November 17th – 23rd, 2018  

SCH Physicians: Dr. Nyamogo (OB-GYN), Dr. Alwar (Paediatrics), Dr. Ligeyo (Orthopaedic

Surgery), Dr. Taha Yusufali (Surgery)

Family and Emergency Medicine Residents: Dr. Charles Ochola, Dr. Richard Luate

Pre-Intern: Dr. Emmily Koiti

Intern: None

Visiting Resident: None

Senior Research Coordinator: Joseph Owuor

Assistant Program Coordinator: None

Fellow: Dr. Sevgi Sipahi (Ob/Gyn), Dr. Ayesha Venkateswaran

Nursing Consultant: None

Visiting Consultant: None

HOSPITAL NEWS

The week kicked off in the fields with a match between SCH football club and Mindhine football  club and the scores were 3:4 respectively. Whereas, the Ladies held a march between the Juniors and the Seniors whose scores were 0:4 respectively.  This week, SCH outreach team was invited to join other service providers for a joint Outreach activity for 2 days at Ambira Sub County Hospital.The partners included MOH Siaya County,

Rotary Club of Nairobi, Beyond Zero, Ugunja Health Pillars, Ambira Sub county Hospital, Lions Eye Hospital, Sasa Harambee, Jaipur Foot, Matibabu, PATH, Amref, CHS, Kenyatta National Hospital, KEMSA, DAWA, Regal Pharmaceutical Limited, Galaxy Pharmacy, Medisel, Harleys Limited, Laboratory and Allied Limited, Cosmos and Jhpiego.

On Monday 19th SCH hosted 29 facility in charges from Gem Sub County for a sensitization meeting of Empower Health Hypertension in Pregnancy Maisha Mapya project. Also in attendance were the Dr. Felix Tindi and Ms. Zilper Imbuye the Sub County Reproductive Health Coordinator

On Tuesday and Wednesday of this week, Debora Rogo, SCH’s General Manager, who epresented the hospital in Siaya County’s Scientific Conference Planning Committee, attended a 2-day review meeting to assess how the conference went, participate in the drafting of the final report to the County’s Governor, and set the stage for policy making from the fruit born during the conference.

The Team Bid farewell to Dr. Sevgi Sipahi from MGH and wished her well in her future endeavours.

RESEARCH UPDATE

The ESM-Ketamine research team is continuing to work on several studies / manuscripts surrounding the ESM-Ketamine work. Four manuscripts reporting on ESM-Ketamine use for gynecologic operative procedures, for procedural sedation (at Siaya County Hospital), for operative orthopedic procedures and for supporting reproductive health procedures (with a focus on areas of humanitarian crisis) have been submitted for peer review. The manuscript on patient satisfaction is currently in progress. A qualitative study of Ketamine surgeons has been developed, local collaborators are being involved, and the IRB submission process has been initiated.

New research proposals are continue to develop. These include the impact of Ketamine on facilities and communities, evaluation of Ketamine use across Kenya by Residents, a descriptive paper on procedural sedation, and an ethical piece on pain control for emergency and essential surgeries in the developing world, and a cost effectiveness model of Ketamine anesthesia.

Dr. Orero and Dr. Nyamogo continue to serve as Team Leader and Assistant Team Leader, respectively.

EDUCATION

Teaching Rounds

Teaching rounds included:

â?? Continuous bladder irrigation as part of post-operative care status post prostatectomy

â?? Fluid resuscitation in upper GI bleeding

â?? Shoulder joint exam, provocative tests for impingement versus rotator cuff tear

â?? Anticoagulation, antipyretics and corticosteroids in management of ischaemic stroke

â?? Aspiration pneumonia versus pneumonitis

â?? Management of COPD versus asthma

â?? Postpartum pulmonary embolism status post Caesarean section

Residency and Internship Program Update

We continue to receive a high request of inquiries from medical officer interns applying to our internship programme and will update the team once the Kenya Medical Practitioners and Dentists Board (KMPDB) and the Ministry of Health (MOH) confirm placement of additional interns. A recent medical school graduate from South Sudan, Dr. Emmily Koiti, has joined SCH as a pre-intern and we expect addition interns and pre-interns to arrive in the coming weeks.

Hospital Education,

 The Nurses CME was led by Dr Sevgi, where the topic of discussion was Postpartum Hemorrhage. 

