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September 2019

KFH Magazine Chosen for Excellence Dr. Bukara Emmanuel orthopedic surgeon

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On the Cover Dr. Emmanuel BUKARA MBCHB, FC (ORTHS)SA, MMED ORTHS (WITS)

FELLOW SPORTS ORTH SURG Senior Consultant Orthopedic Surgeon Director of Specialized Surgical Services

Content Letter from CEO

News/Information KFH launches minimally invasive shoulder surgery KFH growth plan Rwanda’s first cardiothoracic surgeon rejoins KFH How King Faisal Hospital is improving Oncology Services A tour of the Emergency Unit: Patient Flow A & E Events KFH joins the world to celebrate Blood Donation day Mother’s day & Celebration of ICM at KFH KFH Labor day Celebrations Health tips Mommy & Baby nutrition Importance of Ergonomics Clinical Research/Clinical contribution KFH Ebola prevention & preparedness Study findings on early rehabilitation of anterior cruciate ligament injuries Opinions Testimonies

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Foreword

from the CEO

Greetings! I am thrilled to be reaching out to our staff and patients for the first time as the new acting CEO of King Faisal Hospital in this issue of the KFH magazine. I am grateful for the opportunity and will serve with utmost responsibility and dedication. Our mandate as a hospital is to be a patientcentred hospital with a motivated, professional skilled team. We have had quite some changes and while it may seem challenging at times, the goal is always to grow and establish a remarkable patient-centred hospital where everyone will receive the best possible care. In regards to patient care and improving quality, we have broken down our approach to short, medium and long term goals to address issues that have not been going on well, such as patient flows, timely delivery of results and immediate response to our clients’ needs. At King Faisal Hospital, we are driven by our purpose to improve the quality of life for every person who comes through our doors and elevate the communities we touch. Going forward, my hope is that everyone will continue to nurture the commitment to our clients, looking for opportunities for personal growth and taking on new tasks and initiatives as we pursue to overcome challenges.  As a hospital seeking to grow our reputation, we will continue to invest in infrastructure, provide additional training opportunities and develop partnerships. This will enable us to increasingly meet the needs of our customers. Finally, King Faisal Hospital embraces the responsibility of continuing to fuel the local economy and positively impact the overall health and well-being of the residents in this country and in the region. I look forward to keeping you updated on the latest developments at King Faisal Hospital, as we continue to grow from strength to strength in the quality services and programs we provide.

Dr. Edgar M. Kalimba Ag. Chief Executive Officer KFH•09/19

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King Faisal hospital commences minimally

invasive shoulder surgery in Rwanda King Faisal hospital has become the first Rwandan hospital to operate shoulder injuries using minimally invasive surgery techniques. With the help of a team from Smith and Nephews led by Dr. Nyiko Chauke from South Africa and 4

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Dr. Emmanuel Bukara, an orthopedic surgeon at King Faisal Hospital, they carried out 13 minimally invasive shoulder surgeries from 27th May to 31 May 2019.

technology using small surgical tools and cameras that are inserted into someone’s body through very small incisions. The surgeons use the camera to guide them through the procedure, Incisions can often be closed with just a few stitches.

Minimally invasive surgery is a medical operation which is done on patients. The procedure employs

Dr. Bukara Emmanuel, an orthopedic surgeon at King Faisal Hospital acclaimed the


new addition to the medical services the hospital offers, noting that it was rarely performed in East Africa. Currently few surgeries of the same nature are being done in Nairobi. “We no longer have to make a big incision. With the help of a camera, we make a small pinhole and start operating. It can be done in orthopedics surgery, general surgery, gynecology, and even neurosurgery”, Dr. Bukara said. “With minimally invasive surgery, you are able to precisely target the area to be operated on using a camera which is less time consuming”, he added

now. There is also no much pain as it was before”, he said Dr Bukara recommended patients to seek medical advice once they have pain shoulders. It needs to first be investigated by doing X-rays and MRI which looks best at the soft tissues, then the patient will be managed accordingly. The new procedure uses sophisticated consumables, and stitches that are quite expensive but the result is much better compared to the former surgery procedure. The advantages of minimally invasive surgery are that recovery time is quick, you

experience less pain and decreased chances of infections. The service is now available at King Faisal Hospital. It will help in all aspects; in sport injuries and the whole population in general. Orthopedics at King Faisal hospital have been doing knee arthroscopies, (doing surgeries of the knee with the help of a camera). Currently, we want to take a step further and also perform minimally invasive shoulder surgeries. This will help those who used to travel abroad to look for such service or those who would stay home for failing to afford to go abroad.

