetime normally grow and divide as needed. When cells are abnormal or get old, they usually die. When something goes wrong in this process, it serves as the onset of cancer. The cells keep making new ones while the old or abnormal ones don’t die as they should. Cancer affects both men and women. The most common cancers for men are prostate, colorectal, lung, and skin cancers. Knowing about these cancers and what one can do, helps in the prevention or early detection and management. When the lumps are small, and the disease hasn’t spread, it might be easier to treat hence saving a life. Newsline enlightens on Prostate Cancer; its symptoms, treatment, and all there is to know about it. To help us demystify this type of cancer, we had a sit down with Dr. David Kimani, a consultant Urologist at Kenyatta National Hospital. He explains: “This disease occurs in the prostate and is one of the most common types of cancer in men. The prostate is a small walnut-shaped gland in males that produces the seminal fluid that nourishes and transports sperm. The prostate gland is located just below the bladder in males and surrounds the top portion of the tube that drains urine from the bladder (urethra).” “Prostate cancer is the leading solid cancer in men in Kenya. The lifetime risk of patients getting cancer of the prostate is in the ratio of 1 in 8 men. Since it is very common, people get worried about it, but the reality is that if you research well, the risk of dying from prostate cancer is 3%,” revealed Dr. Kimani. “This means there are many

patients who will live with prostate cancer, and sometimes die with prostate cancer but not because of prostate cancer,” Dr. Kimani explains, busting the myth of prostate cancer being the number one cancer killer in men. According to the doctor, the prostate is a gland within the male that changes in its anatomy and its size with age. “The chance of getting prostate cancer goes up as a man gets older. For all men beyond the age of 40, their prostate starts increasing in size, though the rate at which they increase will differ from one individual to another,” Dr. Kimani continues. Symptoms Prostate cancer may cause no signs or symptoms in its early stages, but when it is more advanced, it may cause symptoms

ISSUE 14 | Kenyatta National Hospital Newsline

PHOTO | COURTESY Dr. David Kimani with a colleague at the KNH Main Theatre after a prostate surgery.

“ “For all me​n beyond the age of 40, their prostate starts increasing in size, though the rate at which they increase will differ from one individual to another,” - Dr. Kimani.

such as difficulty urinating, decreased force in the stream of urine, blood in the urine, blood in the semen, bone pain, unexplained weight loss and erectile dysfunction. Several risk factors cause prostate cancer. The common causes include age, hereditary, and race. Other factors known but not scientifically proven but are suspected to contribute to high chances of getting prostate cancer include lifestyle and physical fitness. The major risk factors are: • Old age- The risk of prostate cancer increases as one grows old. It’s most common after age 40 and the average age of

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diagnosis is about 68 years. • Family history/heredity- If a blood relative, such as a parent, sibling, or child, has been diagnosed with prostate cancer, one’s risk may be increased. Also, if one has a family history of genes that increase the risk of breast cancer (BRCA1 or BRCA2) or a very strong family history of breast cancer, their risk of prostate cancer may be higher. • Race- For reasons not yet determined, black people have a greater risk of prostate cancer than people of other races. In black people, prostate cancer is also more likely to be aggressive or advanced. Screening for prostate cancer “Now here is where the problem lies. The unpleasantness of putting a finger through the rectum also called Digital Rectal Exam just to feel the prostate or the doctors can request one to do the blood test, discourages many,” explained Dr. Kimani. • Digital Rectal Exam (DRE): During a DRE, the doctor inserts a gloved, lubricated finger into a male’s rectum to examine their prostate; which is adjacent to the rectum. If the doctor finds any abnormalities in the texture, shape, or size of the gland, one may need further tests. • Prostate-Specific Antigen (PSA) test: A blood sample is drawn from a vein in the patient’s arm and analyzed for PSA, a substance that’s naturally produced by one’s prostate gland. It’s normal for a small amount of PSA to be in a man’s bloodstream. However, if a higher than usual level is found, it may indicate prostate infection, inflammation, enlargement, or cancer. If prostate cancer screening detects an abnormality, the doctor may recommend further

tests to determine whether one has prostate cancer, such as Ultrasound, CT scan, MRI, or collecting a sample of prostate tissue/prostate biopsy. Prostate biopsy is often done using a thin needle that is inserted into the prostate to collect tissue. The tissue sample is analyzed in a lab to determine whether cancer cells are present. “It is only a pathologist who concludes if one has cancer or not. One may have an MRI that suggested they have cancer or examination symptoms that suggested they have cancer, but all these are suggestions. Unless the pathologist looks at the prostate tissue and says there is cancer, only then we will label you as a cancer patient,” Dr. Kimani insisted. Treatment Prostate cancer treatment options depend on several factors, such as how fast one’s cancer cells are growing, whether it has spread, and one’s overall health, as well as the potential benefits or side effects of the treatment. “Since different treatments have variable effects, it is important to outline the options available to the patient. This may include; surgery or radiation; this is used when the cancer is of low grade and confined to the prostate gland (localized disease) and therapies such as hormonal and chemotherapeutic options are generally used when the malignancy has spread from the prostate to other areas of the body (i.e., advanced disease). “Treatments for localized prostate cancer can result in a cure, but those for advanced disease are mainly used to

“ We urge men from the age of 40 years to see a doctor and discuss what their prostate cancer risk level is with the doctor’s advice”

delay disease progression or palliate symptoms. Bottom line, as long as you have a prostate, that means you are a man and therefore are at a lifetime risk of developing prostate cancer. We urge men from the age of 40 years to see a doctor and discuss what their prostate cancer risk level is with the doctor’s advice, one may go through a screening process and if the disease is found in its early stages, they can be healed,” Dr. David Kimani concluded.

PHOTO | COURTESY Dr. David Kimani giving a talk at The Kenya Association of Urological Surgeons (KAUS) conference in Kitui county.

PHOTO | COURTESY Dr. David Kimani - Consultant Urolologist, KNH

- Dr. Kimani

ISSUE 14 | Kenyatta National Hospital Newsline

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Phantom limb pain, phantom sensation, and residual limb pain By Luke Kung’u The feeling of wholesomeness is the aspiration of any living thing and more so for human beings who can express their feelings more elaborately. Pain is the unpleasant but unavoidable circumstance that is brought by the loss of someone or something that one has an attachment with, and it affects the way we act and think. To someone else, pain may not be perceived to be a bother, but it is everything to the bearer. Now come to think of losing a body part that one has had for the greatest part of their lives. This is what amputees face as some of their body parts are taken away. It is nightmarish, to say the least. The fact that real pain can be experienced while the body part is missing is food for thought. It is a reality shrouded in mystery. Newsline engaged Senior Assistant Orthopedic Technologist, Mr. Damiano M. Mwangi, to unravel the secrecy that is ‘phantom pain’; and this is what he had to say. Read on: Q. Kindly differentiate between Phantom limb pain, Phantom sensation, and residual limb pain. A phantom limb is a vivid perception that a limb that has been removed or amputated is still present in the body and performing its normal functions. Amputees usually experience sensations including pain in the absent limb. Phantom sensation: Resembles the somatosensory experience of the physical limb before amputation, including warmth, itching, sense of position, and mild squeezing. That is, the patient perceives sensation in a severed body part. Changes occur in both the central nervous system and peripheral nervous system after an amputation that depends on the subsequent reorganization of the primary somatosensory and motor cortices of the brain. Residual limb pain: this is when the phantom sensations become intense enough for the amputee to

define them as pain. It is a complex poorly understood pain syndrome that is described as burning, aching or electric type pain in the amputated limb. Q. What symptoms are exhibited in such pain? Patients suffering from phantom limb pain perceive that the amputated limb is still present and functioning as usual. In many cases, these patients will experience a wide range of sensations in the phantom limb, some of which include: • A tickling feeling • Cramps • A shooting, piercing or stabbing pain • Numbness • Cold • Warmth • Tightness • Itchiness Q. What causes the pain? There are numerous theories about the causes of phantom limb pain including peripheral, central, and spinal theories: Peripheral Theories: Remaining nerves in the stump grow to form neuromas, which generate impulses. These impulses are perceived as pain in the limb that has been removed. Central nervous system: Melzack proposed that the body is represented in the brain by a matrix of neurons. Sensory experiences create a unique neuromatrix, which is imprinted on the brain. When the limb is removed, the neuromatrix tries to reorganize, but the neuro signature remains due to the chronic pain experienced before the amputation. This causes phantom limb pain after amputation.

PHOTO|COURTESY: Pain pathway in the dorsal horn

ISSUE 14 | Kenyatta National Hospital Newsline

Spinal theories: When peripheral nerves are cut during amputation, there is a loss of sensory input from the area below the level of amputation. This reduction in neurochemicals alters the pain pathway in the dorsal horn.

