KNH NEWSLINE ED 4 2022

Newsline

11/3/2022

We Listen, We Care

11/3/2022

PHOTO | STEVE MUTUKU

Issue 4

Flying the KNH flag on the football pitch ISSUE 4 | Kenyatta National Hospital Newsline

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Contents

Editor’s note

ISSUE 4 Editor’s note p.2 Flying the KNH flag on the football pitch p.3-4 Hi-tech boost to COVID-19 fight at KNH p.5 Interventional Radiology - Enhanced Care through technology p. 6-7 Building Pediatric Emergency Care Champions for KNH p.7-8 Our story in pictures p.9 KNH Signage: Improving patient experience p.10-11 KNH/UON Consultants meet to discuss ways of improving service delivery p.12 Work about work: Focus on the responsibilities that matter p.13 Fetal Alcohol Spectrum Disorder p.14 Multi-Drug TB - All you need to know p.15-16 World Glaucoma Week: The world is bright, save your sight- p.16-17 World Kidney Day: Frequent screening can save your kidneys p.18 Adopt a bed p.19 Comic zone p.20

ON THE COVER Flying the KNH flag on the football pitch p. 3

Marketing & Communication Department Design Concept Team: Dave Opiyo, Edel Q. Mwende, Yvonne Gichuru & Collins Cheruiyot Editorial Team: Dave Opiyo, Edel Q. Mwende, Winfred Gumbo, Jacquline Ngure, Sheila Muriithi, Yvonne Gichuru, Verah Mugambi and Godfrey Osangir Stories: Dave Opiyo, Jacqueline Ngure, Edel Q. Mwende, Verah Mugambi, Winfred Gumbo, Sheila Murithi, Yvonne Gichuru, Barbara Otieno, Steve Nduati, Moses Njomo, Joan Macharia & Linnete Leyi Design By: Collins Cheruiyot

Dear colleagues, Every March, Kenya joins the rest of the world in celebrating National Women’s History Month. This, is indeed, a time to reflect on the courage exhibited by women in past generations as well as celebrate how their efforts and bravery afforded them the opportunities and freedoms they enjoy today.

Subsequently, International Women’s Day was observed on 8th March as a global holiday celebrated annually to commemorate the cultural, political, and socioeconomic achievements of women. The UN Women and the world came together under the theme “Gender equality today for a sustainable tomorrow”, and call for climate action for women, by women.

At Kenyatta National Hospital, we are proud to be associated with women leaders who have been a pillar of success and admiration to the staff, led by our very own Senior Director, Clinical Services Dr. Irene Inwani.

From Newsline, we are proud of our women leaders and count ourselves lucky to have them in our lives.

All the Newslines and Newsletters can be accessed online on: https://bit.ly/3uQGCcI Ms. Winfred A. Gumbo Public Relations Officer, Marketing and Communication Kenyatta National Hospital

Photos: Nicholas Wamalwa, Steve Nduati, Barbara Otieno, Joseph Musembi, Eugene Ameli, Sheila Muriithi & Steve Mutuku Tel: +254 20 2726300-9 Ext. 43121 or 43969

Find us on Social Media

Fax: +254 20 272572 Email: caffairs@knh.or.ke knh.caffairs@gmail.com To contribute or report on newsworthy items, please contact the Editorial team.

ISSUE 4 | Kenyatta National Hospital Newsline

Kenyatta National Hospital

@CeoKnh @KNH_hospital

Kenyatta National Hospital Official Page

www.knh.or.ke

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Flying the KNH flag on the football pitch

By Dave Opiyo

O

n Saturday, March 5, 2022.

Time 3 pm.

Kenyatta National Hospital’s football team players are warming down, after a tough match against Terror Squad from Kasarani. The match played at the Strathmore University grounds in Nairobi, has just ended in a goalless draw.

“I’m sure the next match against Limuru Sportif will go our way,” Mr. George Makambi, the team’s head coach tells Newsline in an interview.

Oozing optimism, Mr. Makambi adds: “The team has had a good run of form registering victories in many of their matches. The boys are rearing to go.”

In their last match, KNH FC, as is fondly known, walloped Waterworks, a team comprising mainly of military officers 3-1.

“All the team needs is some extra motivation and we are good to go,” he adds while appreciating the support they have received from the Management and other wellwishers.

Just a few weeks ago, for instance, the team benefitted from a donation of tracksuits from Ukaguzi Non-Deposit Taking Sacco as part of its corporate social responsibility.

Mr. David Sumaili, Chairman, the Sacco’s chair said as an organization they aim to promote financial and physical health as a way to give back to society.

“KNHFC is a winning team with committed players. We hope to continue partnering for the sake of the youth,” he added.

“The future is the youth, and this is part of the reason we decided to support KNHFC. I also want to thank the KNH Management as well as the football team as we join to share and support the success and glory of the players,” he said.

PHOTO | STEVE MUTUKU KNH FC ( in yellow Jersey) and Terror Squad FC fight for the ball during Nation wide Division Eastern zone league games at Strathmore Complex Sports Ground.

Mr. Morris Karaine, HoD Administrative Services, while appreciating the donation said: “Youth football provides mental and physical wellness for employees.

We have developed a clear policy on sports and recreational activities and this has enhanced teamwork, promotion of staff wellness, and improving our corporate image in the institution.”

Mr. Job Makanga- Dir, Planning and Strategy who received the donation on behalf of KNH CEO, Dr. Evanson Kamuri emphasized that the KNH management was trying its best to entrench the culture of sporting and recreation in the institution.

The KNH FC football team has a rich history. It was started in 1984 by hospital staff as a means of keeping fit. But as days went by, they realized they could compete

ISSUE 4 | Kenyatta National Hospital Newsline

“The team has had a good run of form registering victories in many of their matches. The boys are rearing to go.””

Mr. George Makambi

with other teams given the quality of players at the time.

Mr. Makambi explains that the team then registered to play in the Nairobi Provision League – Division 4. This is the lowest league in football in Kenya’s hierarchy. But with time, the team, registering impressive results, climbed the ladder. It currently plays in the Nationwide Division 2 League – Eastern Zone.