Shema, who had been suffering from a frozen shoulder for a year, said he did not experience as much pain as he had been expecting a day after the operation. “There are some directions in which my right arm was not able to move but it is possible

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Development

at KFH

King Faisal Hospital

Growth Plan What plans does King Faisal’s new management have for infrastructure and technology upgrade towards better service delivery? King Faisal hospital has always made it a priority to provide its clientele -from Rwanda and beyond- with the best health care services. This has been among the contributing factors making King Faisal Hospital one of the leading health care facilities in Rwanda and in the region. With its continued ambition towards continuous

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improvement, the hospital’s Acting Chief Executive Officer Dr. Edgar Kalimba, spoke on the impact of the recent changes in management as well as plans in a bid to propel the hospital to the peak of health care delivery. Below are excerpts. What impact has the transition had on the hospital? In terms of operations, it hasn’t had any notable impact. The hospital is fully functional and we are operating optimally. Obviously, with any change of management, there are issues

such as contracts with entities who supply medication and consumables which we needed to re-engage. We have to look at some plans that Government has that had stalled for the last two years and see how we can make up on the lost time. So I would say operationally it hasn’t had a major impact, but strategically, we have had to look at a different approach. We are looking at the investment component again, but by and large our clients and the Rwandan population beyond should be reassured


that things are getting better and will keep getting better.

ones that need to be improved even more.

In regards to patient care and providing quality care, we have broken down our approach into short, medium and long term ambitions. With that, some of the services and systems that have not really been going well (like patient flows, the time it takes to get results and how we respond to our clients’ problems) get addressed immediately. There are a lot of things that we are looking to improve rapidly and then also address more complex issues such as upgrading infrastructure and technology.

What are some of the present challenges at the hospital that you are working to address?

As the newly appointed CEO of King Faisal, what plans are underway in regards to pushing the hospital to the peak of health care delivery? I think the mandate of the hospital is very clear, it is to be a patient-centered hospital, which means every patient matters to us and every patient should be given the best possible care-world class care. That calls for motivated, professional, skilled and patient-centred personnel. This is what we are looking at as well as cutting down on redundancies. This will enable management identify aspects where the hospital has been inefficient and how we improve that. King Faisal has always had a reputation of being one of the leading medical institutions in the country, how do you plan on maintaining this? We are the best hospital in Rwanda but we still hold ourselves accountable. From our perspective what we are offering now is not enough; we know that we have to do much more and maintain the good component, improving the

The challenges are mostly around funding. I think we don’t critically look at what it means to build a quality health care system. The cost involved in investing in health care is very high; medical equipment is quite expensive; we need huge investment for that. We also import everything that we use at the hospital; this means we still lack adequate investment in the pharmaceutical industry. We need to manufacture the necessary pharmaceutical products which we currently do not. I am aware that the Government has done a lot in getting the right investment into the pharmaceutical industry and other related areas. We know what we need and how much it costs but the task now is to get that investment to avail that quality in such a way that all Rwandans can access it. The Government is very innovative and is always looking at different approaches to accompany us as a hospital to the level where we can invest further. And in this aspect, we are also forging partnerships and Memoranda of Understanding with global institutions that have affordable health care solutions. All challenges have solutions; we just need to implement the right strategies.

should a hospital’s management, either at the individual or systematic level, do to improve the quality of health care? Those of us who work in the health sector need to remember that we are here for the patients. Patients should be the focus; everything that we plan as hospitals and the health sector should be really directed at how we improve patient experience, improving diagnosis and treatment. The second thing will be how we help the care delivery teams from doctors to nurses and everyone who works in the health sector to perform better as well as motivate them to offer quality care. How can we innovatively work smarter as hospitals? At the moment, a large number of hospitals are overwhelmed in multiple ways, we have quite a workload and the resources are limited. We should keep trying to figure out how we can innovatively bridge some of those gaps. I think we have a lot of opportunities in the health sector that we can tap into, there are a lot of development partners and we have a highly supportive and organized leadership. We need to engage each other more innovatively and proactively. Sometimes a section of us who work in hospitals and the health care tend to work in reactive mode; we move from managing a crisis to another one but we all need to get to a level where we proactively plan, budget, implement, in a way that is sustainable and strategic.

In a bid to improve health care countrywide, what KFH•09/19

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Rwanda’s First cardiothoracic Surgeon commences at KFH Rwanda first-ever cardiothoracic surgeon joins king faisal hospital after graduating from Colleges of Medicine of South Africa (CMSA) this year 2019. Dr. Maurice Musoni joined the hospital with the goal of transforming lives, incorporating the newest and most innovative cardiac surgical techniques at KFH. Who is Dr. Musoni Maurice? I am a cardiothoracic surgeon by profession. I recently joined King Faisal Hospital after my return from South Africa.

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Could you briefly tell us what a cardiothoracic surgeon does?

a Pulmonologist and Cardiologist?

A cardiothoracic surgeon is a doctor who specializes in surgery of organs that are in the chest, that means the lungs, the heart, esophagus and any other structures that would rise in the chest. But not only surgery, I also specialize in diagnostic procedures like bronchoscopy and esophagoscopy. These are procedures that can be offered to Rwandans.

These are our sisters units or support specialities. One is cardiothoracic surgeons, pulmonologists and cardiologists are physicians. These physicians see patients, make diagnosis, treat them with medication and then, when need arises for surgery they refer the patient to the surgeon. They are like the cardiothoracic surgeons’ fideles. We get referrals from other specialities.