PHOTO | neurosciencenews Individual experiencing Phantom

Other related causes: Residual limb pain is believed to be caused by Ischemia, infections before amputation, neuroma, and pressurerelated wounds. Psychological factors such as stress and depression also influence the development of chronic phantom limb pain. Q. How is the pain diagnosed and managed in a hospital as well as at a home set-up? The residual limb pain is diagnosed through carrying out clinical examination (patient assessment) procedures that include; patient history, clinical examination, clinical investigations, and differential diagnosis among others. Various pain management strategies have been used including: • Peripheral Sensitization: Irritant management with attention to excluding differential diagnosis, poor wound dressings, stump oedema. • Pharmacology (Follow the pain

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ladder), Application of Stump sock, Education, Prosthetic (IPOP; immediate post-operative prosthesis), Scar management, Acupuncture, physiotherapy, Selfmassage, Sleep hygiene. • Psychological and Social Factors: Education, Sleep hygiene, Physical exercise Relaxation techniques, Referral for formal mental health/ social support. • Musculoskeletal (MSK) Factors: Enhancing on Joint range of motion, muscle power, managing Trigger points/myofascial release, and Neural mobilization • Combining: Orthopaedic, prosthetics, physical and occupational therapy with a cognitive understanding of the condition will amplify the effects of treatment. Q. How common is the pain? The incidence of phantom pain widely varies in the literature ranging from 50 to 85 percent depending on the criteria used to define the syndrome. Inadequate control of preoperative and postoperative pain may increase the risk of chronic amputation pain. Q. How often is the pain reported to health care providers? The onset is mostly immediate after amputation, some at a few weeks, rarely months later. In most cases, the reporting of the pain is immediately after recovery from anesthesia, or during a patient assessment session. Residual limb pain is a poorly understood clinical phenomenon that remains the subject of intense research due to the acute and chronic nature of the condition. The incidence is reported to be as high as 60-80% in patients’ post-

PHOTO | COURTESY Senior Assistant Orthopedic Technologist Mr. Damiano M. Mwangi

amputation Q. How can the pain be prevented and when is one supposed to call a doctor? The phantom pain can be prevented through the application of the right surgical technics, the use of effective painkillers during the procedure and after it, and optimal stump care and rehabilitation. The patient should report the pain immediately. The management of phantom pain leads to indirect management resolution of other anomalies. Q. Who is vulnerable to such pain? Phantom pain is independent of age in adults, gender, level, or side of amputation. The phantom limb pain phenomenon is seen more commonly in adults than in children. This is likely due to the brain as the brain of children has typically not finished consolidating images of their external organs. Q. What are the treatment options? (therapies) Coping techniques such as muscle relaxation, meditation, biofeedback, massage, and hypnosis have been shown to help some patients deal with phantom pain or related symptoms. Additionally, certain drugs such as analgesics, muscle relaxants, sedative-hypnotics, antidepressants, antipsychotics, and anticonvulsants are commonly used in treating phantom pain. In some cases, shock therapy and acupuncture have been used to relieve symptoms. When non-invasive treatments fail to work, invasive approaches such as stimulation of the spinal cord, intrathecal drug delivery, and deep brain stimulation have been used to treat phantom limb pain. Electrical nerve stimulation techniques such as transcutaneous electrical nerve stimulation and transcranial magnetic stimulation are beneficial in some patients. Mirror therapy is a therapeutic intervention, which has been shown to affect motor and sensory processes through the relative

ISSUE 14 | Kenyatta National Hospital Newsline

dominance of the visual input it provides. The effect is created by viewing a reflection of the intact limb, through a mirror placed where the amputated limb would have existed. Q. Could there be any complications from this kind of pain? Risk factors include chronic pre-amputation pain, post-operative surgical pain, and psychological distress. The risk factor for phantom pain includes the hypersensitivity of the distal part of the residuum. This hinders the distal weight-bearing of the residuum and problems during donning and doffing of prosthesis Q. What information is at the disposal of the person undergoing amputation and the family/relatives? The patient and family must be made aware of the psychosocial repercussions of amputation. The rehabilitation team plays a greater role in ensuring that after the treatment, the patient is reintegrated back into society. Q. Are there myths related to such pain and what does society say about it? Early theories on the underlying cause of phantom pain were based around it being imagined or “in the head”. An apparent similarity to phantom illusions experienced in a psychotic state-led professional is to believe phantom pain was purely psychological or imaginary. The reason someone with an amputated limb felt pain was because they weren’t dealing with the loss very well, and it manifested as physical pain. Dr. G. Riddoch reported that many patients were reluctant to discuss their phantom pain for fear they would be thought insane. Q. What is your parting shot? The success of rehabilitation of an amputee dwells on the teamwork between the rehabilitation team and the patient. There is limited research carried out in Kenya on the life of amputees in the broad spectrum of their rehabilitation, service transition, psychosocial support, patient reintegration back to society/ occupation, and societal perception, among others. This calls for intensive study in this field to optimize service provision through innovativeness, and the generation of evidence-based data through research.

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Disaster preparedness training for MMUH staff By Jacqueline Ngure Disaster preparedness entails conducting a risk assessment and placing emphasis on reducing the identified risks to ensure that institutions are way ahead of the game in the event of any disaster. The Mama Margaret Uhuru Hospital (MMUH) Disaster Management Committee underwent a five-day training on Disaster Preparedness and Response from Monday, June 20, 2022, to Friday, June 24, 2022. The training was facilitated by the Kenya Red Cross Training Institute (KRCTI) to equip staff with cutting-edge skills for managing emergencies and disasters should they occur. Disaster is defined as a serious disruption of the functioning of a community or a society causing widespread human, material, economic and environmental losses, which exceed the ability of the affected community to cope with using its resources. Therefore, it is safe to define disaster management as the range of activities designed to maintain control over disasters and emergencies and to provide a framework for helping those at risk to avoid or recover from the impact of a disaster. However, according to Mr. Sammy Kamanu, a trainer with KRCTI, for a

situation or disruptive event to be declared a disaster, a hazard must meet with a vulnerable situation. A hazard by itself is not necessarily a disaster. Looking back on past disasters such as the 1998 American Embassy bombing, the Sinai fire tragedy, and the 2015 Garissa terrorist attack where 147 students lost their lives, among many such incidences, Kenyatta National Hospital plays a pivotal role in managing mass casualty incidents for our Country. It is against this backdrop and the understanding that electioneering years in Kenya do raise political temperatures which could potentially result in Mass Casualty Incidents.

KNH has put in place structures and measures to enhance its capacity in managing disasters. Constituting a Disaster Management Committee at Mama Margaret Uhuru Hospital and training the team on disaster preparedness is but one of the many activities that will enable us to maintain control over an emergency should it arise. It is this team that will henceforth be charged with the responsibility of ensuring that MMUH has a contingency plan to mitigate, prepare, and respond to disaster be it internal (such as a fire) or external (such as mass casualties).

PHOTO | JOAN MACHARIA Mama Margaret Uhuru Hospital (MMUH) Disaster Management Committee

PHOTO | JOAN MACHARIA Mr. Sammy Kamanu, a trainer with KRCTI, training the MMUH Disaster Management Committee on Disaster Preparedness and Response

ISSUE 14 | Kenyatta National Hospital Newsline

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Engage with:

Nicholas Wesonga Wamalwa: The bubbly photographer By Shiphrah Njeri Nicholas Wamalwa commonly referred to as “Wamz” is not your regular suit guy. Many of us have probably run into him in the hospital`s corridor clad in a dapper colorful suit that reflects his ever-bubbly nature. Every time one gets to meet or interact with him, he is either rushing to an event or holding a camera, rollup banner, or a street banner. But how well do you know him? Nicholas works as a Marketing and Communication Officer (MCO) in the Marketing and Communication Department at KNH. He began his journalism and media career back in college where he was also a leader as an elected vice president of the Kenya Institute of Professional Studies (KIPS) Technical College. Newsline had a one-on-one with him. Growing up, what were your career aspirations? I wanted to be a pilot but later on, developed a passion for journalism. How did you get into your current field or position? I started working at KNH as a student on attachment for three months, then volunteered for six months with great zeal and was later confirmed for the position of MCO. What’s your top career highlight? I love working with dignitaries during large hospital events and also offering photography support to the Ministry of Health under the CS health. My most memorable event was one we traveled to Mombasa to cover Intergovernmental Authority on Development (IGAD). What’s the weirdest experience in your career? It was during an event when an official changed the setup for the microphones, the P.A system, and the sitting arrangement without notifying me. In addition, he started taking

photos and videos for the event; this was awkward as he kept blocking my camera shots. What’s the weirdest thing a customer has ever done? One weekend during my weekend coverage at the KNH information center, a client, out of the blue, started wailing. I was confused. I did not know how to handle the situation.