This, he explains, is just a stone’s throw away from the Premier League. “ If we continue playing the way we are, we will probably move to Division One, the Superleague then the Premier League. We intend to achieve this within the next five years,” says Mr. Makambi.

The team has produced several soccer greats, that have represented the country at the highest levels. Some of the players

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PHOTO | STEVE MUTUKU Collins Achieng eyes the ball as they battle with Terror Squad FC during Nation wide Division Eastern zone league

who have played for the national team and have at some point played for KNH FC include Nicholas Muyoti, Mulinge Munandi, Nathan Munai, Jerim Onyango amongst others.

According to Mr. Makambi, the team is looking forward to training and playing their home matches at their pitch, which is currently being refurbished. “We are currently using the KMTC and at times, Strathmore University grounds for a training and matches,” he says.

But even as they tackled their next round of matches, Mr. Makambi urges KNH staff to turn out in large numbers and support the team whenever they play.

“The players have shown a high

“ If we continue playing the way we are, we will probably move to Division One, the Superleague then the Premier League. We intend to achieve this within the next five years,” said Mr. MakambI

level of commitment and discipline.

They report for training early in the morning by 5.30 am. We go for roadworks, then have some sessions with the ball and work on

ISSUE 4 | Kenyatta National Hospital Newsline

our tactics. Our training sessions end by 7.30 am,”he says.

PHOTO | STEVE MUTUKU KNH FC warmup before their match against Terror Squad FC

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Hi-tech boost to COVID-19 fight at KNH

By Jacqueline Ngure

T

he United Nations Development Programme (UNDP) in collaboration with the Ministry of Health in January last year launched the piloting of smart anti-epidemic robotic solutions to aid the health response and management of the COVID-19 pandemic in Kenya.

The partnership saw UNDP donate three robotic devices, two of which would be placed at Kenyatta National Hospital (KNH) and one in Jomo Kenyatta International Airport (JKIA).

At KNH, these devices are now ready for deployment in mapped locations - including Accident & Emergency, as well as the Tower block.

Newsline Interviewed Senior ICT Officer, Francis Wanga, who led the team that has been laying the requisite infrastructure to operationalize the devices.

Mr. Wanga expressed confidence the devices will soon be strolling the corridors of KNH, detecting higher or lower than normal temperatures and fumigating surfaces.

“The mapping stage entailed taking the devices around the Hospital as they drew the maps and then feeding the collected information into the robotic system so that once deployed they will selfcontrol,” Said Wanga.

The smart technology that the robots employ enables the devices to scan the temperatures of people over a wide coverage area and even detect persons not wearing a mask or those not wearing them properly.

The deployment of smart antiepidemic robotic solutions will play an essential role in protecting frontline healthcare workers by limiting direct human contact with patients.

The robots will further support preventive measures and enhance public awareness of COVID-19 preventive measures and generate real-time statistics reports.

The KNH main tower block which receives an enormous number of people, especially during visiting hours will host one of the devices,

which will greatly assist our Covid-19 response teams in monitoring temperatures and flagging those that need attention & intervention.

The other robot will be placed at Accident & Emergency, which is our gateway for all patients coming to KNH, and will be programmed to perform scheduled fumigation of surfaces around the department.

So far, the ICT department has trained officers from ICT, Security & Safety, and Public Health departments on the use and control of the devices.

Mr. Wanga also says that they are currently engaging the electrical department in KNH to provide docking stations for the devices, complete with charging ports where the robots will safely dock after traversing the hospital corridors.

Compelling evidence has shown that the use of technology can accelerate the development of COVID-19 diagnostics, therapeutics, and vaccines.

Digital innovations can also strengthen the health and community systems needed to deliver diagnostics, therapeutics, and vaccines to people in need.

The integration of the robots into the Hospital healthcare systems, will enhance the control of infections, prevent transmissions and support the storage of big data to inform decision making, and preparedness, ultimately contributing to the flattening of the infection curve.

As the world contends with the impact of COVID-19 – a highly infectious virus – frontline healthcare workers remain highly vulnerable due to exposure to the

“ The mapping stage entailed taking the devices around the Hospital as they drew the maps and then feeding the collected information into the robotic system so that once deployed they will self-control,” Senior ICT Officer, Francis Wanga

ISSUE 4 | Kenyatta National Hospital Newsline

virus’s transmission.

The biggest gain according to Wanga, is the potential of what we can do if we can reprogram the robots and manipulate them for other functions.

“The beauty is the devices are ours for good and therefore the more we get to interact with them, the more we’ll be able to understand them and manipulate their technology for say, taking vitals at triage in A&E,” Wanga adds.

PHOTO | STEVE MUTUKU

Smart antiepidemic robotic

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Interventional Radiology - Enhanced Care through technology PHOTO | RADIOLOGY PARTNERS

By Vera Mugambi Interventional radiology (also called IR) is a rapidly growing area of medicine. Intervention Radiologists are physicians who specialize in minimally invasive, targeted treatments performed using imaging guidance.

Interventional Radiology procedures are an advancement in medicine that often replaces open surgical procedures. They are generally easier for the patient because they involve no large incisions, less risk, less pain, and shorter recovery times.

In IR doctors not only interpret your medical images, but they also perform minimally invasive surgical procedures through small incisions in the body that diagnose, treat, and cure many kinds of conditions.

The concept behind interventional radiology is to diagnose and treat patients using the least invasive techniques currently available to minimize risk to the patient and improve health outcomes.

Newsline sat down with Dr. Felister Wangari Maina, an Interventional Radiologist at Kenyatta National Hospital. She educated us on the ABCs of Interventional Radiology.

Dr. Wangari Maina has been a radiologist for the last six years at

KNH. “During this time, I have worked alongside the few IR specialists in Kenya and have improved my skills a lot. Kenyatta has the only Interventional Radiology suite in the public sector in the whole country, so we get patients from all over the country”, Dr. Wangari explained as we started the interview.

IR is gaining traction in the medical field in Kenya and is beginning to be appreciated as a major contributor to patient care. The possibilities as far as the improvement of patient care in our setting are endless.

“Interventional radiology in simple terms is a specialized service where we offer either treatment or diagnosis through imaging. For example, when you have a tumor in the liver, we can go through a small vessel, through a small cut then we give chemotherapy drugs directly into the tumor. So basically this means the patients avoid long hospital stays that are associated with surgery”, Dr. Wangari continues.