How is a Cardiothoracic surgeon different from

Why is that many doctors do not venture into this


speciality, the fact is that you are the first cardiothoracic surgeon after medicine has been in Rwanda for so long? In Rwanda it’s a very rare speciality, not like any other. We have to start from somewhere. But it also has its own specification or characteristic that makes it a rare speciality. One, it takes very long to train, because there is a whole earning in college you have to acquire. And if you are going to be working with a cardiologist one needs to know all the diseases in cardiology, on top of knowing which one you should operate on or not. It took me seven years after graduating from medical school. In total, it could take one about 15 years. Have you carried out any surgery since you joined King Faisal Hospital? What we are currently doing is down surgeries, and we’ve

already done a couple of them, we hope in the near future we will venture into heart surgeries. But slowly as we acquire equipment and infrastructure then we can progress into more complex surgeries. We also have the responsibility to train our junior doctors, those in medical school, even post graduates in surgery. We also teach other specialities and discuss with them; ICU, critical care, discuss patients in multidisciplinary board, tumor board, cancer board, it is largely about sharing knowledge. Hopefully once we’re established, we can start a department that trains cardiothoracic surgery. We hope other hospitals in the country collaborate with us and refer patients’ early, insurance companies to be aware that we offer this service at King Faisal hospital. We are also considering part time outreach programs at

other hospitals, may be one or half day clinic just to see difficult patients in the wards. What message do you have for Rwandan aspiring cardiothoracic surgeons? It is an interesting field. It is a young field in our country. Lot of jobs opportunities, young people should venture into these kind of surgeries because we need to build the field. We need people to specialise and subspecialise. Cardiothoracic has different subspecialties; you may decide to do only adult cardiac surgery, you may do only congenital paediatric surgery. You may do general cardiothoracic surgery, which is the lung and esophagus. It is also an enjoyable profession, long hours of working but you still balance it out and socialise.

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Dr. Archille Manirakiza

Dr. Fidel Rubagumya

JUNIOR CONSULTANT, Clinical and Radiation Oncologist (Part time)

JUNIOR CONSULTANT, Clinical and Radiation Oncologist (Part time)

How King Faisal Hospital is improving

Oncology Services With an alarming rate of cancer cases in Rwanda, rendering quality comprehensive cancer care is important to King Faisal Hospital.

“It’s a platform with all specialists; ideas are shared on how best to treat our cancer patients which has greatly improved service delivery,” he says.

Oncology, as a department at King Faisal Hospital is striving to achieve this by availing specialists and a well-coordinated system that facilitates the evaluation and delivery of proper cancer treatment.

Oncology as a branch of medicine The discipline of medicine deals with the prevention, diagnosis, and treatment of cancer.

This is why once a week, medical practitioners at the facility convene in a bid to jointly address cases of cancer patients.

Dr. Fidel Rubagumya, a Clinical Oncologist at the hospital explains that though oncology comes off as a new service in medicine, it has essentially been in existence for years.

Dr. Archille Manirakiza, a Clinical and Radiation Oncologist, says that the department holds hospital tumor board meeting every Friday to discuss the different cases being handled.

“When you look at the history of cancer, you find that it has been in existence over a long time. People have treated cancer using several ways; both traditional and modern,” he says.

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Before Rwandans and the rest of the world became aware of the disease, a tumour was associated with sorcery and hence was treated as such. “The oncology field was previously not as prominent but currently the dynamics have changed. I can say in Rwanda we can treat a range of cancer ailments,” Rubagumya says. Considering that oncology is an expansive department, it has several subfields. These include medical, surgical, radiation and the most recent, clinical. The medic explains that just like there are different forms of cancer, the symptoms and traits of each cancer ailment differs as well. What makes cancer different is that we have different cells


in our bodies, for instance, a cell on the nose is different from one on the liver. With cells having different characteristics and behaviour there is a difference in their multiplication. How does cancer occur? Ordinarily, human bodies have cells that multiply, so at times there are ‘mistakes’ that happen during that division. Normally, the body corrects these ‘mistakes’ through filtration which leads to the subsequent clearance of the faulty cells. It is the cells that are omitted during filtration that later turns out to be cancerous. And the type of cancer that emerge depends on the type of cell and location on the body. If the division was happening on the skin and the ‘mistake’ occurs on a skin cell, then it becomes a skin cancer. The causes of the ‘error’ during multiplication of cells is still unknown and is often attributed to genetics and mutations.

the patient preferably with the next of kin present. This provides an avenue to understand what is at stake, the extent of the ailment considering that in most instances patients have little understanding of the situation. Discussions at this phase mainly centre on the right diagnosis, the stage of the disease and what the chances of curbing the ailment. “The discussion also focuses on the treatment, how much time it’s going to take, the possible side effects but also matters relating to life after treatment which includes aspects such as the recommended diet for the patient,” he said. Dr. Manirakiza observes that a majority of patients seeking treatment include cases of breast cancer, colon cancer, sarcoma, rectal cancer, strains of lung cancers, head and neck related cancers as well as cervical cancer. The hospital also offers

chemotherapy and surgery. Patients also have access to palliative care services and which involve an interdisciplinary approach to incorporate specialized medical and nursing care for people with life-limiting illnesses. Dr. Rubagumya says that though oncology has evolved over the years, there is need for more to be done especially in terms of early detection of cancer. “A lot of programmes for awareness have been done but that’s where we still need more effort. Because we have the capacity to treat, what remains to be done is to make sure that people are educated so that these cancers are detected at an early stage,” he says. He says there is a role for policymakers and medics in charge of cancer to reach out and educate the general public on early detection of cancer at an early stage.