PHOTO | THELLESI CO

Mr. Nicholas Wamalwa Marketing & Communication Officer, KNH

Do you have a five-year plan? I look forward to contributing to further improving the work we do at the KNH M&C department. My ultimate dream is for us to have our media station at KNH. What advice would you give anyone seeking to scale the heights you have? Everything is possible and if you work wholeheartedly with all your mind and soul, you will be able to achieve your goals. What do you listen to on your commute? Steve Harvey and T.D. Jakes. What are your hobbies? Editing videos and watching documentaries. Which is your favorite sport? I love watching wrestling and my favorite wrestler is Drew McIntyre. Do you have a favorite outdoor activity? Sanctuary keeping (cleaning and dusting) my local church. Newsline: What is your favorite food? I enjoy eating chapati and beans.

ISSUE 14 | Kenyatta National Hospital Newsline

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A case for active TB case finding By Dr. Tabitha Munyoki On March 24, 1882, Dr. Robert Koch announced the discovery of Mycobacterium tuberculosis, setting humanity on an important road map to managing the scourge. However, a cure remained elusive for another half-century, with the discovery of an effective antibiotic taking place in the mid-1940s. Before these monumental discoveries, in the 1800s, when TB outbreaks occurred, it was theorized that the first family member to die of TB came back as a vampire to infect the rest of the family. To stop it, the town’s folk would dig up the suspected vampire’s grave and perform a ritual. Today, we know TB as an airborne infectious disease, spread when an infected person coughs, speaks, or sings. Prior to the COVID-19 pandemic, TB was the leading cause of death from a single infectious agent, ranking even above HIV/AIDS. According to the Global tuberculosis report 2021, there were 1.5 million TB-associated deaths, 1.3 million deaths among people without HIV, and an additional 214,000 deaths among people living with HIV. The pandemic led to underreporting in the number of people reported as newly diagnosed with tuberculosis, the numbers falling by 18% from 7.1 million TB diagnoses reported in 2019 to 5.8 million in 2020. TB remains widespread with about one-quarter of the world’s population being infected with latent TB, according to the World Health Organization. The infection is more likely to develop into a disease when a person’s immune system is compromised, for instance, due to HIV, malnutrition, other illnesses, or aging. These are often the most vulnerable populations: isolated by geography, severe poverty, and social stigma. The average person has a 5-10% risk of falling ill with TB and if left undiagnosed and untreated can infect 5-15 people through close contact over a year. Other adverse effects of late diagnosis include; developing extra

pulmonary TB, chronic lung disease, drug resistance, reduced quality of life, and death. The burden of TB in Kenya is higher than previously thought according to the Kenya Prevalence Survey of 2015/2016. Kenya, it says, is among the 30 high TB burden countries globally. Moreover, the survey concluded that Kenya misses up to 40% of TB cases that go undiagnosed. Based on our morbidity pattern, 60-80% of the patients presenting themselves to the hospital with respiratory infections are presumptive TB cases and should be investigated to rule out TB. In addition, at least 10% of presumptive TB patients should be TB cases (Bacteriologically confirmed and clinically diagnosed) whereas 1015% of TB cases should be children under 15 years of age. Active TB Case Finding is the systematic identification of presumptive TB cases from a predetermined target group or population by doing the symptomatic screening, facility Based Active Case Finding (FB-ACF), contact management, and Community outreach interventions. A four-symptom screening tool can be used in all settings. Among adults and adolescents, systematic screening for TB disease should be conducted using the WHOrecommended four symptom screen

ISSUE 14 | Kenyatta National Hospital Newsline

which includes; current cough, fever, weight loss, or night sweats. Children presenting with a history of frequent respiratory tract infection, failure to thrive, lethargy and irritability as well as reduced playfulness may have TB and should then undergo evaluation for TB and other diseases. The low index of suspicion and capacity and knowledge gaps in health care workers as well as lack of sensitization materials are some of the hindrances to active TB case finding.

PHOTO | HIV info

A diagram showing Latent TB and TB Active disease

Mitigation measures include: • Frequent sensitization of health care workers on current guidelines and creation of demand for job aids and SOPs; • Cough monitors to triage people with TB signs and symptoms, or with TB disease. • Fast-tracking of presumed TB cases. • Minimizing time in the facility and Prompt initiation of effective TB treatment of people with TB disease among other infection control strategies. • Additionally, there is a need to appoint TB champions across all service delivery points to champion this agenda by frequently using data-led strategies toward reducing TB

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morbidity and mortality among patients, visitors, and healthcare workers. Mycobacterial culture is the gold standard for TB diagnosis that is done using different types of mediums, however, results in turnaround time can range between 1-6 weeks. WHO recommends the use of molecular diagnostic tests for the rapid diagnosis of TB disease. The Xpert MTB/RIF assay is a cartridgebased automated test that uses

real-time polymerase chain reaction (PCR) on the GeneXpert platform to identify MTB and mutations associated with rifampicin resistance directly from sputum specimens in less than 2 hours. Other diagnostic tests aid in the diagnosis of TB depending on feasibility and availability. However clinical acumen remains fundamental in the early detection of TB and is vital with the help of screening and diagnostic tests to prevent TB-related mortality.

The first-ever bundle of gifts for MMUH

The end TB strategy aims at a 90% reduction in TB deaths and an 80% reduction in TB incidence by 2030, compared with 2015. At the core of this strategy is a dual approach of maintaining and strengthening current TB control priorities concurrently with increasing efforts to identify and treat latent TB in populations at risk for TB disease. Maintaining a high index of suspicion is the fuel needed to strengthen active TB case findings.

MMUH opens Chaplaincy Hall

PHOTO | JOAN MACHARIA Mr. Mike Wambui and Ms. Sharon Hope, both from Mawingu Technologies Ltd donating baby diapers, sanitary towels, yogurt, and assorted toys to MMUH

By Jacqueline Ngure Mama Margaret Uhuru Hospital (MMUH) received its first-ever donation of baby diapers, sanitary towels, yogurt, and assorted toys from well-wishers on Wednesday, June 22, 2022. Mr. Mike Wambui and Ms. Sharon Hope, both from Mawingu Technologies Ltd extended the kind gesture to the children admitted at MMUH as a way of giving to society.

The generous donation was received by the MMUH Head of Clinical & Nursing Services Dr. Caroline Robai who appreciated the team for the thoughtful gesture noting that it will significantly complement the Hospital’s resources and put a smile on the faces of the patients. MMUH remains open to partnerships and collaborations that enhance its capacity to offer quality healthcare services to all Kenyans.

ISSUE 14 | Kenyatta National Hospital Newsline

PHOTO | JACQULINE NGURE MMUH Staff during the opening of MMUH Chaplaincy Hall

Mama Margaret Uhuru Hospital (MMUH) fraternity is excited about the opening and consecration of a Chaplaincy hall within the hospital on Monday 20th June, 2022. The exercise was led by the KNH Chaplain, Rev. Kanamba Miriti who called upon the MMUH staff to remain faithful in their service to God and his people. Rev. Miriti’s message was

drawn from the book of Colossians 3:12 “Therefore, as God’s chosen people, holy and dearly loved, clothe yourselves in compassion, kindness, gentleness, patience and humility.” The Chaplaincy hall which is located on the first floor of Mama Margaret Uhuru Hospital will provide spiritual nourishment services to both staff and patients in MMUH.

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Happy birthday to the 439+ July babies! From Marketing & Communication team 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. 26. 27. 28. 29. 30. 31. 32. 33. 34. 35. 36. 37. 38. 39. 40. 41. 42. 43. 44. 45. 46. 47. 48. 49. 50. 51. 52. 53. 54. 55. 56. 57. 58. 59. 60. 61. 62. 63. 64.