Why Interventional Radiology?

Dr. Wangari: Interventional radiology reduces cost, recovery time, pain, and risk to patients who would otherwise need traditional open surgery. Because of this, IR has become the primary way to

ISSUE 4 | Kenyatta National Hospital Newsline

treat many types of conditions. The treatments IR can effectively perform are ever-changing and expanding.

PHOTO | COURTESY

Dr. Felister Wangari Maini

Some of the procedures done at IR include; Angioplasty: This involves the repair or unblocking of blood vessels.

An X-ray exam of the arteries and veins to diagnose blockages and other blood vessel problems; uses a catheter to enter the blood vessel and a contrast agent (X-ray dye) to make the artery or vein visible on the X-ray.

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Embolization: The doctor puts a substance through a catheter into a blood vessel to stop blood flow through that vessel. This can be done to control bleeding.

Drainage: These are very common.

Biliary drainage and stenting use a stent (small mesh tube) to open up blocked ducts and allow bile to drain from the liver.

Chemoembolization: Delivery of cancer-fighting agents directly to the site of a cancer tumor; currently being used mostly to treat cancers of the endocrine system, including melanoma and liver cancers.

Fallopian tube catheterization: This involves the use of a catheter to open blocked fallopian tubes without surgery. It is a treatment for infertility.

Biopsies: The doctor puts a small needle into almost any part of the body, guided by imaging techniques,

to take a tissue biopsy. This type of biopsy can give a diagnosis without surgery. An example of this procedure is called the needle breast biopsy.

Foreign body removal: The doctor puts a catheter into a blood vessel to remove a foreign body in the vessel.

Gastrostomy tubes: The doctor puts a feeding tube into the stomach if you can’t take food by mouth.

At Kenyatta National Hospital, the most common procedures done/ administered include; angioplasty, embolization (this has the highest number), drainages, and biopsies.

“There are only 10 Interventional Radiologists in Kenya and seven of them are in KNH. So IR is quite a super-specialized branch of medicine and there is a need for more. We hope that quality IR services will continue to spread throughout the country and through this, it will become more

affordable and available to even our most marginalized and poorest patients, who so rightfully deserve our services”, Dr. Maina concluded.

IR specialists are not the primary caregivers, they have to be referred from other doctors who require an intervention to be done to the patients and then taken back to their doctors.

At KNH, IR clinics are held on Wednesdays. The patients are seen and scheduled for procedures on Mondays, Tuesdays & Thursdays.

Referrals are from different clinics within KNH and all over the country.

The fast development of technology is going to drive a lot of change in medicine moving forward and Interventional radiologists are in a unique position to pioneer technical innovations that can improve patient care.

Building Pediatric Emergency Care Champions for KNH

By Linnette Leyi KNH Pediatric Department in collaboration with the School of Nursing training department conducted the first-ever Pediatric Advanced Cardiovascular Life Support (PALS) training for nurses and doctors from the unit.

The training aimed to equip the staff with the skills and knowledge to manage pediatric emergencies.

It involved theoretical and laboratory work which was done at the School of Nursing skills lab, which is well equipped with advanced technology for teaching to simulate various clinical situations.

The two-days training was led by Jason Kiruja, Winnie Kubai, and Jane Kainyu from the Pediatric Unit, and Frederick Ndiawo from Accident & Emergency. Participants were certified and will be PALS champions for the department.

PHOTO | STEVE NDUATI Jason Kiruja, (Left) training paediatric nurses and doctors in the skills laboratory

PHOTO | STEVE NDUATI Ongoing theoretical class during the PALS training

ISSUE 4 | Kenyatta National Hospital Newsline

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From the communication desk:

Professionalism in client service and communication

By Sheila Murithi Professionalism is very important in most work settings and at the least the most basic skill any individual should possess. It is at the foundation of excellent client service and is even incorporated as part of KNH’s core values.

Professionalism is projecting the right image for your institution by paying attention to your appearance as well as displaying good conduct and behavior at all times. It is the attitude you demonstrate with every client encounter.

Serving a frustrated client while keeping a level head and controlling your emotions is not always easy. It is especially vital for health care workers, as they are client-facing, to observe polite behavior and good judgement so as to improve patient satisfaction and promote positive brand perception in the public. In the hospital, health care workers are often the face of the institution. Clients usually interact with them as opposed to the management who ideally hope that the staff will uphold the values the hospital claims to have roots in.

PHOTO | INSTRUCTURE

Excellent client relations can be demonstrated when a staff keenly listens to concerns and deals with the client needs and does not addon to their problems with the lack of empathy. The more effectively we handle complaints, the more likely our patients are satisfied and this in turn endorses positive wordof-mouth.

Professionalism in communication is crucial in building client confidence.

Excelling in this can result in converting clients into loyal advocates. Many clients will not think or complain over the cost of service if our communication and conduct conveys a higher degree of professionalism that is worthy of a level 6 National Referral Hospital.

To demonstrate professionalism in the workplace, focus on the key points below:

that their loved one may succumb to illness if they are not quickly attended to or at times it is anger because the client is not receiving the service they expected or hoped they would receive in KNH. It is easy to get defensive and match a client’s behavior but this rarely resolves anything. Most of the time , clients are just looking for reassurance and are more likely to calm down when they realize that you are doing the best you can to meet their needs

1. Maintain a helpful and positive attitude.

3. Provide prompt response

When you are faced with a hostile client, it helps to remember that you are there to assist and find a solution. The hostility may actually come from a place of fear. Fear

2. Be appropriately dressed for work What we wear also affects how clients and patients perceive our hospital. Ensuring you are well groomed, clean, neat, smell good and appropriately dressed gives a good outlook and the client’s first impression is decent.

Clients today expect quick solutions. By offering timely answers, we show clients that their time is important to us.

Utilizing technology, such as phone calls, social media and emails, that assists in handling client interactions can reduce waiting time and increase satisfaction. Also providing a knowledge base such as FAQs in our communication tools can help clients resolve concerns quickly and on their own.