However, Dr. Rubagumya says there are cancers that have direct causes such as cervical cancer which is caused by human papillomavirus. How treatment is delivered at the hospital At King Faisal, screening for preventive, diagnostic and consequent treatment is then offered in line with cancer handling. Some of the screenings that are done include pap smears, prostate screening, lung cancer screening and breast cancer screening. When a patient comes for treatment, Dr. Manirakiza highlights the need to know the right stage of the ailment which among other things call for a detailed discussion with KFH•09/19

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What’s the role of a hospital’s emergency department? At King Faisal hospital, just like at any standard medical facility, the emergency care department serves to provide fast care to critical incoming cases. With proper evaluation through a triage classification, patients are screened, categorised and managed depending on the level and extent of their illness. A triage refers to the evaluation and categorisation of an ailment especially when there are insufficient resources and time for medical care of everyone present at a go.

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With most of the emergency cases handled at the department being unpredictable, using the triage system is paramount. Florence Mukarugwiza, the Nurse Manager at Accident and Emergency at King Faisal Hospital says that because emergency care caters for people in need of urgent medical attention, it calls for competent and standby medical personnel. When patients in need of these services arrive at the unit, medics are readily available to attend to them,

receiving and direct them to where they can be catered for. Some are admitted while others are discharged after stabilisation. Physicians covering all specialities are available in the department. The hospital’s emergency department also has access to maternity and an intensive care unit departments. “This is one of the things that enable us meet the international standard in emergency services. We also have a theatre that is available for emergency cases. All


this is to make sure that our patients are well attended to,� Mukarugwiza says. Important aspects for an efficient emergency care department include the need to have competent staff such as nurses, doctors, physicians and specialists. An emergency department also ought to be well-equipped. Mukarugwiza says this unit is equipped with resuscitation services along with other support services that are available 24 hours a day. King Faisal Hospital qualifies in all the above aspects. Resuscitation is the process of correcting physiological disorders (such as inability to breathe or a failing heartbeat) in an acutely ill patient. A faulty emergency department that lacks most of these essential aspects negatively impacts the quality of care that the patients receive and is likely to have a higher mortality rate.

Who is supposed to be attended to in an emergency department? When a patient walks into an emergency department,

they are taken for a triage where nurses present receive and categorise them. This helps the medical personnel determine the urgency of care needed.Patients are categorized as stable, moderate or critical. King Faisal Hospital uses the Australian triage code, which has five categories. Category one for patients who are most critical, it is coded red symbolising the need for patients to receive immediate attention. These cases are received and assessed immediately, and intervention is also administered as fast as possible. Some of these patients come in with ailments like cardiac arrest, respiratory arrest, heavy bleeding among others. Category two involves patients who are in a coma on arrival but are able to breathe and have a regular heart rate. These cases are coded orange and are attended to within ten minutes,in case the team has Category one patient. Category three cases are yellow-coded patients who have to be attended to in thirty

minutes. They tend to have medical conditions such as low blood pressure and/or low oxygen circulation. These at times are to be received immediately depending on the number of patients that are being attended to at the department. Category four has patients who come in with issues such as abdominal pain among other illnesses. If not attended to immediately, they are not at immediate risk. They often do not need immediate attention like those bleeding or those with breathing difficulties. Mukarugwiza explains that such patients tend to seek emergency care services when they are, for instance, in a rush or when seeking to be served by highly specialised doctors. In category five are those whose situation is much like those in category four and can at times be attended at the department or can be referred to the Outpatient Department. These varying categories calls for practitioners to conduct screening to inform their decisions and consequently save lives.

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Events

Celebration of Mother’s day and International Midwife day at King Faisal Hospital This year’s Mothers’ Day at King Faisal Hospital was dedicated to the mothers who gave birth at the hospital on May 12th, honouring the mother, motherhood, maternal bonds, and the influence of mothers in society. Over 1,000 babies are born at King Faisal hospital every year. The hospital has a team of trained personnel to provide proffessional and compassionate care at all stages of pregnancy for a mother. The relationship between a midwife and expectant mother is essential for a positive experience during pregnacy, childbirth and postpartum phases.

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May 12th 2019, the management of the hospital offered nursing pillows to all mothers who gave birth on that weekend to ensure that babies are in the proper posture for nursing and tummy-to-tummy contact. This reduces the strain on the mother’s muscles and helps them focus on helping the little ones latch properly. Josephine Murekezi, the Nursing Director of Maternal & Child at King Faisal Hospital and a member of the Rwanda Association of Midwives, has been in the midwifery field for 35years. She shared about her experience as a midwife and the state of midwifery at the hospital.