MR. ALI ABDURAHMAN KABOO MRS. ESTHER KERUBO GESICHO DR. DANIEL ITUMO KIBAYA MISS. ALICE WANJIKU KAMAU MISS. ELIZABETH NJERI GITAU MISS. ESTHER NJOKI REUBEN MISS. EZIKES MUSIMBI CHANZU MISS. FLORAH KINYA MITINE MISS. GRACE MUTHONI NDUNGU MISS. JUDY WANGARI WAITHAKA MISS. MABLE ADEMA BUDOHI MISS. MARGARET MUNA MISS. MARY NJAMBI MWANGI MISS. ROSE ACHIENG OMOL MISS. WANJIRU MAINA MR. DAVID ONGARORA OGEGA MR. DAVID WAKABA KAHARI MR. JOHN MURIGI NGUGI MR. JOHN MWAKWARI MALOGHO MR. KANDIE MUSA SUMUKWO MR. KENNEDY OURU GOGO MR. MATHEW KIMWATU KATUA MR. PATRICK MARANGU INOTI MR. PETER KOBIA M’IRI MR. SAMUEL MOSOMI NYANGAU MR. SILAS NYABUTI KIRIAMA MRS. FELISHINA WAGITHI KABIRU MRS. JENIFFER AUMA OGUTU MRS. MARGARET ATIENO ODUONGO MRS. NURU RASHID ABDUL AZIZ MRS. SUSAN WANJIRU NJOROGE MRS. WINFRED MWIKALI MBITHI MRS. ELIZABETH WAMBUI GITAU MRS. LILIAN WANGUI KABUA MR. DAVID MAINA KINGORI MR. JAMES NGIGE MATHERI MRS. RHODA ATEMO MUSITA MRS. RUTH MAGIRI KIBUNJA MRS. PAULINE KAVITHE MUSA DR.JOYCE WANJERI NJOROGE MRS. HELLEN NYASUGUTA H. OPANGA MISS. LESA MBEKE MUTUA MISS. MARY WAITHIRA KIMATHI MR. LEONARD OLAKHI OUMA MRS. JULIA MUKIRI MWITI MISS. ALICE APIYO MUGGA MISS. JANE ADONGO MUGA MRS. MARGARET MINAYO EPHRAIM MRS. FELICITY NANCY MUCHENA MRS. LYDIA NYOKABI KAGEMA MISS. CHARITY WAIRIMU KARIUKI MR. SAMUEL NJOROGE NGANGA MISS. ALICE MUHONJA MACHO MRS. PRISCILLA GATHONI WAMAHIU MR. GERALD KABERIA MR. PETER KAMANDE MACHANGA MRS. CATHERINE MWARI MUREITHI MR. EDWARD MUNGAI NDUNGU MRS. MARY FLORENCE NEKESO OJIAMBO MR. PETER NDUNGU NJOROGE MRS. ESTHER WANJIKU KARANJA MRS. MARGARET MUENI MULILI MR. PAUL KIMENYI MRS. BETH K. MWANZA

65. 66. 67. 68. 69. 70. 71. 72. 73. 74. 75. 76. 77. 78. 79. 80. 81. 82. 83. 84. 85. 86. 87. 88. 89. 90. 91. 92. 93. 94. 95. 96. 97. 98. 99. 100. 101. 102. 103. 104. 105. 106. 107. 108. 109. 110. 111. 112. 113. 114. 115. 116. 117. 118. 119. 120. 121. 122. 123. 124. 125. 126. 127. 128.

MRS. PAMELA PRISCILLA ODOLI DR. MUSA KIPYEGON KIPINGOR MISS. ALICE MUTHIRA WAWERU MRS. JULIETTA NJERI KILONZO MISS. MARY WANJIKU NDUNGU MISS. ERINAH NDUBI BWIBO MRS. ZIPPORAH WANJIRU MATHENGE MRS. JANE MEDZA WATKINS MR. DAVID HUMPHREY OYILE KUNGU DR. JOHN KINUTHIA MR. PATRICK NGANGA THUKU MISS. NANCY WANJIRU GITERU MISS. ROSE WANJIRU MUTHII MISS. MARGARET MUTHONI MAINA MISS. GRACE WANGARI GATOGO MISS. MARGARET WAMUYU MWAI MR. DANIEL MAYAKA MR. JOHN MAINA MWANGI DR. PENINAH WANJIKU GIKORE MISS. MARIAM ABDULLA ALI MR. STEPHEN OPUKA HAGGAI MISS. REBECCA MONYANGI ONCHIRI MISS. WINFRED ATIENO MR. JAMES WAIHAKA MUGAMBI MISS. MARY WAIRIMU GIKUHI MISS. CHARITY NJERI KAROMO DR.(MRS) HANNAH WANGUI WANYIKA MRS. VERONICA MUENI KIIO MRS. RHODAH MWIKALI KIILU MISS. JOAN MBITHE MUTISO MISS. NANCY NJOKI NJERI MR. DUNCAN MSAFIRI MWAJEU MR. JOSEPH KARIUKI NGATIA MR. LUKE NDERITU MATHAI MR. JOHN ODUOR ONDIEGE MR. JOHN MAINA MWANGI DR. VIOLET CAROLINE A. OKECH MR. JAMES NJOROGE KIRAGU MR. ROBERT MWANGI KAMUTU MRS. PRISCA WANGITHI KINGORI DR. PATRICK MBUGUA KINUTHIA MRS. PAULINE GAKAA KITHINJI MRS. VERONICA NJERI ONGARO MRS. VICTORIA ACHIENG OOKO MR. JONAH OWIYO JAKOYO MR. RICHARD KAMILAT MR. NICHOLAS WANJOHI KARIUKI MR. MUSILA MUTUNGA MUASA MRS. JOSEPHINE NABWIRE EGOKHE MR. BERNARD MUTUKU MBEVI MR. JOSEPH MUIRUNGI MISS. NANCY WAIYEGO KIMANI MR. MARTIN KINYUA MWAI MISS. HILDA WANJIKU MBIYU MR. STEPHEN KARANJA NGANGA DR. TOM BOSIRE MENGE MR. SAMMY CHEBII KIPKEMOI MISS. EPHELM RITA NYAANGA MR. JULIUS MBATI WOBULU MISS. ELIZABETH NYOKABI GATHERU DR. RHODA MUTUNDU MUNENE MR. PATRICK GITHINJI NYAMU MR. STEPHEN MUTHII MWAI MR. CHARLES RUITA MWANGI

129. 130. 131. 132. 133. 134. 135. 136. 137. 138. 139. 140. 141. 142. 143. 144. 145. 146. 147. 148. 149. 150. 151. 152. 153. 154. 155. 156. 157. 158. 159. 160. 161. 162. 163. 164. 165. 166. 167. 168. 169. 170. 171. 172. 173. 174. 175. 176. 177. 178. 179. 180. 181. 182. 183. 184. 185. 186. 187. 188. 189. 190. 191.

MRS. ROSEMARY MUTHONI THAIYA MISS. VELMA OMUYAKU ASIRA MISS. BEATRICE ACHOLA OYUCHO MISS. FLORENCE WANGUI NGATIA MR. DAVID KILINGISU MISS. EUPHEMIA AMUKANGA MISS. JANET WASIKE MR. BENJAMIN SAIRIAMAKI SEIN MISS. PAULINE WANJIRU NGUGI MR. OBADIAH KARUKU KABU MISS. ROSE WAMBURA MACHARIA MR. JOSEPH ASABE INYUNDO MRS. ALICE GATHONI NGINYANGI MISS. EMILY GAKII KIRUJA MISS. ROSEMARY WAIRIMU KARIUKI MR. FREDRICK NYANG’AU NYANYUKI MISS. CATHERINE KIARIO MR. HANNINGTON W. O. AJUOGA MRS. JERUSHA NCORORO MUNYAKA MR. CAESAR BARARE OBURU MR. BENSON NDUMBA M’MARETE MRS. VERONICA KATUMBI LEMBA MISS. PERIS WANJIRU NJUGUNA MISS. EMILY WAMBUI KINUTHIA MISS. MONICAH WAITHIRA KIHARA MR. JACKSON NDIRANGU MACHARIA MISS. PURITY KIENDE KUNGANIA MR. DANIEL KIANDA MUTHUI MRS. NAOMI WAMBUI KIARIE MRS. LUCY NYARUAI NDURU MR. SAMUEL AMAYODI BULIMO DR. MARTIN MAGU MURAGE MISS. LUCY WANGARI MAINA MR. MOSES OWUOR AKURO MISS. JANE WAMBUI NJOROGE MISS. JENIPHER TRUPHOSA OMONDI MR. EDWIN GITONGA NDIGA MISS. CATHERINE NAITO MUGUONGO MISS. MILIKAH WAHU KARIUKI MRS. FRIDAH KAGURE MURIUKI MISS. CAROLINE NKATHA MAGAJU MISS. JANE B. KAINYU MUNYUNGI MR. PAUL MUNANGA DR. SAMUEL MUNYI NYAGAH MISS. NANCY MUTHONI NJUGUINI MISS. GLADYS KWAMBOKA NYABORO MISS. RITA JULIAN MIYAWA MR. HUSSEIN AHMED MOHAMMED MRS. TERESA WAMBUI KAHIA MISS. JANET WARIGIA NDUNGU MISS. JANE KANANU KAMANJA MISS. MONICAH WAMAITHA KAMAU MR. STANLEY KIMUTAI AYABEI MRS. MILLICENT ALUOCH MBOYA MISS. JANE WAMBUI NDICHU MISS. LUCY KATHURE NDEREBA MR. ADAN DIDA JALDESA MR. KENNETH KIPSANG KIPCHIBI MRS. PAULINE KAVUTHA MAITHYA MR. ANDREW KHISA WASIKE MR. HENRY KIMATHI MUTUA MR. JOHN WANGAI MR.IBRAHIM AYUB OKWEMBA

HAPPY BIRTHDAY JULY BABIES ISSUE 14 | Kenyatta National Hospital Newsline

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192. 193. 194. 195. 196. 197. 198. 199. 200. 201. 202. 203. 204. 205. 206. 207. 208. 209. 210. 211. 212. 213. 214. 215. 216. 217. 218. 219. 220. 221. 222. 223. 224. 225. 226. 227. 228. 229. 230. 231. 232. 233. 234. 235. 236. 237. 238. 239. 240. 241. 242. 243. 244. 245. 246. 247. 248. 249. 250. 251. 252. 253. 254. 255. 256. 257. 258. 259. 260. 261.

