Opening Day for Roche Health Center!

April 1st will forever be so much more than April Fools day for everyone who has worked on the Roche Health Center. April 1st will now stand as the first day that the Roche Health Center offered medical assistance to the community of Roche. So many thanks go out to everyone who has contributed to this project! A special thank you to Dr. Esther Kawira and our Tanzanian partners, The Shirati Health, Education, and Development Foundation (SHED). Your continued support of the project has made the dream of providing health care to this region a reality. Read more about SHED's work @ www.shedfoundation.org/home . Dr. Kawira was so kind to send a report of the first day at Roche Health Center. Please enjoy:

April One was Day One for starting patient care at Roche Health Center!

Two days earlier we had moved a nursing assistant, Daniel Paul, plus
some furniture, to the site. On Friday, April 1, we loaded up another
large table, 15 plastic chairs, and two action packers of drugs and
supplies. Besides me, there were Nyamusi Magatti, SHED volunteer as
driver and receptionist, and Carla, nursing student from Goshen
College who also volunteered to help at reception. At the last minute
we added Adek, a driver and mechanic, who would know what to do in
case of bogging down in swampy ground (it had started raining heavily
here in mid March). In other words, he would know how to put the Hilux
into four wheel drive.

It was a cool cloudy morning, and there were puddles in the road along
the way. It turned out that we went through them all easily, and soon
arrived at the Roche Health Center. Patients were already waiting.

The building was large enough that, even without the internal walls,
we were able to spread out and create some privacy of the doctor
consultation area from the lab and drug dispensing areas and
reception.

The first patient was an 85 year old gentleman who had been suffering
for many years with symptoms of prostatism. Besides being given
treatment for infection, he needed referral to see the urologist at
Shirati Hospital. I got on my cell phone and was able to contact
Shirati Hospital for the date in May. I also started a list of
"things to bring along next time", the first item being a copy of the
schedule of the Flying Doctors!

At some point I also got messages on my cell phone, welcoming me to
Kenya! The Roche Health Center is within eyesight of the
international border, and the networks aren't quite precise.

During the day I also got several children who were ill with malaria.
I was able to confirm it on site using malaria rapid testing. The
Kenya residents had not just had indoor wall spraying like we have had
in our district, so I wonder if those with malaria were all from
Kenya. Maybe we could keep a record of which ones use nets and have
had their walls sprayed.

Another feature of being near the border is that more of the patients
did not know Swahili and I needed a translator from Luo to English,
easily provided by Daniel my assistant.

The two sickest patients were children. One was a five year old girl
who had been having fever on and off all week, and had started
vomiting that day. We confirmed malaria, and were able to get the
first doses of tylenol and malaria drug into her without it being
vomited. The other was an 8 year old girl who appeared chronically
ill and had skin infections and adenopathy. Her father said he had
been taking her to many places for treatment but without success. I
suggested she come back for HIV testing next time (next item for the
list, HIV test kits).

I saw one pregnant woman with a bladder infection, another woman who
had endometritis after a delivery the week before.

Another man, walking with a stick for assistance, brought a discharge
summary from the national hospital Muhimbili in Dar es Salaam from a
year ago. He is post stroke, and is supposed to be on diabetes and
blood pressure medicine, but has been out of and off of both for the
past five months. He lives near the Roche Clinic. His BP was high,
and he has glucosuria. We will get him started back on his drugs (add
Metformin, hydrochlorthiazide and Nifedipine to the list).

We have permission to give the traditional "RCH" (Reproductive and
Child Health) services at Roche as an outreach of the Sota Health
Clinic. At Sota, we have been given the vaccines and the refrigerator
literally within the past one week, so once we have this underway at
Sota, we will see how to extend those services to Roche also. This
includes antenatal checkups, child immunizations, and Family Planning,
in case anyone is interested.

I really enjoyed holding the first clinic in the Roche Health Center
building. There was plenty of natural light and air, not to mention
the wonderful view out over the valley when I opened the door. It was
a comfortable venue for patients. We seemed to have a big crowd in
the waiting area most of the time, no doubt some being onlookers who
were checking out how things were being done and will spread the
information.

Daniel Paul is occupying the two small end rooms at one end of the
building, and finds it to be elegant quarters. He has instructions as
to how to handle emergencies, and a small stock of drugs and supplies
for that purpose. We are not officially offering emergency services
there, but we want him to be able to help for first aid, and to know
what to do and when to refer. His presence most of the time also adds
to the care taking function of the watchmen. He has worked for me at
Sota for six months, and is reliable and trustworthy. We think he
will prove to be a good choice as the first health care worker for
Roche Health Center.

My nursing officer Dorothy will go to Roche twice during this coming
week in my absence (Tuesday and Friday), and after that I will
normally go on Tuesday and she will go on Friday. She is an excellent
HIV counsellor, and will go prepared to do testing and counseling.
Hopefully the ARV drug treatment that we hope to soon do at Sota can
also be started at Roche under Sota auspices at first, as for the RCH
services.

We'll give you updates as we work out the details of working at Roche.
Sincerely,
Esther

Please check the blog for updates and photos! For more information about Village Life Outreach Project, please visit our website @www.villagelifeoutreach.org, email to contact@villagelifeoutreach.org, or call 513-684-8614.