What is International Day of the Midwife and how did it start? IDM has been celebrated for over 100 years, it started in Belgium with intent to unite the midwives, allowing them to share knowledge, skills and networking. The midwives belong to an international association (International Confederation of Midwives) with a membership of about 132 countries. Rwanda has been a member for five years now.

What is the difference between a midwife and a nurse? At entry level, one does nursing then specialises in midwifery. A midwife specialises in delivering babies and caring for mothers. The journey starts when the woman is pregnant till when she delivers and the nurse attends to all conditions except pregnancy.

What are the roles of the midwives here at King Faisal Hospital? Our role is to care for women from adolescence, teaching them about the reproductive system and preparing them for bodily changes that they will experience as they get ready for motherhood. After conception, when women come for antenatal consultation, they receive antenatal cards that their gynaecologists use to make proper follow up on the condition of the mother and child. Great care is taken, performing routine checks to rule out common complications like high blood pressure. We educate them about the dos and don’ts, proper eating habits, time to rest, comfortable shoes and clothing types during pregnancy and a whole pregnancy life style in general.


We teach them about signs of pregnancy, and danger signs of someone who is in labour, when she needs to seek medical advice and what she needs to bring to the hospital when she comes to deliver. We also advise them on what to bring and how they should pack their luggage, who should escort her (which most of the time is preferably their partner).

What can pregnant women expect when coming to deliver at King Faisal Hospital? Once the woman is at the hospital with the midwives,

we keep monitoring how the labour progresses. Our team of midwives are capable of knowing whether the labour is progressing or not. When there is no complication, midwives are capable of helping the mother deliver without an obstetrician.

How do midwives follow up with mothers after delivery? Before discharging the mother, we monitor their progress. When the mother has had a normal delivery, we keep her for 24 hours just to monitor her. After the 24 hours without complications, it is

believed that she is safe to be discharged. A doctor’s visit is then scheduled for postnatal check-up and family planning.

How do you pass on the knowledge to young and upcoming midwives? Being a teaching hospital, we receive students from various teaching institutions across the country who come for training. Most of our senior midwives carry out outreach programs, sharing their knowledge with other midwives across the country. We also organise workshops, or select hospitals to share our experiences with.

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King Faisal Hospital’s

blood donation drive Without people volunteering to donate blood, lives can be lost since blood and blood products cannot be manufactured.

Blood is among the most precious gift a person can give to another; it is a gift of life. However not as many people take part in blood donation drives. It is upon this background that King Faisal Hospital took the initiative to organize a blood donation drive in June this year with the main intent of encouraging the general public to donate blood. One can never underestimate the significance that blood donation possess towards saving lives. Blood donation is not only vital to the recipient’s health, but to the donor’s health too. Diana Kaneza, Senior Public Relations Officer at the hospital says that owing to the nature of the facility’s work, they are witnessing the tremendous impact of blood donation in saving lives. With this, she says they saw the need to step-up and work closely with the National Transfusion Centre to encourage people to donate blood. “Without people volunteering to donate blood, lives can be lost since blood and blood products cannot be

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manufactured. We solely rely on volunteers to save lives,” she adds. Kaneza observes that the campaign fulfilled its objectives as the public turned out in huge numbers enabling the collection of 120 pints of blood during the period.

What this meant to King Faisal as a health care facility: As a health care facility, this meant an increase in stock (of blood and blood products) which other health care facilities can also benefit from, Kaneza says. Juliette Karitanyi a Communications Officer at King Faisal Hospital says that staff from the hospital owned the campaign and were in support of the idea of the blood donation drive. She highlighted that the doctors and the nurses who took part enabled the public to see the importance of giving blood. “We took several pictures of doctors from different departments like paediatricians, gynaecologists, nurses and neurosurgeons among others taking part in

the campaign,” she explains. The images among other things showed the personnel holding up posters encouraging people to donate blood. “The hospital staff did this because they know the importance of donating blood,” Karitanyi says. Doctors and nurses also took part in an online campaign where they would request the public to come in and donate blood. “After that, we extended the idea to the public where we chose a few influencers who were willing to support. We had journalists, comedians, and social media influencers among others who also posted photos requesting people to come in to donate blood,” Karitanyi adds. The campaign ran for a week and during the period, multiple activities were carried out. “We also conveyed this message to the public via media outlets such as holding talk shows on radios,” she notes. There were two days for blood donation. The first day was


organized at the premises of King Faisal Hospital and the other was organised at the car-free zone. During this entire period, the hospital’s staff educated the public on how precious blood is as a resource for human beings and that it is only by donating that lives can be saved. In the process they were also able to debunk myths and misperception about blood donation. “Some people are reluctant to donate blood thinking that it is sold somewhere. But this is not true, we receive if for free

and give it for free,” Karitanyi explains.

on 11th June 2019 at Car free zone in the city centre.