The clinicians have continued to have their every morning CME where, Mr. Gabriel has taken lead in Chronic Obstructive Pulmonary Disease (COPD) and Ms. Everline has taught on Hypertensive urgency and emergency.

September 29th, 2018 - October 6th, 2018

SCH Physicians: Dr. Nyamogo (OB-GYN), Dr. Alwar (Paediatrics), Dr. Ligeyo (Orthopaedic Surgery), Dr. Taha Yusufali (Surgery)

Family and Emergency Medicine Residents: Dr. Charles Ochola, Dr. Richard Luate

Interns: Leju Modi

Visiting Resident: Dr. Richa Kalra

Program Coordinator: Leslie Ojeaburu

Assistant Program Coordinator: Sebastian Karlson

Senior Research Coordinator: Joseph Owuor

Fellow: Dr. Sevgi Sipahi

Nursing Consultant: None

Visiting Consultant: None

HOSPITAL NEWS

On Saturday morning Dr. Richa Kalra finished up a video interview with the patient she has been working with over the past month (the patient was the employee’s daughter that was mentioned in the previous report). She departed from Kisumu shortly after finishing up her project. We are appreciative that she was able to stay with us for so long. Monday morning’s Nursing CME was presented by Titus Kwede and covered the topic of Maternal Perinatal Death Surveillance Report. The weekly ob/gyn clinic was co-lead by Dr. Sevgi and Dr. Nyamogo as part of the former’s orientation to SCH.

There was a simulation for the Emergency Department (ED) on Thursday morning. The scenario consisted of a patient who had been involved in a Road Traffic Accident (RTA) and was unresponsive. Dr. Modi was the lead clinician during the RRT and the simulation was lead by Sagam’s General Surgeon Dr. Taha and Javan Ibamba, CO in charge. Following the simulation both Dr. Sipahi and Joseph went to KMET where Dr. Sipahi and Dr. Nyamogo held their OB/GYN clinic as part of the former’s orientation.

In addition to everything listed before, SCH has launched a new research initiative called Maisha Mapya, in collaboration with Medtronic Labs, which is an extension of the Empower Health app initiative that digitizes monitoring of high blood pressure.. This innovative venture will test whether wearables (worn on one's wrist) can be used to measure vital signs in pregnant women. If there is an abnormal measurement, a signal is sent through the software to a clinical team for follow up. For a pregnant mother, her blood pressure measurements and vital signs are closely monitored during antenatal (ANC) visits as part of the care she needs during her pregnancy. We wish to see if these wearable can monitor their vitals between ANC visits or assist expectant mothers who are located far away from health facilities or cannot afford to access such care. It would further empower women to be engaged in their care and improve health education, thus, improve adherence to ANC appointments, which are now fully covered by the Kenyan government under the 'Linda Mama' initiative. 

We shall also be testing this app in our maternal clinic so we can use technology to monitor the gestation period for our mothers. As part of the initiative, Medtronic Labs has trained SCH administration, clinical, nursing and community health staff as members of the project.

EDUCATION

Teaching Rounds: Teaching rounds will commence the week of October 1st.

Residency and Internship Program Update

We continue to receive a high request of inquiries from medical officer interns applying to our internship programme and will update the team once the Kenya Medical Practitioners and Dentists Board (KMPDB) and the Ministry of Health (MOH) confirm placement of additional interns. A recent medical school graduate from Uganda, Leju Modi, has joined SCH and we expect addition interns and pre-interns to arrive in the coming weeks.

Hospital Education

Last week’s hospital wide CME featured two groups of guest presenters. The first presenter was from Kannina International LTD, a specialist medical and diagnostic centre. They showcased the range of tests that their centre has to offer, fielding questions on both the cost to the patients and the efficacy of these tests. This was followed by a presentation from Shaaban Levi, an AstraZeneca representative, who went through the benefits of Symbicort, an inhalant indicated for asthma and COPD.

The nurses CME was the start of a multi part CME (it will take place over the course of a few weeks) on infant and child care in Kenya. These CME’s will all be presented by one of SCH’s nurses, Cecillia. The focus of the CME are to recognize danger signs in infants and children under the age of 5 to help reduce the statistic that for every 1000 births in Kenya 52% of children die before the age of 5.

