KARURA shortly before independence, a tragic fire wiped

KARURA HEALTH CENTREBackground Karura Health Centre is a non-profit healthcare organization, which provides its’ patients with free healthcare services. Karura Health Centre is a subsidiary to the Westlands Health Centre in Nairobi. This Health centre is a public hospital which offers its patients, free consultation for unwell clients of all ages, free HIV testing, free prescribed drugs to patients, free pregnant consultation and healthcare services, and free treatment to rape victims.

Karura Health Centre was opened for the purpose of catering to the Muthaiga Golf Club labourers (for example, the waiters, janitors etc.), also, the workers around who worked for the European residents in the Muthaiga area. This was during the 1950’s, where the centre was a privately owned health care centre. However, shortly before independence, a tragic fire wiped out all traces of the health centre’s history. The exact date of opening cannot be traced.

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Karura Health Centre was rebuilt shortly after the fire took place, which was immediately before Kenya’s independence. After independence, Karura Health Centre merged with the Westlands Health Centre, became a public hospital, and now legally, is a property of Nairobi City Council.Karura Health Centre offers services as mentioned below:• Antenatal Clinic – Record pregnant women weights and blood pressure, also providing counselling services to expectants.• Comprehensive Care Clinic – Patients diagnosed with HIV/AIDs, receive antiretroviral drugs to those who cannot afford.• Pharmacy – Medicines prescribed by the doctor are dispensed, and given (free).• Outpatient Services – Testing for HIV/AIDs, tuberculosis, blood pressure, and the common outpatient illnesses, for example, diarrhoea, migraines, back aches, etc.

• Planned Parenthood clinic – This clinic provides clients with information and provisions of various family planning methods. They are advised and supported as well as various family planning types or medications are offered. 1FeelingsUpon working for Karura Health Centre for eleven (11) weeks, I am confident to say that I gained a lot of helpful knowledge and experiences which will last me a lifetime. When I started volunteering at the centre, I was a little bit wary, and somewhat nervous, however those feelings vanished, almost immediately I started working.

When I first started working at the centre, I was given a tour around the hospital. I was the only one, as I started late (on the third week). I was shown the various consultation rooms, where HIV/AIDs tests were taken; the pharmacy, areas where patients were diagnosed and treated; and how and where the records were kept and traced back. I was given a warm welcome to the centre by Dr Kariuki and Dr Ringera, who were the only doctors on site. They introduced me to the support staff, who were extremely warm and welcoming. They were very patient with us when it came to assistance and teaching of the rules, procedures and system of the centre.

At first, I was overwhelmed and confused because I had to know whether the client was new or revisiting, and how to ask for personal information.In the beginning I was assigned to the patient register. At this point, basic patient information was required such as, full names, phone numbers, national identification numbers, and ages. There was a separate book for minors under five years of age, and others over age five. This was an exciting moment for me, as I noticed most of the clients looked like they were financially struggling, offered to pay what little they had, to see a doctor. I happily said no.

It was free! I was assigned to this station for the first three weeks.Between the third and ninth week, I worked at the triage area, where we had to take patients’ blood pressure, pulse rates, weights, and height, and had to discretely ask for their HIV status. I overcame the language barrier, and perfected my Swahili communication skills. It was great! At this point, I was shocked when I saw young girls, less than twenty four years of age come in, and test HIV positive, only realizing the trouble and hardship they must be facing.During the last few weeks, I was assigned to the pharmacy area, where I had to dispense the right drugs to patients. Also, update the pharmacy books, and sort drugs to make it easier, and less time consuming to find.

This required a focused, and attention-to-detail mindset to avoid mistakes.Overall, my experience at the Centre was a great and positive one. I learnt many things, made great memories, and made good friends. Memories here, will last me a lifetime.

2Learned Experiences/Gained KnowledgeOver eleven weeks of my experience at the centre, I worked in four different departments.1) Pharmacy – I learnt the various types of medications which were prescribed to patients with different classes of illnesses. Here, Dr Ringera and Dr Kariuki patiently explained why certain medicines were provided. They varied from age, severity, and consistency.

Patients with recurring illnesses were given higher degree dosages. I also had to pack the medicines from the larger containers to the smaller ones. I learnt to cautious and had to be very focused at this point, not to make mistakes.

2) Patient Register – At this department, I had to take the patients name, national identification numbers, telephone numbers, and ages. Here I learnt to be patient with clients who were sick, and sensitive to their speeds and understanding.3) Patient triage – In this department, more sensitive information was required. I had to establish the patients’ HIV status, tuberculosis status.