4. Always follow up When we follow up with patients and clients, we make sure they are satisfied with our service. Taking this extra step encourages them to continue obsessing over our hospital because we demonstrate empathy in fulfilling their needs and commitment to improving their patient experience. In future, they know they can always count on professional and quality service from KNH

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Our story in pictures

PHOTO | NICHOLAS WAMALWA

KNH CEO, Dr .Evanson Kamuri, EBS with Mr. Ezekiel Abiola, the group Chairman after they donated 5 bed in boosting adopt a bed campaign

PHOTO | STEVE MUTUKU

MFI donated four beds in the ongoing Adopt a Bed Campaign

PHOTO | NICHOLAS WAMALWA

Wilson Chepkwesi (L) - Ag. HOD, Security and Safety gifts the outgoing HOD Security and Safety - Rev. Manaseeh Mugwanga a portrait of himself as appreciation for his service as he retires from service

ISSUE 4 | Kenyatta National Hospital Newsline

PHOTO |NICHOLAS WAMALWA

Fr. John Kariba leading a Holy Mass celebration at KNH Chapel 2nd floor

PHOTO | NICHOLAS WAMALWA

Afrolyne Nyaboke personal assistant to SDCOS (Centre) demonstrating how ripple Mattresses work during the PCEA donation toward the Adopt a Bed Campaign

PHOTO | NICHOLAS WAMALWA

DEP class of 2004 donated two beds towards the Adopt a Bed campaign in KNH

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KNH Signage: Improving patient experience

By Barbara Otieno and Steve Nduati I am lost, Can you help me? A question we are asked so often by patients and their family who have arrived at hospital in the midst of a medical crisis at casualty or seeking directions to their pre-scheduled doctor’s appointment in outpatient clinics. Even with customer care desk points spread throughout the hospital, it is not enough to help patients’ combat confusion in getting from one end of the hospital to the other.

KNH, is the biggest referral hospital in East and Central sits on a 42-acre land with 4 main entry points. Over 800 people seeking comprehensive services in various functional units daily, foot traffic is bound to increase in the hospitals. These include diagnostic and treatment functions, such as clinical laboratories, imaging, emergency rooms, and surgery; and the fundamental inpatient care. A carefully planned and well-thoughtout healthcare signage is key.

Navigating through the baffling puzzle-like design of the hospital can make an already hectic situation more stressful even for hospital staffs who are accustomed to the sterile surroundings of the hospital.

Way finding signage is strategically placed throughout the hospital making it more accessible to its diverse set of users; management and staff, doctors and nurses, patients and visitors as well as suppliers.

Given the numberof diverse set of users and the range of their cognitive abilities, way finding needs to be appropriate for all users.

KNH’s way finding design uses the distinctive colour Blue, in line with its visual identity along with a visible attention-catching clear textual content to communicate directions easily. The use of colour as visual cues is a proven way to enhance way finding efficiency in the hospital environment. Including signage in KNH does more than just enhance overall patient experience; it improves communication and marketing efforts, and benefits staff and the hospital itself.

ISSUE 4 | Kenyatta National Hospital Newsline

PHOTO | STEVE NDUATI

Reduce Anxiety Benefits of Hospital Signage

PHOTO | STEVE NDUATI One of the Service Delivery Charters located at corporate outpatient centre (COC)

Compliance guides Service charter outlines KNH’s commitment in delivering optimal care in the range of healthcare services; enhancing patient satisfaction in the hospitals healthcare process increasing service delivery and quality of life.

The Patient Charter entitles clients and patients to demand quality services from KNH by informing them of their rights and responsibilities.

Guidelines for resolution of conflicts that may arise between the patient and the hospital are also laid out on the Charter.

PHOTO | JOSEPH MUSEMBI The ICT department signage located at 1st floor Casuality

A carefully planned and wellthought-off healthcare signage is key in large hospital layouts such as KNH. Way finding hospital signage guides distressed family members to even inductees on where they need to be. Navigational signage can include anything from diagrams in hallways that point people to specific departments or Clinic numbers to colored foot print markings; decreasing hallway congestion.

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3. Makes Children and Patients Less Anxious

5. Recognize the hospital’s financial supporters. /Donors

PHOTO | BARBARA OTIENO An ambulance donated by NHIF outside A&E

PHOTO | STEVE NDUATI Color coding signage at level 3 - Paediatric ward

Not all signage is for directional purposes.A Hospital is a dreadful place to be in, especially for children.

Recovery wings at KNH often utilize bright, cheerful signage with colours that have a relaxing effect puts young Patients at ease. Some examples include fun graphics or well-known cartoon characteron walls.Young patients will have less difficulties during their treatment and recovery as they will be more relaxed.

6. Speed up patient intake/ digital signage PHOTO | JOSEPH MUSEMBI Safety notices at a construction site

KNH safety Signs meet OSHA (Occupational safety and Health Administration) standards and to help KNH stay within compliance and prevent patients and hospital staff contacting infectious microorganisms and accidents.

Suitable safety signage plays a key role in providing important safety information by: PHOTO | JOSEPH MUSEMBI Paul Ngesa, CCC demonstrating how patients use the patient check-in kiosk

Different from the standard patient intake process, through which hospital staff handsyou a clipboard with several forms for you to fill out, patients at the Comprehensive Centre clinic (CCC) have the option to complete their intake process digitally on the patient check-in kiosks in the reception area.

Some of the many ways CCC uses digital signage is by: Retractable banners and displays is a fitting channel for the hospital’s public health interventions which include: screening programs, promotion of free testing services, vaccinations, maternal health education programs.

ISSUE 4 | Kenyatta National Hospital Newsline

7. Maintain a safe workplace

Donor recognition walls signs and plaques are an integral component of a creative branded display along side an organisations colours and logo.

Adding a pop of colour in hallways and waiting areas in the hospital or on vehicle wraps of hospital -owned vehicles will likely stir up interest from patients and visitors.

4. Educate Patients & Promote Hospital Service

PHOTO | STEVE NDUATI A LAMAZE banner diplayed outside physiotheraphy

• Showing estimated wait times on screens in waiting rooms accelerating patient intake process reduces wait time • Well-prepared on-screen content that provides important healthrelated information that is of interest to patients and visitors • Displaying step by step directions to assist patients in navigating the clinic.