MR. MICHAEL ODOYO MBOGA MISS. SUSAN WANJIRU NGUGI MISS. ROSEMARY WANJIRU KAMAU MISS. NYAKUNDI ELLIVIN MWANGO MISS. ANNET SILAKO SASAKA MISS. VIOLET KAGEHA ATONYA DR. JULIANA ANN MARIE MWIKALI MUIVA MISS. MARY MUKIRI KIMATHI MR. DANIEL NDEGWA KINYUA MISS. MARY MAJALA NIVEN MR. DARIUS NYAMBU MWALUGHA MISS. VIRGINIA WANJIKU WAITHERA MR. PATRICK IRUNGU MWANGI MISS. MARYANNE MAKENA GITOBU MR. ANDREW MWASHILLA MWAMBUA MISS. HARRIET WANJA RIUNGU MISS. SABINA WANJIRU MBURU MISS. POLLY MUTHONI GICHONI MISS. CATHERINE WANGARI NJENGA MRS. PHYLIS M NAFULA WANJALA SEWEDE MRS.JUDITH MUSIMBI JUMA MISS. CAROLYN MAURINE OUMA MISS. PURITY WAIRIMU NGIRI DR. LYDIA OKUTOYI MISS. MARY NTHOKI MUTUMA MISS. SALINAH ESELINE CHERUTOI MR. PHILEMON MUGA ORWA MR.KIRUNYU KIRUNYU NDIRANGU MISS. IRENE GATWIRI BUNDI MISS. REMONAH ATAYI OLUKAKA MR. BONIFACE SAULO AMUNGA MISS. ANNE NJERI MBUTHIA MISS. CECILIA WACEKE MURUO MR. JACKSON GITU MWANGI MISS. MARY NGIMA WANGAI MR. FREDRICK KYALO MUTHENGI MISS. LILLIAN WANZA KIILU MISS. ANASTASIA AYOTI KHASIANI MISS. MARY ADHIAMBO OTIENO MISS. MONICAH CHELAGAT KILATYA MRS.ROSE MORAA BOSIRE MISS. CAROLYNE ANYONDE OKIYA MISS. CATHERINE WANJIRU MATHENGE MISS. EVELEEN N. MOSOTI MR. DAVID KINUTHIA KARUGA MISS. PAULINE GATWIRI NKONGE MISS. PAULINE WANGARI KING’ORI MISS. PRISCAH SYINDU MWAVU MISS. TERESIA MUGECI MWANGI MISS. WINFRIDA KADZO MJIDU MR. MARK OTIENO MBIRO MRS.GENTRIX KASITI IMBATSWA MR. GEORGE OMONDI OUTA MR. BERNARD KEITANY CHEPTOO MISS. ABDIA AHMED OSMAN MISS. AGNES RUGURU NJIRU DR. CHRISTINE AMO MAMAI MR. GEOFFREY MBURU GITAU MISS. GLADYS AKINYI GOR MRS. GLADWELL MUTHONI WANJAU MISS. CAROLINE MUTHEU MUTUMA MISS. CECILIA WATHITHI WAIGWA DR. LINDA KWAMBOKA MOSE MR. JASON KIRUJA GITONGA MISS. RITA KENDU M’ITURUCHIU MRS.MERCY CHELAGAT MUTAI SORE MR. ZACHARIA P. KIMENGICH MR. FRANCIS MARIACH KENIMAK MR. HILLARY NDUBI MAUGO MR.SHADRACK NYAANGA OISANGA

262. 263. 264. 265. 266. 267. 268. 269. 270. 271. 272. 273. 274. 275. 276. 277. 278. 279. 280. 281. 282. 283. 284. 285. 286. 287. 288. 289. 290. 291. 292. 293. 294. 295. 296. 297. 298. 299. 300. 301. 302. 303. 304. 305. 306. 307. 308. 309. 310. 311. 312. 313. 314. 315. 316. 317. 318. 319. 320. 321. 322. 323. 324. 325. 326. 327. 328. 329. 330. 331. 332.

ISSUE 14 | Kenyatta National Hospital Newsline

MISS. ANNET CHEPKWEMOI KINGWA DR.PHOEBE VICTORIA JUMA MISS. EUNICE AMONDI LIHARE MISS. BEATRICE KATHURE MURITHI MISS. MARY AWUOR OKEYO MISS. GRACE ATIENO ABONGO MISS. SALLY JELIMO KEINO MISS. WINNIE NKIROTE KUBAI MISS. RUTH NDUKU MUTISYA MR. RICHARD OKOKO OGENDO MISS. CAROLINE AUMA ONGALLOH MISS. BEATRICE GATHIGIA GITHINJI MISS. MERCY KARENGEKA MALENYA DR. ALLAN IKOL ADUNGO MRS. ANNE NJAMBI NDUNGU DR. LINDA WANJIRU GATHARA MR.DAVID ODUOR OWINO MISS. RITA LINDA AKINYI DR. MATILDA KEROBO ONGONDI MISS. ANN RWAMBA NTHIGA MR. JOHN MWONGELA MUSAU MISS. MARY MWIKALI KASONE MISS. MERCY WANGECHI NJOGU MISS. RAEL NYANCHAMA OSIENO MISS. ANN CHRISTINE KAGENDO MUTUA MISS. RUTH MORAA NYAIGOTI MR.MICHAEL OTIENO OLANGO MRS LUCY KWANGA OTIENO DR.RABECCAH MBITHE MUTISYA MISS. RAHAB MWERU MUNENE MISS.JUNE DIANA AKELLO MR. KELVIN AUKA NYANG’AU MR. JACKLINE CHEPCHIRCHIR MISOI MR. WYCLIFF MURITHI KITHINJI MISS. PENINAH WANJIRU NJUGUNAH DR. ALEX OKELLO WAMALWA MRS.RISPER CHEBET MR. SHADRACK IKONZE ILUKU MISS. MERCY BERYL ACHIENG DR.LILIAN KWAMBOKA NYAMERA MR. NICODEMUS KIOKO MUTHOKA MISS. BEATRICE AKOTH ACHOLA MRS.MILLICENT AOKO ODAMO MISS. SELINE AUMA OJWANG DR. PRISCILLA MOSEREMBE ANGWENYI MR. JOHN IKAARI MWITA MR. JARED OMONDI ALOO MR. JOSECK AGANYO MAGETO MISS. RODA AUMA OMONDI MRS.ROSAPAULA KAWIRA NGAI MISS.ROSE KAGENDO GITOBU MR.BRIAN MUTEGI MUTIIRIA MISS. ERAH NKIROTE RWANGUA DR. JOHN C. MWANGI RODRIGUES MISS. LUCY MWITHA WAMITHI MR. JOHN LISTER WAICHOKA MR. THEOPHILUS OGAMO SAKED GORO MISS.JANETH WALI MWAISABU MISS. EUNICE MOKEIRA MABWOGA MRS.CAROLINE NTINYARI BUNDI MR. CHARLES MAMBOLEO NYANGAU MR. PAUL THUO MAINA MISS. LYDIA WAIRIMU KUIRA MR.ARTHUR NENOH OYARO MR. FRANCIS NGUGI NGINA MISS. JULIET WANGARI KINYANJUI MR.PETERSON KINYUA NTHIGA MISS. SALOME CHEMUTAI MR. GEOFRY KEVIN ABALA MR. VALENTINE MUTUGI PERIS MR. PETROVIC MULUBI KAIGA