The blood donation drive took place on the 10th of June 2019 at King Faisal Hospital and

A majority of the donors were doing it for the first time with most of them being youth. KFH•09/19

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KFH celebrates staff for

outstanding service delivery on Labour Day 2019 Labour Day (International Workers Day) is marked annually on 1st May to celebrate workers in their various occupations across the world.

Over time, we realised that there are employees who were mentioned by patients for their outstanding services; internally, externally and on social media.

While the day means different things to different people -depending on the location and context-, the overall aim of the public holiday is to celebrate the contribution of workers to societal progress.

Patients have been nominating outstanding employees throughout the year. We worked closely with the Head of Customer Care, who provided us with a customer care report through which the best performers in the hospital were recognized and appreciated.

Patience Umufite, Human Resources Director, explains the importance of annual celebration honouring workers at King Faisal Hospital as well as patient-centered quality care.

How did King Faisal Hospital celebrate Labour Day 2019? Labour Day celebration is part of our annual activity calendar at King Faisal Hospital. It is part of the Human Resources Retention Strategy as well as a way to show appreciation of the employee’s performance. This year, the celebrations were organised by Human Resources Directorate and Public Relations Office with the focus of celebrating staff performance based on the customer care information report.

How did you select the best employees eligible for awards?

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Among those awarded include: Christian Bangumukunzi (Social Media nominee), Charlotte Haston (maternity ward nominee), Annoinette Mukajyambere (surgical ward nominee) and Agnes Dusenge (paediatric ward)

As the Human Resource Director, what does Labour Day mean for you and the employees at large? From a personal standpoint, I love to see all of us getting together on that day considering that workers in the different shifts and departments do not get to meet often. It provides a chance and opportunity for them to catch up, share a glass of wine, food and dance their hats off (laughs).

My joy is to see clinical and non-clinical staff enjoying a holiday together. Activities such as dancing and cracking jokes lift spirits as work is quite intense with busy schedules. These activities serve as a boost and motivation in our daily work.

This year’s theme focused on quality service, what’s King Faisal Hospital approach to adopting this as a practise and way of doing things going forward? During the celebration, we conducted an exercise where employees structured group discussions around how to boost patient care through delivering quality of services. Among the key highlights that emerged include a resolution to make our practice look and feel engaging, improve easeof-access and commitment to timeliness. From the discussions, the staff members also resolved to treat and handle patients with respect and attention and improve communication at every step of the patient visit. King Faisal Hospital is Rwanda’s leading referral hospital and one of the biggest hospitals in the Great Lakes Region with 160 bed occupancy. KFH employs more than 500 workers among them are 83 medical doctors; full-time and part-time.


Dusenge Agnes Nurse

Haston Charlot Midwife

Bangumukunzi Christian Customer Care Officer

Mukajyambere Antoinette Nurse

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“Picture by senivpetro / Freepik”

Health Tips For

Mommy & Baby Esther Batetiwabo, a nutritionist at King Faisal Hospital has a unique way to educate mothers to-be on self-care, baby care, lactation and breast feeding as well as diet and nutrition required. She said, that early antecedents of child and adult health start at prenatal and even preconception. The aim is for children to have a healthy childhood through educating mothers. In the first 6months of birth: The mother is advised to eat a balanced diet every day. A balanced diet has three main types, or categories. Carbohydrate food (energy giving food), the second

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category is Proteins, that are mainly called (Body building foods), and third category are minerals and vitamins that are

mainly called (body protecting foods). The mother is encouraged to eat a balanced diet because the child needs


all nutrients in breast milk. For a mother to have a balance diet, she should eat three big meals which are breakfast, lunch and dinner. A mother can have healthy snacks, (in between meals) that make at least five times a day in order to meet the quantity and energy needed. On top of that she needs to drink lots of water. The baby needs to breastfeed from 8 to 12 times a day. The baby will get a full meal when the mother eats well, and her breast milk has enough nutrients, enough water and everything the child needs. After 6 months of life: The mother must continue to breastfeed her baby up to at least 24 months or 2 years. When the baby turns 6 months, the breast milk quantity reduces. This is when the mother needs to introduce complimentary feeding made up of the three categories of the balanced diet in semisolid form. The mother needs

to make the food easy for the child to swallow and digest. The additional food supports his/her growth. The mother at this point can also introduce infant formulas. Food you should not feed your kids before 12 months: The mother should avoid these kinds of food because some of them have allergens that can cause allergic reactions to the child. •

Egg White

Peanuts

Cow milk (It has a strong protein called white protein, very difficult for a baby to digest because the baby enzymes are still weak.) The milk has also animal fat that is not good for the baby.

Egg White Peanuts

Cow Milk

For the cow milk, it is advised to start giving it to the baby when s/he turns 10 to 12 months.