• Use self-service medical kiosk to check-in, update records, schedule future appointments, print receipts for waiting queue list displayed on screens in the clinic.

• Reminding staff to always wear PPE (Personal Protective Equipment) when working around infectious diseases.

• Alert individuals to hazards like radiation, needles, infectious waste, and more.

• Identifying equipment or waste containers or entrances of hazardous areas • Alerting workers and visitors of construction site hazards.

As KNH continues to grow, visibility usability and effectiveness of the hospitals signage becomes increasingly important.Signage is proof that the hospital is taking a proactive role by gaining a better understanding of its customers to further improve patient experiences in a high-stress and fast paced environment.

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KNH/UON Consultants meet to discuss ways of improving service delivery

PHOTO | NICHOLAS WAMALWA KNH CEO Dr. Evanson Kamuri addressing the staff members during the KNH/ UON consultants joint meeting.

By Winfred Gumbo Consultants from Kenyatta National Hospital and the University of Nairobi held a meeting on March 1, 2022, to explore, amongst others, how to further improve service delivery to patients.

The meeting was chaired by KNH’s Senior Director Clinical Services Dr. Irene Inwani who apprised the consultants on the recent developments in the hospital, the main one being the implementation of the referral system.

More work, she said, was being done to streamline services in the facility.

“KNH and UON have worked closely together, especially during the time of Covid-19 and I hope there will be a continuity in working together,” said Dr. Inwani.

“Our patients should be treated with respect and dignity; they should be given the utmost respect they deserve. All these will happen if we have a positive culture,” she added.

Prof. C. F. Otieno, Associate Dean, Undergraduate Studies, Faculty of Health Sciences, UON, while echoing Dr. Inwani’s sentiments, stressed the need for accountability, while

emphasizing the importance of the two institutions working together for the benefit of patients.

Prof. Evelyne Wagaiyu, Ag. Dean Faculty of Health Sciences, UON/ Associate Dean Postgraduate Studies, Faculty of Health Sciences, UON on her part said; “Today is about asking each one of us to do our best since we need each other, we should all work together for the benefit of our students, patients, and the

ISSUE 4 | Kenyatta National Hospital Newsline

institutions.”

KNH CEO, Dr. Evanson Kamuri, EBS emphasized the need for optimism and a futuristic approach towards various matters within the two institutions.

“We need to be authentic leaders, train our students well and treat each other right as there is no profession better than the other,” said Dr. Kamuri.

PHOTO | NICHOLAS WAMALWA KNH Senior Director Clinical Services, Dr. Irene Inwani chairing the KNH/UON joint consultants joint meeting

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Work about work: Focus on the responsibilities that matter

By Edel Quinn Mwende Every Friday presents a new opportunity for Millicent (not her real name) to diarize the activities for the coming week, and carry forward the incomplete activities from the current week.

Her normal workday runs from 8 a.m.-5 p.m. Looking at her checklist, she realizes an alarming trend; only about 40% of planned tasks on her notebook are completed at the end of every week.

This necessitated an evaluation of her daily activities and the amount of time she puts into tasks. She became conscious about how she spent her typical day at work. Looking at the big picture, Millicent has to deliver on her targets at work, maintain great relationships both at home and in the marketplace, remain healthy while maintaining excellence in her position as a supervisor.

On a typical day, Millicent begins to work on the first item listed in her notebook; a report on the half-year staff performance for her twenty staff which would ideally take 45 minutes to complete. Minutes later, a colleague walks into her office and notifies her about an urgent meeting starting in 15 minutes, that she will need to attend.

She then has to stop working on the report and prepare for the unexpected meeting. After the 1-hour long meeting in which her contribution was just a nod, she embarks on the report, and just before recording the performance of her twentieth supervisee, she remembers that she needed to get a training plan approved by her boss who would be away for two weeks. Chasing for this approval takes an hour and a half because she has to wait for the boss to finish their meeting.

Her day is then spent on responding to emails and messages, allocating tasks, receiving calls; all of which ‘comes with the job,’ and finally, the day ends and as she is closing the ‘windows’ on her desktop computer, she remembers that she needs to review the staff performance report and email it to the Human Resource department. As she closes

her notebook, she glances at the remaining four tasks and realizes that she has spent her day ‘working about work.’

‘Work about work’ entails the activities that take time away from meaningful work. It is all of the activities one engages in throughout the day that are not the skilled work one is hired to do.

They inundate employees and get in the way of real work and some include; communicating about work, searching for information, managing shifting priorities, and chasing the status of work. These activities are mundane, time-consuming and most people erroneously assume that ‘it comes with the job.’

According to Asana’s Anatomy of Work Index 2021, 60% of a person’s time at work is spent on work about work and not on skilled work. Those hours add up to huge amounts of lost

‘ W O R K AB O UT WORK’

time hence resulting in unbalanced workloads and long hours at work.

At the very top of an organization’s pyramid is the mission, which guides all decisions, followed by strategy, then company-wide objectives, departmental objectives, quarterly objectives, individual projects, and tasks. This is the everyday work that fills up most of our time. Work about work is a universal problem, but there are a few ways to combat it: Be clear on their organization’s objectives for the year Get clarity on how your work adds value to the company Once everyone is aligned with the organization’s pyramid, rethink technology- using it in a way that helps, rather than hinders, processes while at the same time cutting the clutter and bringing everyone into a single system by not having too many systems in place. A good example is the new SAP ERP and E-hospital systems at KNH which will assist combat ‘work about work.’

It entails the activities that take time away from meaningful work. It is all of the activities one engages in throughout the day that are not the skilled work one is hired to do.

At the end of each workday at KNH, consider spending five minutes doing a self-reflection on how your day has been: what things went right and what did not. Think about the reasons for that, as well as what you could do to change that in the future to ‘work on work.’

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PHOTO | Source: https://blog.asana. com/2021/01/anatomy-of-work-index/#close

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Fetal Alcohol Spectrum Disorder

The intern’s experience

By Barbara Otieno

By Moses Njomo The discovery of pregnancy comes with mixed reactions of elation and anxiety of what to expect.

This is followed by numerous questions: When to start a pre-natal clinic? What to eat and what to drink.