333. MISS. HELLEN ANGEI SAGALA 334. MR. JAMES SANYA OPIYO 335. MISS. MAGGINERRO NYADIMO ODINDI 336. MR. STEPHEN OTIENO ODERA 337. MR. FRED MWITA ROBI 338. DR. ANN NYOKABI KIMAMA 339. MISS. VIRGINIA WANJIKU NJENGA 340. MISS. JUDITH ANYANGO OWINO 341. MR. JULIUS CHERUIYOT KOECH 342. MRS.REGINA WAIRIMU WANGECHI 343. MR. SOLOMON MIRERA OMARE 344. MRS. GRACE WAIRIMU MUKAMI 345. MISS. EVE OKAL MIDIGO 346. MR. SHADRACK OTIENO OGEMBO 347. MRS.ANITA KEMUNTO MICHWEYA 348. MR. PHILEMON ODHIAMBO AWITHE 349. DR. ANN KABURA NJAMBI 350. MISS. LILIAN ADHIAMBO OLIBE 351. MR. NASHON OTIENO OWINO 352. MR. HANNINGTON OKOTH OUMA 353. MR.PIUS MAUNDU NGALA 354. MISS. JANET AKOSE AMIRA 355. MR. GIDEON MWAURA MWANGI 356. MISS. SHARON NTHENYA MUTUKU 357. MR. BEKING KIBET NGETICH 358. MR.STANLEY MORUMBE NYANGENA 359. MR. SHEDRACK KATENGE KITHOME 360. MR. RICHARD OKARI 361. MISS.ANN WANJIRA WACHIRA 362. MR. VICTOR MUTHUI NYERERE 363. MRS. MAERO VIVAN WESONGA 364. MISS.FAITH SANTAI DABALEN 365. MISS. VALENTINE WAHU KIMANI 366. MRS. AKINYI ESTHER OSUMBA 367. MR. COLLINS KIPKORIR TUITOEK 368. DR. FRANCESCA AKINYI OGOMBE 369. MR.MOSES MUSASULA WAFULA 370. MR. ROBERT WAFULA SIKUKU 371. MISS. BRENDA NDANU MWANGANGI 372. MR. EVANS BILANI SAMITA 373. MR. HENRY KARUTI KIMATHI 374. MISS.MERCY MUSENGYA MUTHAMA 375. MR. JEREVASIO MACHARIA NJERU 376. MISS.JANE MUTHONI MBURU 377. MRS.MILDRED ATIENO OUKO 378. MR. JULIUS KITHINJI MUCHIRI 379. MR.CHRIS MWITI GITONGA 380. MRS. ELIZABETH INYANJI BARASA 381. MRS.BARWAKA SHARIFF ABDULLAHI 382. MISS. RACHEAL MORAA MAKORI 383. DR. RUTH BIBIANA KHAINGA 384. MISS. MARY SINAIDA NICHOLAS 385. MISS.XANDRA CHEPNGENO LANGAT 386. DR.PATRICIA NYOKABI NJUGUNA 387. MRS.MONICAH WAIRIMU NDUNGU 388. MR.JARED ONYANGO OGAL 389. MRS.JULIA NAMUSIA WAWIRE 390. MR. JOSEPH MUTUKU SUSAN 391. MR.JAMES MUCHUGIA IRUNGU 392. DR. RACHAEL AKINYI OCHIENG 393. MRS.DEBORAH NYANCHAMA MESESI 394. MR.JESSE KINYANJUI GITAU 395. DR.JENNIFER NAITORE 396. MR.KENNEDY MUTUNGA NDAVI 397. MRS.CYNTHIA NJERI IKUHA 398. MR.WILLIAM MWAMUYE JILANI 399. MRS.WINNIE KERUBO MOGA

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The KNH 4th Cohort Nursing process certification By Yvonne Gichuru KNH concluded the ceremony for mainstreaming nursing process training phase 2 and certification for nurses from the Obstetrics & Gynecology Department, Orthopedic Department, and Kenyatta Prime Care Centre (KPCC) at the National Nursing Association of Kenya Complex-KNH on Tuesday, June 28, 2022. The Nursing Division, through Nursing standards, facilitated Nursing process training and implementation from 4th October 2021 to 10th June 2022. The 60 graduates were the 4th cohort of the class that has been trained through the Nursing Standards, Students, and Research department. “The primary aim of the nursing process approach is to establish the health status and the problems of the clients as we endeavor to improve our patient care by training our nurses,” said Ms. Christine Musee – Deputy Chief Nurse, Surgery KNH as she gave her remarks on behalf of the chief guest, KNH CEO Dr. Evanson Kamuri, EBS. In attendance was also Mr. Paul Wambugu – Lecturer- School of Nursing Services, Kenyatta University who was an external assessor for the Nursing process training. He gave implementation evaluation feedback on the training and recommended continuous mentorship and sustainability measures to improve the

PHOTO | NAHASHON ONGIGI Ward 1D as they receive their certificate of recognition as one of the best Obstetrics & Gynecology wards.

implementation of the nursing process. “You should take advantage of the opportunities such as collaborating with institutions of higher learning, research, and other academic writing to be able to bridge the gap in nursing care despite the challenges,” he said. Ms. Musee also commended the team for their positive attitude and determination to learn about the nursing process. “I appreciate the Nursing division for providing an opportunity for capacity building for KNH nurses. We have the capacity, ability, and willingness to be a center of excellence in the nursing process,” she said.

PHOTO | NAHASHON ONGIGI Ms. Adelaide Lemba awarded with a certificate of recognition by Ms. Christine Musee - Deputy Chief Nurse, Surgery for being the mainstreaming nursing process champion.

ISSUE 14 | Kenyatta National Hospital Newsline

PHOTO | NAHASHON ONGIGI Some of the mainstreaming nursing process trainees receiving their certificate of participation

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The first-ever Family Week at KNH “You don’t choose your family; they are God’s gift to you” By Cynthia Cherono KNH chaplaincy unit organized the first-ever Family Week, which was held from Tuesday, June 21 to Friday, June 24, 2022. It was intended to sensitize the staff on the role of Chaplaincy in family care issues that affect their functionality and productivity at the workplace. The Chaplaincy unit is key to offering spiritual care to staff and patients at the Hospital, hence enhancing their functionality and drawing new positive energy that is dispelled back home to their families. The theme for the event was the “role of spirituality in families.” The chaplaincy in KNH gives care to the patients, their relatives and friends, the staff and their families, and students. To the staff, the chaplain responds to individual and family needs as well as work-life concerns such as job stress, coworker relations, and career direction. The unit also guides management about issues affecting employee and hospital well-being, including organizational change, ethical challenges, conflict resolution, team development, and outplacement. The Director of pharmaceutical services Dr. Alfred Birichi on behalf of the KNH CEO, Dr. Evanson Kamuri, EBS, launched the event on Tuesday, June 21, 2022. He said that the Hospital’s mandate is to provide specialized health care services to patients and it is in this view that the KNH chaplaincy gives families this chance.

PHOTO | ELIJAH NG’ANG’A Director Pharmecutical Services Dr. Alfred Birichi launching the KNH family week

PHOTO | ELIJAH NG’ANG’A Guest Speaker Chaplain Vicki Okumu speaking on Spirituality and Family

Quality health care endorses the wellness of both patients and staff; hence KNH used the Family Week platform for interaction to heighten the level of spiritual care and for better health outcomes. Dr. Birichi thanked the chaplaincy unit for organizing the Family Week and the various participating teams including; the Nursing services, Marketing and Communication, Aids Control Unit (ACU), Diabetes and Endocrinology Centre of Excellence, Security, and Safety, KNH choir, and Catering unit. Ms. Ruth Nyasikera, Ag. Deputy Chief Nurse-Nursing Standards, Students and Research representing the Director Nursing Services said: “Family is characterized by relationships, it goes beyond the relative and KNH should excel in providing specialized care.” The Senior Director Clinical Services representative Ms. Margaret

ISSUE 14 | Kenyatta National Hospital Newsline

Githire appreciated the family. She said: “Spiritual care is key to every human being and I encourage the staff to give clients time for interaction. Deficiency, loneliness, bitterness, and rejection affect families and for us to be complete we need spiritual care.” The guest speaker Chaplain Vicki Okumu spoke about spirituality and family and urged KNH staff to find purpose in what they do. “Through what you do you will be able to have a holistic community because “we listen, we care”. As we walk let us clarify each other’s roles, and have respect for the people around us because it is the spirituality you bring to the job that matters. Have relationships that matter, be authentic, and have meaning in what you do, caring for colleagues and patients. Let us be intentional in what we do,” said Chaplain Vickie. The head of the Chaplaincy Unit Fr. John Kariba encouraged everybody to use the chance during the family week to seek assistance in various areas of interest and he applauded the management for aiding in their call on spirituality matters. During the event, the Chaplaincy Unit organized a webinar sensitization on various topics which included; conflict management, work and burnout, and youth and teen parenting in collaboration with KNH youth center and chaplains from Servant for the Sick Homes, to be able to encourage good relationships amongst families here at the workplace and home. Conflict management- In KNH this is a key management skill,

PHOTO | ELIJAH NG’ANG’A Guest Speaker Chaplain Vicki Okumu (3rd R) with KNH Chaplaincy unit staff during the family week sensitization