I also had to record their weight, blood pressure, and pulse. At this stage, I learnt how to appropriately ask the patients about their HIV status, and speak better Swahili.4) Child Wellbeing Infirmary – At this department we had to take measure the heights and weights of the babies.

I would mark on the given graphs the mass and heights recorded overtime. These graphs were pre drawn, and would help assess whether the mass and height were in the “healthy range”. Here, I also helped with organising vaccinations which were to be given according to the age of the children.Overall, the one main skill I polished up was on my Swahili communication skills. I may be unable to speak the language fluently, but I definitely have improved, compared to my previous state before joining Karura Health Centre.

3ActivitiesPharmacy:• Recording the stock of medicines available.• Recording and updating the books, of the amount of medicines which were given to the patients.• Organised the drugs into smaller packets, to allow ease of locating and simply giving the patients.

This saved time for the doctors.Patient Register:• Updated the names, national identification numbers, phone numbers, and ages of the patients.• Located in records, the existing prescription cards.

• Later updated the records, recording which patient was given specific drugs, and their specific dosages/amounts.Patient Triage:• Recorded names of patients, height, and weight.• Measured and recorded blood pressure, and pulse rates.

• Screened whether the patients were eligible for HIV/AIDs tests.• Screened patients for diagnosis of tuberculosis.Child Welfare:• Record weight of children. Attach a strap on the child which suspended them in the air, where the mass was to be taken. • Record height of children.

Here, the child was to be placed on a measuring board, and was measured in centimetres.• Plot the height and weight of the children to help assess whether the child was growing at the normal rate. 4IncidentsChild Welfare Clinic:As I worked in the child welfare clinic, there was a four year old girl, who was certain of getting her injection. She was screaming, crying and, throwing things around.

It was extremely difficult to write her details. Also, taking the height of a two year old girl, was so scared, she did not want to leave her mother. She refused to remain still, which made it hard to record her height.Staff Lack of Punctuation:The required time of arrival of staff at Karura Health Centre is agreed upon at 8:00am. Unfortunately, staff would come in later, find lots of irritated clients, and proceeded to move very slowly. Patient Triage:For a few days, the weighing machine had broken.

Clients were to have their blood pressure, pulse rates, and heights taken for proper diagnosis. This could not happen, and were asked to come back the following week. One patient got so frustrated and asked us to pay for his transport, claiming he came from very far. Luckily, the doctor had organised a mechanic to fix it.

Poor sanitation of the washroom:The main toilet of the centre was always dirty, and were extremely unhygienic. Most of us would have had to walk to Muthaiga Golf Club, where, the guards there sometimes did not allow us to enter. 5Academic AnalysisVision 2030: Healthcare services focused toward achieving the Vision 2030:• Geographical location of the healthcare centre makes it easier and available to the public.

• Accessibility of reproductive healthcare and family planning. Women were provided with free education and methods of contraception.• Promotion of partnerships, with the private sector, for example The University of Meryland, Westlands Health Centre. This enabled the clinic to get aid, during any case where they do not have the facilities to take care of emergencies. For example, surgeries.UN human rights to health care: Karura Health Centre gives respect through the following means:• Right to essential healthcare services.

• Provision of health education.• Without discrimination, provide healthcare to all those that need it.Kenyan Constitution Objectives:• Service delivery systems – Karura Health Centre ensures that equipment and other facilities are adequate to serve high numbers of patients.

• Reduction in communicable diseases – At Karura Health Centre, patients who are HIV positive are provided with free condoms, available at the dispensary, and are appropriately educated to prevent the spread of the virus.• Provision of essential health services – Medicines are always available and are not saved. The pharmacy department keeps full record of all the medicines and give patients exactly how much they need. For example, patients with HIV are given ARV’s for three months and are advised to return after three months for more.

• Health work force – The staff and doctors available on site are just enough to maintain the large number of patients coming in every day. 6Recommendation/Conclusion Doing my community service at Karura Health Centre has been a great learning experience for me. What I learnt will definitely help me in future endeavours.In my opinion, Karura Health Centre has a massive potential for growth. Growth in this institution can be boosted through the use of technology. For example, a basic computer for record keeping of client details.

They also have the physical space to beautify the environment. Using the available space, they can expand the building of the facility, to build more departments, like surgery, or a dental clinic, to accommodate the increasing number of clients coming to the centre. Finally, to get more donations, increase funding, or more recognition, Karura Health Centre can make use of existing social media platforms to boost awareness. This could help the organisation grow faster.


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