When it comes to alcohol consumption, there is a common public misconception that drinking during pregnancy is safe depending on the type and quantity of alcohol, or timing during pregnancy.

Dr. Mary Waiyego, Neonatologist, KNH, explains that alcohol consumption could be fatal to the foetus especially in the first trimester during organ formation.

According to Dr. Waiyego, FASD (Fetal Alcohol Spectrum Disorder) is a range of disorders that can affect babies who are born to mothers that consumed alcohol during pregnancy.

It can cause a range of developmental, cognitive, and behavioral problems, which can appear at any time during childhood and last a lifetime. The most profound effects of prenatal alcohol exposure are brain damage and the resulting impairments in behavioral and cognitive functioning.

No lab test can prove a child has FASD. Dr. Waiyego explains that diagnosis is done after the delivery of the child. To diagnose FASD, doctors look for unusual facial features, lower-than-average height and weight, small head size, problems with attention and hyperactivity, and poor coordination.

They also try to find out whether the mother had a history of drinking.

Unfortunately, there is no cure for FASDs, but research shows that early interventional treatment services can improve a child’s development and outlook.

According to the Global Prevalence of Fetal Alcohol

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Meet: Leakey Kebaso Department: Biomedical Department

Spectrum Disorder among Children and Youth in the General Population in 2012, The prevalence of FASD in Kenya is 6 out of 1,000 population.

There are many types of treatment options, including medication to help with some symptoms, behavior and education therapy, parent training, and other alternative approaches. No one treatment is right for every child. Good treatment plans will include close monitoring, follow-ups, and changes as needed along the way.

Dr. Waiyego concludes that FASDs are 100% preventable. The bottom line is that the mother must stop using alcohol before getting pregnant.

She reiterates that no amount of alcohol is safe. A woman should stop drinking immediately after she knows that she is pregnant, or if she is addicted to alcohol, she needs to see a doctor for immediate intervention.

Tasks: Collaborative Installation, maintenance (both preventive and curative) and provision of technical support for the biomedical equipment Three things you have learned about KNH? - Implementation of GEMBA Kaizen; 5 pillars sort, set in order, shine, standardise and sustain are notable in every work space you enter in KNH. - Digital record keeping - Customer Service How has the internship added value?

With the theoretical and practical knowledge i have gained, my confidence in the biomedical engineering practice has been elevated.

Most memorable moment at KNH? When I got to learn and take part in the repair of the Linear accelerator, machine used in cancer treatment.

Your five year career plan after graduation?

Iam planning to advance my studies obtain a Masters Degree and look for other internship opportunities to improve skills and thereafter look for permanent employment.

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Multi-Drug TB – All you need to know

By Joan Macharia Multidrug-resistant TB (MDR TB) is caused by an organism that is resistant to at least isoniazid and rifampin, the two most potent TB drugs. These drugs are used to treat all persons with TB disease.

According to the clinical officer in charge of the TB discipline at KNH, Dr. Stanley Ayaibei, Multidrug-resistant TB popularly known as MDR-TB, may have other forms of resistance known as mono resistance which is resistance to only one single medicine, poly-resistance which is resistance to not only the two (2) drugs which are commonly used to treat TB; isoniazid and rifampin, but many. MDR-TB is specifically resistant to the two drugs.

Q. How does drug resistance happen?

Resistance to anti-TB drugs can occur when these drugs are misused or mismanaged. This for example includes when patients do not complete their full course of treatment when health care providers prescribe the wrong treatment, the wrong dose or length of time for taking the drugs, when the supply of drugs is not always available, or where the drugs are of poor quality.

Q. How does one know they have MDR-TB? One may know they have MDRTB if a sample has been taken to the Lab where drug resistance is identified using special laboratory tests which check the bacteria for sensitivity to the drugs or detect resistance patterns. These tests can be molecular in type or culturebased. Molecular techniques can provide results within hours and have been

successfully implemented even in low-resource settings.

Q. Who is at risk of getting MDR-TB? Anyone is at risk of getting this disease considering it’s an airborne disease. But it’s more common in people who do not take their TB medicine regularly, do not take all of their TB medicine as prescribed, develop TB disease again after having taken TB medicine in the past or have spent time with someone known to have drug-resistant TB disease. Also at risk are the refugee countries like Somalia where health care is not stable, defaulters from initial treatment, congregate settings like prisons, street families, cancer patients since their immune system is low, and many others.

Q. How can MDR-TB be prevented and can it recur?

It can recur and we can also have extreme resistance. MDR-TB is preventable and treatable. It is a deadly disease and can kill if not well treated. The most important thing a person can do to prevent the spread of MDR-TB is to take all of their medications as prescribed by their health care providers.

No doses should be missed and treatment should not be stopped early.

Patients should inform their health care providers if they are having trouble taking the

PHOTO | NBCNEWS Dr.Stanley Ayaibei.

Clinical officer incharge of TB discipline KNH.

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medicine. If patients plan to travel, they should talk to their health care providers. Health care providers can help prevent MDR-TB by quickly diagnosing cases, following recommended treatment guidelines, monitoring patients’ responses to treatment, and making sure therapy is completed. People should also avoid exposure to known MDR-TB patients in closed or crowded places such as hospitals, prisons, and many others.

When treatment of MDR-TB started in KNH, it took 24 months but currently there is an injectable drug and treatment now takes 18-20 months. Drugs are supplied by the government and they are free to patients but they are very expensive and limited and they may have many adverse effects on the patients since they are very strong. We offer nutritional care and facilitate transport daily since the treatment is monitored daily.

WHO recommends the use of a novel rapid diagnostic test and a shorter, cheaper treatment regime. The new treatment can be completed in 9-12 months. Not only is it less expensive than current regimens, but it is also expected to improve outcomes and potentially decrease deaths due to better adherence to treatment and reduced loss of follow-up.

PHOTO | NBCNEWS A doctor examines TB on Xray of the lungs

Q. How common is MDR-TB? It is a very common disease with additional resistance to 2nd line drugs or total drug resistance. While

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TB is curable, when patients do not adhere to the treatment regimen, MDR-TB is more problematic to treat.

Q. How can it be controlled?

The two reasons why multidrug resistance continues to emerge and spread are mismanagement of TB treatment and person-to-person transmission.