Complimentary feeding

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Understanding Ergonomics

THINGS YOU NEED TO KNOW ABOUT

ERGONOMICS &

WORK SAFETY Maintaining an optimal level of wellness is absolutely crucial to live a higher quality life. Whether you are at work or home, understanding how to take care of your body and what risks you are exposed to are important steps on the path to safety and health. It is especially important to understand how environmental factors are contributing to your overall health. These factors include your environment, occupation, and the location of your workplace. Ergonomics is a field of study that attempts to reduce strain, fatigue, and injuries by improving product design and workspace arrangement. The goal is a comfortable, relaxed posture. Mr. Damascene Gasherebuka, Physiotherapist at King Faisal

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Hospital brings you tips to ensure that every employee is well equipped with training and understanding of the health hazards around them as an indicator of strong leadership. Arrange Your Workstation Every time you work, take time to adjust workstations that aren’t quite right in order to minimize awkward and frequently performed movements.

Adapt Laptops Laptop computers are not ergonomically designed for prolonged use. The monitor and keyboard are so close


together that they cannot both be in good positions at the same time. For prolonged use, it’s best to add a separate monitor and keyboard. The laptop can be placed on books so the top of the screen is at eye level, then use an external keyboard so that your elbows can rest at 90° by your side. Modify Your Body Mechanics If you wear eyeglasses, make sure they fit properly to avoid tilting your head. Type with light strokes, and try to keep your muscles relaxed. Sit “tall,” aligning your ears, shoulders and hips. When you sit, think

about making yourself an inch taller. Switch hands when using a mouse, if you are able. Completely rest your wrists during breaks, including taking your hands off the mouse. Move frequently Movement has many benefits: it relaxes tissues, lubricates joints and prevents stiffness, improves circulation, reduces fatigue, and builds stamina. At least every 10 minutes, take a short (10-20 second) break. Take your hands off the keyboard and move! Every 3060 minutes, take a brief (2-5 minute) break to stretch and/ or walk around.

Keep fit Physical fitness can help you avoid and treat problems related to computer use. Build your stamina with exercises for strength, flexibility, and cardiovascular health. Kindly see the doctor if you are experiencing constant pain, numbness, weakness or other problems that interfere with daily tasks.

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Ebola preparedness measures at King Faisal Hospital

The World Health Organization took the rare step of classifying an ongoing Ebola outbreak in Eastern Congo a “public health emergency of international concern” just days after the first case of the virus was confirmed in the city of Goma on the border with Rwanda (with DR Congo) in mid-July 2019. The Ebola Outbreak in neighbouring country DR Congo was first announced in August 2018. Consequently, the Government of Rwanda has taken serious measures for prevention and surveillance which have been intensified at all points of entry and at community level.

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Dr. Ngambe Tharcisse, Head of Quality assurance and risk management explains how KFH has set up preparation measures. What is Ebola virus disease? Ebola is a viral hemorrhagic fever that affects humans and other primates caused by Ebola virus. The fever’s spread is believed to be a result of direct contact with an infected wild ani-mal or fruit bat. Besides bats, other wild animals sometimes infected with EBOV include several monkey species, chimpanzees, gorillas, baboons, and duikers.

How do people be infected with the Ebola virus? Interaction with the abovementioned animals can lead one to get infected. The disease has a high probability of death on the infected persons, it is one of the most serious diseases hu-manity has ever faced. A single patient could lead a whole country to be declared an Ebola epidemic. There is a high risk of transmission as it spreads easily among humans and could also be spread by animals. One can get infected through contact with body fluids, sweat, saliva, blood, sexual secretions as well as


body fluids including breast milk and urine. What are the typical signs and symptoms of Ebola virus infection? Ebola symptoms vary but the most common include sudden onset of fever, intense weakness, muscle pain, headache and sore throat which are commonly experienced at the beginning of the disease (‘the dry phase’). As the disease’s phases progress, patients commonly develop vomiting and diarrhoea (‘the wet phase’), rash, impaired kidney and liver function and in some cases, both internal and external bleeding. Can Ebola be prevented and treated? People can protect themselves from infection by following specific infection prevention and control measures. These include hand washing, avoiding contact with the bodily fluids of in-dividuals who are suspected of or confirmed to have Ebola.

The treatment is rather supportive. A patient receives medication for symptoms exhibited such as fever and vomiting. The supportive management’s impact depends on how the body responds to the infection and its ability to fight the disease. There is also an Ebola vaccine administered to people who are at risk especially in regions where there is an outbreak.

From the point of entry to triage, our staff have been trained and are on alert to identify high indexes of suspicion. They inquire about patients’ travel history and check for symptoms to find out if the person has not been in contact with an Ebola-infected person within the past twentyone days.

How prepared is KFH in regards to the Ebola virus? As a hospital, we are observing the general trends of precautionary hygiene through hand-washing, scrubs and personal protective equipment. We are preparing an isolation unit where we can hold and treat a person suspected to be infected. The isolation period is three days before we get the diagnosis. A rapid response team has been trained through the facilitation of the Ministry of Health to respond to cases.