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and it involves using different tactics depending on the situation, negotiation, and creative thinking. With properly managed conflict, KNH can minimize interpersonal issues, enhance client satisfaction, and produce better health outcomes for our patients. Workplace conflict does not automatically mean that there are specific employees at fault, although in some cases that will be the issue. If you have employees who question the status quo and are pushing to make changes that they feel would be positive for the organization, that can indicate that the organization has a high level of Conflict and can also mean that employees are comfortable enough to challenge each other and that they feel as though their conflicts will be fairly resolved by the organization. Conflict management, when done properly, can even increase the organizational learning of an organization through the questions asked during the process. Work and burnout- The KNH chaplaincy unit spoke about work and burnout because the management had received complaints from staff that are unable to work because of stress that is related to work. Work burnout is work-related stress; it’s a state

of physical or emotional exhaustion that also involves a sense of reduced accomplishment and loss of personal identity. In KNH, the Employee Assistance Program helps staff by providing counseling services and doing sensitization on what to expect in a hospital environment. In case there’s Work-life imbalance, lack of control in the offices, unclear job expectations, dysfunctional workplace dynamic, extremes of activities, and lack of social support, the staff is encouraged to have a good relationship with colleagues, discuss concerns with their supervisor, seek support from friends, get enough sleep to be able to tackle tasks professionally and with soberness. Youth and teen parenting- KNH youth center is a special unit geared to helping the teens and youths in implementing a program that seeks to reduce violence against children with a special focus on sexual exploitation of children and child sex tourism, which seeks to address child sexual abuse and exploitation in all its forms. The specific objective of the program is to advocate and lobby for improved protection of children against violence, in particular, sexual exploitation at the local and national

levels in Kenya. Cases of violence against children are common in our societies and to seek services for the abused child, one needs knowledge of where to seek assistance and KNH youth center is a place to be. During the family week, the Youth Centre team was given a chance to present on the teens and youth parenting. The speaker began by saying, “parenting is for the courageous.” Challenges arise when children grow. Parents should be there to help them make their decisions. Spiritual development is an important aspect and we should have a spiritual identity, where parents are supposed to connect children to their creator. Parents should adjust to changes, especially on social media, and should guide their children in making courageous decisions. How the youth behave is a reflection of who raised them but the greatest rule is to make room for improvement because God expects us to guard children, discipline, and draw near to the children as role models. Remember, who we are, our children become, and as Proverbs 22:6 states; “Train your child in the way he should go; and when he is old, he will not depart from it.”

Boost as KNH Security officers train on Security Certification Compliance Course By Peter Githua & Steve Arwa Kenyatta National Hospital has completed a Security Certification Compliance Course for Forty (40) Security and Safety Services officers. The course commenced on Monday, June 27, 2022 and ended Friday, July 1, 2022, with the aim of ensuring that health care security officers maintain a proactive rather than reactive approach in the protection of key installations, infrastructures, and corporate assets. This course is in line with the Security legislative framework informed by The Private Security Regulatory Authority Act 2016 (PSRA).The training was facilitated by the Institute of Professional Security Studies (IPSS) which the approved training body by the authority (PSRA). In her comments at the end of the training, the Director Healthcare Quality (HCQ) Dr. Lydia Okutoyi

expressed her joy and noted that this will equip the Security and Safety Officers to be an integral part of the Hospital’s journey of growth. “You are expected to demonstrate utmost professionalism, be firm and stable in optimizing patients’ experience”. This training is going to equip you with the relevant insight in being able to anticipate and handle the emerging issues, risks and expectations not only of the Hospital but the country at large,” said Dr. Okutoyi. The Executive Director (IPSS) Lt. Col. (Rtd) Julius Githiri thanked the Hospital for the partnership. He highlighted some of the content within the program that is highly valuable. Among the areas covered were; Risk and Vulnerability Assessment, Emergency Planning & Preparedness, Emergency First Aid, Effective Communication and

ISSUE 14 | Kenyatta National Hospital Newsline

Customer Relations. “The Hospital Management expects nothing short of effective Security & Safety Services, improved customer care and application of uniformed standard of security,” said Lt. Col. (Rtd) Julius Githiri.

PHOTO | ELIJAH NG’ANG’A Ag. HoD Security Mr. Wilson Chepkwesi give his thanksgiving remarks as they conclude Security Certification Compliance Course

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Our story in Pictures

PHOTO | STEVEN ARWA

PHOTO |NICHOLAS WAMALWA

KNH security and safety officers having a group photo after a succesful training on Security Certification Compliance Course. Facilitated by Mr. Wilson Chepkwesi Ag. HoD Security & Safety and the Executive Director (IPSS) Lt. Col. (Rtd) Julius Githiri

Health CS Mutahi Kagwe visiting the KNH stand during the launch of the Damu -KE Conference

PHOTO | NICHOLAS WAMALWA

PHOTO | STEPHEN ARWA

Mrs. Damaclyn Mageto feeding her mother a piece of cake in celebration for her twins at ward 9D

Members of the PCEA Bahati Matyrs Parish present their donation to ward 1E, during their visit to the KNH Chaplaincy Unit. The group, led by Rev. Pauline Kanuthu fellowshiped with chaplains from KNH shortly before visiting the ward.

PHOTO | NAHASHON ONGIGI

Ms. Ruth Nyansikera – Principal Nursing Officer, Nursing Standards, Students and Research, Mr. Paul Wambugu – External assessor and Lecturer- School of Nursing Services, Kenyatta University, Ms. Ruth Nyaga - Nurse In charge, Labour Ward, Ms. Esther Sang - Nursing Officer, Mr. Mwiti - Nursing Officer and Ms. Christine Musee – Deputy Chief Nurse, Surgery cutting the cake to celebrate the nursing process graduates.

ISSUE 14 | Kenyatta National Hospital Newsline

PHOTO | ELIJAH NG’ANG’A

Participants of the mainstreaming nursing process training including nurses from Obstetrics & Gynecology department, Orthopedic department and Kenyatta Prime Care Centre (KPCC) displaying their certificates and other members of the Nursing division after the ceremony at the National Nurses Association Kenya Complex within KNH.

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KNH participates in the first Damu-KE conference By Linnette Leyi The Kenya National Blood Transfusion Service convened a conference focusing on blood transfusion and organ transplant and practice. This was the first conference of its kind held in the African region focusing on the health policy, regulatory and practice ecosystem and its interaction with blood transfusion medicine and the highly specialized aspects of Transplant and regenerative medicine. The three-day conference was coordinated in a hybrid format with a mix of an online approach and inperson panel discussions. The Chief Guest-Health CS Mutahi Kagwe who officially opened the conference on 28th June, 2022 reiterated the Ministry’s commitment in investing in the health sector to drive Universal Health Coverage (UHC). “This conference is an investment in transfusion and transplant services,” he informed the participants. “The recently launched

Centre for Kidney Disease & Organ Transplantation and the Histocompatibility and Immunogenetics Laboratory at Kenyatta National Hospital is a step in the right direction in ethically sourcing for organ donors and conducting donor and recipient matching locally,” he added. He acknowledged blood donation efforts being put by NGOs, county hospitals, secondary and tertiary education schools and individuals, especially regular and repeat blood donors. Present were Kenya’s top female and male blood donors who encouraged every healthy individual to donate blood at least once a year. CS Kagwe also launched the Kenya Blood Banking Information System; the Kenya Policy on Donation, Transfusion, and Transplant of Human Derived Medical Products; the National Standards and Guidelines for Blood Transfusion Services in Kenya; and the Intergovernmental Framework on Coordination of Blood Transfusion Service. KNH’s kidney specialist Dr. John Ngigi and Dr. Ali Kassim made presentations during track sessions

on topics concerning safe and quality kidney services and innovation in transplant infectious disease testing. The Hospital also had a display tent where Nancy Wang’ombe-Transplant Coordinator, Perpetua Asuko-Incharge Blood Transfusion Unit and Gladys Kwamboka-Renal Nurse educated participants on KNH’s kidney and split-liver transplant services and blood transfusion.

PHOTO | LINNETTE LEYI KNH team during the DAMU-KE conference at Windsor Golf Hotel & Country Club

KNH School of Nursing holds tracheostomy care training for nurses By Cynthia Cherono KNH School of Nursing held a twoweek training course on tracheotomy care for nurses from the Main CCU, Medical wards 4B and 4C. Ms. Josephine Mbugua, a critical care trainer at the KNH School of Nursing said that the training was a result of an outcry raised in the hospital regarding long-stay patients at the Critical Care Unit with tracheotomies. Tracheotomy, or tracheostomy, is a surgical procedure that consists of making an incision on the anterior aspect of the neck and opening a direct airway through an incision in the trachea (tube placed when patients are unable to breathe). The nurses were taken through a one-week theory course and one-

week clinical experience training. They acknowledged that the skills imparted were worthwhile and beneficial to the patients being discharged from ICU to the wards. “Through this training, the average length of stay for patients in ICU will reduce and lead to positive clinical outcomes,” Ms. Josephine added.