According to WHO, there are solutions to control MDR-TB • One is to cure the TB patient the first time round • Provide access to diagnosis • Ensure adequate infection control

in facilities where patients are treated • Ensure the appropriate use of recommended second-line drugs Q. How has Covid-19 affected Multidrug-resistant TB? The covid-19 pandemic poses a unique threat to patients with MDRTB. The Virus has surged globally and overwhelmed health systems and adversely impact the care of other diseases.MDR-TB requires laboratory testing to identify rifampin resistance and cannot be diagnosed solely on clinical history. This is a challenge

when laboratories are overwhelmed with covid-19 testing.

Q. Parting shot: Being a national referral hospital, Kenyatta National Hospital has been receiving many patients, all of who require maximum care. KNH has a state-of-the-art isolation ward; ward 41, with a bed capacity of 15 (seven beds for males and, eight beds for females).

He thanks the KNH management for the support given to the TB discipline.

World Glaucoma Week: The world is bright, save your sight

By Sheila Murithi “Glaucoma is a group of eye diseases that are characterized by the destruction of the optic nerve and this can cause vision loss and blindness.” Explained Dr. Rebecca Nandasaba, an Ophthalmologist in the KNH Eye Clinic during a Skiza Doc live recording which was held earlier in the week to sensitize the public on the disease and to encourage them to come for screening. Glaucoma is the second leading cause of blindness after cataracts.

Since 2006, the Kenyan Government has taken necessary steps to address the disease as it is quite common with Africans and its effects were greatly experienced then due to lack of skilled eye care workers and poorly equipped health care facilities. Today, every County referral hospital has eye specialists or ophthalmologists with diagnostic knowledge and treatment tools for glaucoma. Development of the National Guidelines for Management of Glaucoma in November 2020 as well as collaborations with other countries in the Sub-Saharan region and partnerships with advanced eye care centers, with the ultimate aim of reducing blindness resulting from glaucoma, is a clear demonstration of the government’s commitment towards affordable, quality healthcare.

“Many forms of glaucoma have no or slow progressing warning

signs, which are not easily noticed and can occur at any age” states Dr. Idza Kalu, Ophthalmologist, KNH. She continues: because of this reason we must continue to inform the public on the importance of screening, especially now that we are recognizing the World Glaucoma Week and screening services are free of charge throughout the week.

The World Glaucoma Week which took place from the 6th to 12th March 2022 was a unique initiative that puts a spotlight on glaucoma as the leading cause of preventable irreversible blindness worldwide.

The prompt diagnosis and treatment of glaucoma can prevent needless vision impairment, however, so many are unaware they have the disease or may not have access to much-

ISSUE 4 | Kenyatta National Hospital Newsline

needed care. During the week the KNH Ophthalmology Department aimed to screen over 350 members of the public and create awareness on the disease. Dr. Nandasaba shed some light on who is most at risk of getting the disease. They include people:

PHOTO | WHO The theme of the year 2022, Glaucoma week

1. With a history of glaucoma in the family 2. Aged over 35 years old 3. Of African decent 4. Have injured their eye in the past 5. With high intra-ocular pressure 6. With symptoms such as short slightness, known as myopia With other predisposing symptoms like migraines, low blood pressure at night known as nocturnal

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PHOTO | SHEILA MURIITHI Patient receiving free screening during the World Glaucoma week. In the picture the intraocular pressure is being assessed

hypotension, diabetes mellitus and thyroid disease.

“Routine examination for these candidates is mandatory.” Says Dr. Nandasaba. There are various types of glaucoma, she continues to describe: Primary Open Angle Glaucoma (POAG) is the most common type The normal eye is filled with fluid, which slowly flows inside the eye and keeps it healthy. As new fluid is made the old fluid flows out. If the fluid does not leave the eye as it should, or if too much fluid is formed, the fluid will build up. As this happens, the pressure inside the eye rises to a level that damages the optic nerve and loss of vision may result. That is why controlling the pressure inside the eye is very important.

Congenital/Childhood glaucoma Children may be born with a defect in the angle of the eye that slows the normal drainage of fluid. Symptoms are obvious, such as: Cloudy eyes, Sensitivity to light and Excessive tearing. The treatment is usually surgery, and it is safe and effective.

If done promptly, there is usually an excellent chance of the child having good vision.

Secondary glaucoma This is glaucoma that develops as a complication of other eye conditions such as eye surgery or advanced cataracts, eye injuries, certain eye

tumours, or eye inflammation.

Treatment includes medicines, laser or surgery.

It’s an interesting disease this glaucoma. In efforts to understand it more, Newsline came across and article on Glaucoma Awareness Month by UCLA Health and found out that it actually discriminates and can selects it victims: • African Americans are 6 to 8 times more likely to get glaucoma than white Americans. Blindness from glaucoma is 6 to 8 times more common in African Americans than white Americans 2 • People with diabetes are 2 times more likely to get glaucoma than people without diabetes 2 • Hispanic Americans face an increased risk compared to African Americans, but the disease may also progress faster as they age, compared with other ethnic groups.3 • Asians are at an increased risk for the less common types of glaucoma: angle-closure glaucoma and normal-tension glaucoma.2 • Also at risk are people over age 40, those who are severely nearsighted, and those who have a family history of glaucoma.

So how then do you know you have glaucoma? Dr. Nandasaba explains that at first there are no symptoms.

Vision stays normal, and there is no pain. However, as the disease progresses, you may slowly lose side

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vision. Objects in front may still be seen clearly, but objects to the side may be missed. If untreated, you will slowly lose your peripheral (side) vision. You will seem to be looking through a tunnel. Glaucoma can develop in one or both eyes.

“Just because you think you can see well, doesn’t mean all is well,” said Dr. Kalu. “Once vision is lost to glaucoma, it can’t be regained. That is why regular screening, especially among those at higher risk for glaucoma, is absolutely vital. When caught early, glaucoma can be treated with eye drops or laser treatment. But in advanced cases, surgery may be required to slow the vision loss and prevent further damage,” she added.