A single patient could lead a whole country to be declared an Ebola epidemic. KFH•09/19

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Anterior cruciate ligament injuries: Study findings on early rehabilitation at King Faisal Hospital Mr. Mutabazi Eric

Senior Physiotherapist

This article is an abstract of the study conducted at King Faisal Hospital, studying on anterior cruciate ligament injuries focusing on the implications of early rehabilitation in the hospital.  The study was conducted by Eric Mutabazi and the physiotherapy team. The Anterior Cruciate Ligament (ACL) is one of the key tendons that help stabilize your knee joint. The ACL connects your thighbone (femur) to your shinbone (tibia). It’s most commonly torn during sports that involve sudden stops and change of direction in motion — such as basketball, soccer, tennis and volleyball. This study was initiated because of the high

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prevalence of anterior cruciate ligament injuries identified at the facility. Eric Mutabazi, a Senior Physiotherapist at King Faisal Hospital said that the hospital was lucky to have Dr. Emmanuel Bukara, an Orthopaedic Surgeon who has specialized in sports medicine especially in anterior cruciate ligament surgery. “Before 2017, we didn’t have any follow up of such cases. But when Dr. Bukara returned from specializing in sports medicine in South Africa, he started to operate on such cases. The physiotherapy department registered sixtythree cases in a period of about one year,” he said. The objective of the study

was to demonstrate the effect of early rehabilitation in the management of the anterior cruciate ligament reconstruction. The sample size was large in comparison to one surgeon and the physiotherapy team that is present at the hospital. The methodology used was a retrospective study; using both quantitative and qualitative to evaluate and treat their conditions. Systematic random sampling using the ACL patients register was used to select a sample size of 24 cases. Only post-surgical cases that followed rehabilitation at King Faisal Hospital were eligible in this study.


Data was managed using patients’ files especially the progress note form. The measurements tools used were Functional Independence Measures and Patient-Specific Functional Scale for a validated functional test within an appropriate time. Treatment protocols, as well as guidelines on anterior cruciate ligament management were used by the rehabilitation team for successful rehabilitation. King Faisal Hospital and the Kigali Ethical Committee approved the research. The recovery period of ACL Injuries among female and male patients was the same. Among followed cases, 98 per cent fully recovered their

functions and regained routine activities such as military, sports and other activities after about six months of rehabilitation. The findings were that 95. 8 per cent fully recovered their functions and regained routine activities such as military (58.3%), sports (37.5 %) and other (4.2 %) after six months of rehabilitation. The rehabilitation of ACL in Rwanda saved lives and careers of many talented sports men and women. King Faisal Hospital built confidence and trust of many customers and stakeholders through the success of rehabilitation.

Other factors, such as associated injuries and sociopsychological hindrances influencing the return to sports were taken into consideration, both during the rehabilitation during the evaluation of the treatment. Eric Mutabazi and his team hope to that in the near future the latest and digital equipment for better results of ACL rehabilitation will be adopted The team also recommended that continued training be organized by KFH to share knowledge about ACL rehabilitation with physiotherapists across East Africa.

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“First and foremost, thank you King Faisal Hospital doctors and nurses for making me feel so much better. Thanks for your good care and concern. Your “manner” put me at ease and helped me gain confidence. Because of you, I am doing very well. You truly have remarkable doctors and professional that we respect “Dear Dr. Nkusi and and trust.” Team, We saw God Mwiza Anne use you supernaturally “I really appreciate my to treat our father professor (Lutalo) for his Kayitaba.” “A smile at the emergency for a family member will to explain more about who is stressed is really a way of paving my disease.” to recovery. I suggest this service is also “May God continue to Uwimbabazi C implemented during night duty. use you to impact many Many thanks and let’s keep improving.” more! God Bless you” Dr. Abanda TuecheCE. UN Physician- Rwanda Peace and Charles Kiiza “I wish to convey my appreciation to Dr.Nkusi, he helped me so much, I came “I want to thank the King Faisal Hospital here with a severe back “In brief, services were good for the most outstanding and dedicated ache but now after surgery and would like to appreciate work of your doctors and nurses. Perfect can sit and sleep, may God Dr.Butera and Dr Nkusi who did organization and excellent good will and bless doctors” surgery and also appreciate service.” Tuyisenge S everyone who participated on Amb. Ron Adam Ambassador of Israel to my well being here.” Rwanda Rose U “Perfect services, I have no complain for sure mid-wives are really good and Dr.Abdul is “Services are very good, great guy” but mostly appreciate Providence N customer care Division” Cyusa Tw

testimonies King Faisal Hospital. KG 544 ST 10, Gasabo District • P. O. Box 2534 Kigali, Rwanda. Emergency number: +250788530351. General number: +250788309003. Appointment office: 3939,3938 (Toll free), +250783825851.

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KFH•09/19 King Faisal Hospital Rwanda

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King Faisal Hospital Magazine, September 2019 Issue  

Dear Readers, Please find attached the KFH Magazine, September, with a special focus on Minimally Invasive Surgery, CEO's plan for KFH, Rwa...

King Faisal Hospital Magazine, September 2019 Issue  

Dear Readers, Please find attached the KFH Magazine, September, with a special focus on Minimally Invasive Surgery, CEO's plan for KFH, Rwa...

Profile for kfhkigali
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