PICHA | CYNTHIA CHERONO Nurses during the trachaestomy training

ISSUE 14 | Kenyatta National Hospital Newsline

PICHA | CYNTHIA CHERONO Critical care Trainer Ms Josphine mbugua (R) and the trainees (M) and facilitator Mr.Fredrick Ndiawo (Far Left) after the training

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Twins: A miracle unfolds at KPCC

By Petterson Njogu Damaclyn Magero has conceived thrice since 2019, only for her heart to be brutally crushed all three times. Throughout the entire period, she would have traded anything just to hold her firstborn. “My husband and I tried to start a family for such a long time. It felt like forever. I started doubting everything since the baby we wanted seemed to be so near, yet so far,” said Damaclyn. In 2019, Damaclyn suffered two miscarriages, at 16 weeks and 10 weeks respectively. As if that was not agonizing enough, in 2020 at 26 weeks she lost her pregnancy once again. Miscarriage can be defined as a spontaneous loss of pregnancy before the 20th week. Studies reveal that about 9-20% of known pregnancies end in miscarriage, and there is a huge chunk of women who miscarry before they even know they are pregnant. Dr. Peter Michoma, KNH consultant Obs/Gynaecologist, who also doubled up as Damaclyn’s primary doctor disclosed to Newsline that she had a condition known as ‘cervical incompetence,’ which occurs

when weak cervical tissues lead to premature birth or loss of a healthy pregnancy. When she got pregnant again in 2021, she was very anxious about whether this time around, her unborn baby would reach full term. She went for her routine ultrasound and the scan revealed that she was carrying twins. It was overwhelming for them to take in, a situation her husband described as bittersweet. “It is one thing seeing my wife lose a baby but watching her go through such pain of losing twins would have not been easy for us,” said Damaclyn’s husband, who was very emotional holding the twins during discharge in mid-June 2022. To avert past losses and disappointments, Dr. Michoma had advised Damaclyn that the pregnancy would be monitored and supervised, and it was important to get her admitted as soon as possible for observation purposes. Damaclyn was admitted on 7th December 2021 at 11 weeks of pregnancy. She went for a Shirodkar stitch procedure where stitches are done around the cervix (neck of the womb) and tied to prevent the cervix from opening too early during

ISSUE 14 | Kenyatta National Hospital Newsline

pregnancy. A compulsory bed rest ensured another miscarriage did not occur. She had been at Kenyatta Prime Care Centre’s maternity wing for the last eight months. “This is no ordinary celebration. It is a significant miracle unfolding; thanks to the great facility that KNH is and the excellent teamwork at 9D and NBU. Kudos to all of you” concluded Ms. Doris Kimbui-Manager Nursing and Clinical Services at KPCC. Damaclyn thanked all the nurses for the care and emotional support she received during her long stay at KPCC. “We have been with her since day one and we are so glad that today she gets to leave with her two boys in her arms. Her resolve and endurance are commendable; she inspired all of us throughout her pregnancy journey,” said Ms. Marylin Margai, Manager at KPCC maternity wing during a farewell party just before discharge. During discharge, Damaclyn was showered with gifts and a cakecutting ceremony that culminate her eight-month stay at our facility. KPCC wishes long and healthy lives to Damaclyn and her two boys.

PHOTO | PETTERSON NJOGU Ms. Damaclyne Mageto receiving gifts from KPCC staff at the maternity ward level 9D

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KPCC holds medical outreach at Royal Nairobi Golf Club By Shawn Paul Omondi Kenyatta Prime Care Centre held a free medical service camp on Thursday, June 23, 2022, at the Royal Nairobi Golf Club. The activity is part of the Hospital’s initiative to encourage men and women to do regular health checkups. The event was attended by more than 50 people who had access to free medical services including free doctor consultation. KPCC nutritionists; Ms. Irene Kamau and Mr. Sammy Muthui enlightened clients about the recommended diet if they were overweight or were tackling any illness relating to their blood sugars and blood pressure. “Good diet is a crucial factor when it comes to your health simply because what we eat, determines how your body responds to treatment

and not only treatment but also general well-being,” stated Irene Kamau KPCC nutritionist. Kenyatta Prime Care Centre also had an opportunity to advertise and market its services at the Royal Nairobi Golf Club such as our outpatient center, in-patient wards, vaccination center, and also our dental services. “We want to thank Royal Nairobi Golf Club for the opportunity to offer and advertise some of the services that we have in the Hospital, especially since June is Men’s Health Awareness month,” concluded Mr. Simon Too, Marketing and Communications Manager at KPCC.

PHOTO | SHAWN OMONDI Mr. Sammy Muthui a nutritionist from KPCC taking the BMI of a client

Karate classes at KNH All work and no play makes jack a dull boy. Join the KNH Karate club for lessons for all ages at the main kitchen staff canteen on the 2nd floor.

Training starts from 5:30 pm to 7:30 pm; every Monday, Wednesday, and Thursday.

Key benefits include

√ Fitness, √ Self-defense, and √ Sports karate, etc

For more information, Contact: Eng . Richard Binga, 0721485338, rbinga@knh.or.ke ISSUE 14 | Kenyatta National Hospital Newsline

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Comic Zone Laughter, the best medicine!!

By Edel Q. Mwende

Smart grandma in hospital: How to keep yourself informed A sweet grandmother telephoned St. Joseph’s Hospital. She timidly asked, “Is it possible to speak to someone who can tell me how a patient is doing?” The operator said, “I’ll be glad to help, dear. What’s the name and room number of the patient?” The grandmother in her weak, tremulous voice said, Norma Findlay, Room 302.” The operator replied, “Let me put you on hold while I check with the nurse’s station for that room.”

to 20% pain transfer. The husband was still feeling fine. The doctor checked the husband’s blood pressure and was amazed at how well he was doing. At this point, they decided to try for 50%. The husband continued to feel quite well. Since it was helping out his wife considerably, the husband encouraged the doctor to transfer ALL the pain to him. The wife delivered a healthy baby with virtually no pain. She and her husband were ecstatic. When they got home, the mailman was lying dead on their porch. Oops... I guess the husband is NOT the father!!!

After a few minutes, the operator returned to the phone and said, “I have good news. Her nurse just told me that Norma is doing well. Her blood pressure is fine; her blood work just came back normal and her Physician, Dr. Cohen, has scheduled her to be discharged tomorrow.”

Inspirational Quotes

The grandmother said, “Thank you. That’s wonderful. I was so worried. God bless you for the good news.” The operator replied, “You’re more than welcome. Is Norma your daughter?”

1.

“From a certain point onward there is no longer any turning back. That is the point that must be reached.” —Franz Kafka

2.

“One doesn’t discover new lands without consenting to lose sight of the shore for a very long time.” —André Gide

3.

“To dare is to lose one’s footing momentarily. To not dare is to lose oneself.” —Soren Kierkegaard

4.

“Bite off more than you can chew, then chew it.” —Ella Williams

5.

“Success is going from failure to failure without losing enthusiasm.” —Winston Churchill

6.

“Never be ashamed to admit you are in the wrong—it’s just another way to say you are wiser today than yesterday.” —Jonathan Swift

7.

“The person who makes no mistakes does not usually make anything.” —Edward John Phelps

8.

“Our deepest fear is not that we are inadequate. Our deepest fear is that we are powerful beyond measure. It is our light, not our darkness, that most frightens us.” —Marianne Williamson

9.

“The other side of every fear is a freedom.” — Marilyn Ferguson

The grandmother said, “No, I’m Norma Findlay in Room 302. Pain transfer A married couple went to the hospital to have their baby delivered. Upon their arrival, the doctor said he had invented the new machine that would transfer a portion of the mother’s labor pain to the father. He asked if they were willing to try it out. They were both very much in favor of it. The doctor set the pain transfer dial to 10% for starters, explaining that even 10% was probably more pain than the father had ever experienced before. But as the labor progressed, the husband felt fine and asked the doctor to go ahead and bump it up a notch. The doctor then adjusted the machine

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

ISO 15189 ACCREDITED

ISSUE 14 | Kenyatta National Hospital Newsline

10. “For every minute you are angry, you lose 60 seconds of happiness.” —Ralph Waldo Emerson 11.

“Kindness is more important than wisdom, and the recognition of this is the beginning of wisdom.” — Theodore Isaac Rubin

12.

“The only people with whom you should try to get even are those who have helped you.” —John Southard

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