PHOTO | SHEILA MURITHI Dr ldza Kalu conducting an optic nerve assessment for a patient during the World Glaucoma Week

PHOTO | COURTESY Dr. Rebecca Nandasaba, Ophthalmologist, KNH Eye Clinic

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World Kidney Day: Frequent screening can save your kidneys

By Linnette Leyi This year’s World Kidney Day celebration’s theme was “Kidney Health for All – Bridge the gap to better kidney care,” summarizing the need to educate patients, policy makers, healthcare providers and the community at large on kidney health, renal services and kidney disease treatment. The celebrations were held at KNH Administration grounds on 10th March 2022.

The chief guest Dr. Mercy Mwangangi-CAS Health reaffirmed the ministry’s commitment to improving Universal Health Coverage to Kenyans by providing sustainable access to effective and affordable prevention, early detection and access to medicines to treat risk factors for kidney disease and delay kidney disease progression.

She said: “It is estimated that in Kenya, 5 Million people are battling chronic kidney disease. Over the last 10 years, the number of people on regular haemodialysis has increased from 300 to more than 5000 presently.

This is largely attributable to the important role that NHIF is playing in reimbursing the costs of dialysis.”

“Kenyatta National Hospital continues to offer a wide variety of care to patients seeking treatment of Chronic Kidney Disease including Haemodialysis, Peritoneal dialysis and holistic kidney transplantation care, Pre-transplant, Intra and Posttransplant.”

“Many types of kidney diseases can be prevented, delayed, or kept under control when appropriate prevention measures are in place.

As a society therefore, we have a duty & a responsibility to encourage healthy lifestyles (access to clean water, exercise, healthy diet, tobacco control), screening for kidney diseases as a primary healthcare intervention including access to identification tools (e.g. urine and blood tests) and screening of high-risk individuals,” added Dr. Mwangangi.

Speaking during the event, Dr. Ahmed Twahir, former president of Kenya Renal Association (KRA) highlighted that cases of Chronic

PHOTO | EUGENE AMELI Dr. Mercy Mwangangi, Mr. George Ooko, Ms Raheli Mukhwana, Dr. John Ngigi, and other important guests join in cutting cake to celebrate World Kidney Day

PHOTO | EUGENE AMELI Dr. Mercy Mwangangi addressing the audience during the event

Kidney Disease are increasing globally. One out of ten adults worldwide has CKD, and if left untreated, it can be deadly. It is a silent disease that is easily undetectable. Frequent kidney screening helps one to take measures to prevent and reduce the disease’s progression.

Dr. John Ngigi, Ag. Director KPCC and Kidney specialist insisted on the need to expand the pool of kidney donors in the country. It is also vital for the government to continue supporting its citizens in renal care through the UHC program. “Currently, only living related donors can be organ donors. This limits the options available to kidney failure patients.

Whereas the Health Act of 2017 allows the practice of deceased organ transplantation, the regulations to govern this are yet to be gazetted thus delaying the initiation of this service which is widely practiced

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greatly expanded transplantation activities in most countries where it is practice,” he said. He encouraged the MoH to accelerate the process of crafting and gazetting these important regulations to allow for the commencement of this service.

John Gikonyo, a kidney patient and the president of Renal Patients Society of Kenya expressed his gratitude to doctors, nurses, caregivers and NHIF for offering kidney patients support in treatment of the disease. He, however, asked for reforms in NHIF coverage to cater for the costly post-transplant medication.

The event was attended by KNH Board chairman, Mr. George Ooko, KNH CEO Dr. Evanson Kamuri, EBS, Directors and Senior Directors, partners and stakeholders, nurses, doctors and kidney patients.

Free screening was available during the event for diabetes and hypertension which are the risk factors for kidney disease..

PHOTO | STEVE MUTUKU Members of the public getting screened for high blood pressure during the celebration of World Kidney Day 2022

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ADOPT A BED AT KNH DEAR ESTEEMED PARTNER, WOULD YOU TAKE PART IN PATIENT TREATMENT

BY ADOPTING A BED AT KNH?

You can help today by bein g a donor of patient bed(s).

A general bed (two crank) with a mackintosh mattress costs Kshs. 45,000/=. It can be purchased directly from the supplier and delivered to KNH and branding with your name.

THANK YOU FOR TOUCHING THE LIFE OF A PATIENT.

BEDS REMAINING

BED DONATIONS RECEIVED

105

TOTAL BEDS REQUIRED

1,895

2,000 For any enquiries, kindly contact: Kennedy Mbogo 0725686438 Doris Murianki 0726288840

ISSUE 4 | Kenyatta National Hospital Newsline

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Comic Zone Laughter, the best medicine!!

By Edel Q. Mwende The deadly rooms Q. A prisoner is forced to go into one of three rooms, but he can choose which room. The first room is ablaze with fire. The second one is rigged with explosives that will go off as soon as he enters. The third contains a pair of lions who haven’t eaten in years. Which room should he choose to survive?

A. The third room—any lions who hadn’t eaten in years would be dead! Source: Twenty Two Words

My mother was browsing in a store when a saleswoman offered assistance.

Mom admitted she didn’t have anything particular in mind, and the pair started chatting. The woman quickly learned that Mom was retired. Interested, she confessed that she, too, was considering retirement. Mom immediately started telling her how much she liked no longer working and how the saleswoman would enjoy it too. Finally, convinced by Mom’s enthusiasm, she asked, “How long have you been retired?” Mom said, “This is my first day.” — Lee Beacham

Inspirational Quotes “Always keep your eyes open. Keep watching. Because whatever you see can inspire you.”

— Grace Coddington “Never give up on a dream just because of the time it will take to accomplish it. The time will pass anyway.”

— Earl Nightingale “It wasn’t raining when Noah built the ark.”

— Howard Ruff

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

“Holding onto anger is like drinking poison and expecting the other person to die.”

— Buddha “Numbing the pain for a while will only make it worse when you finally feel it.”

— Albus Dumbledore “You must not only aim right but draw the bow with all your might.”— Henry David Thoreau “Even if you’re on the right track, you’ll get run over if you just sit there.”— Will Rogers “There are no traffic jams along the extra mile.”

— Roger Staubach “The road to Easy Street goes through the sewer.”

— John Madden

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Do what you love and the money will follow.”

— Marsha Sinetar

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