September 14th, 2018 - September 21st, 2018

SCH Physicians: Dr. Nyamogo (OB-GYN), Dr. Alwar (Paediatrics), Dr. Ligeyo (Orthopaedic Surgery), Dr. Taha Yusufali (Surgery)

Family and Emergency Medicine Residents: Dr. Charles Ochola, Dr. Richard Luate

Interns: Leju Modi

Visiting Resident: Dr. Richa Kalra

Program Coordinator: Leslie Ojeaburu

Assistant Program Coordinator: Sebastian Karlson

Fellow: None

Nursing Consultant: None

Visiting Consultant: None

HOSPITAL NEWS

This week was a busy and fulfilling week for Sagam and AIHT. Siaya County held its first Annual Scientific Conference that was held between September 18th - 20th, 2018 at Jaramogi Oginga Odinga University of Science and Technology in Bondo Town, Siaya. Before the team took off for the conference, they were joined by the Prof. Pankaj Jani, the President of the College of Surgeons for Central, Eastern and Southern Africa (COSECSA), Dr. Jaymie Henry and Dr. Prem Yohannan, who joined us from Mozambique. After a tour of Sagam, the team embarked together to the conference, where Dr. Rogo, Prof. Jani and AIHT were set to speak and present. They joined Dr. Rogo in meetings that morning with Hon. Dorothy Owino, the County Executive Committee Member for Health (Minister for Health) in Siaya County in regard to supporting the training of surgeons in Siaya County.

The conference featured abstracts from organizations like Centre for Health Solutions, Kenya Medical Research Institute, CDC, KMET, Jaramogi Odinga Oginga University of Science and Technology, and AIHT. During the first day, Dr. Khama Rogo was the keynote speaker, addressing the crowd of over 400 attendees from all throughout Siaya. In his speech, he challenged the members of Siaya to invest more in the intellectual resources at their disposal. He highlighted the rich scholarly history of members of Siaya and encouraged the county leadership to build on these individuals to promote investment in Siaya’s health infrastructure. The Deputy Governor of Siaya, Hon Wilson Ouma Onyango, also addressed the crowd ensuring participants that though this may be the first conference of its kind in Siaya, it certainly would not be the last. At the end of the opening ceremony all participants dispersed, some to abstract discussions and others to symposium presentations. The KMET and Sagam staff set up their booth in preparation for the next two days of the conference.

The second day of the conference was light, with members of AIHT displaying the research that all of AIHT’s partners (e.g., Medtronic labs, Pharmacess, Sagam Hospital, MGH, KMET) have been working on. Visitors seemed primarily interested in the Ketamine training program and the Family and Emergency Medicine (FEM) residency program. This conferences provided ample opportunity to identify individuals interested in participating in AIHT’s programs or in Sagam’s outreaches. Throughout the day, Sagam and KMET staff also spent time preparing the presentations for the symposium the next day.

The third and final day of the conference featured presentations from AIHT. It began with two sessions, one on “Using Innovative Mobile-based Technology to Bridge the Gaps in Chronic Disease Management” by Medtronic and another by Pharmaccess called “The Innovative Health Exchange Platform M-Tiba Can Help Leapfrog Access to Better Care in Western Kenya”. This was followed by an AIHT-hosted symposium on “Innovating for Universal Health Coverage”. This meeting was moderated by Debora Rogo (SCH) with presentations from Dr. Nyamogo, FEM Resident Dr. Luate Richard, FEM Resident Dr. Charles Ochola, Ms. Brenda Achieng (KMET), Washington Dinga (Medtronic Labs), Debora Rogo and Mr. Javan Imbamba (SCH).

Members of the audience were impressed by the volume of work produced through AIHT’s partner organizations but sought to understand the public partnerships that AIHT has formed to guide its emergency care center and rapid resuscitation team.

Wednesday morning started out with our visiting Resident, Dr. Richa Kalra, giving a fantastic presentation on how to identify and treat psychiatric patients. She was able to engage everyone who attended the CME for the whole of the presentation.

After the completion of the CME the outreach team set out early to head to Ulumbi, a small town in the Yala area. This outreach was very special to one of our SCH staff members, Dorothy, who organized the outreach at her home town. We set up the trailer between a church and a primary school at around 9:00 AM and were seeing patients.

On Wednesday, we welcomed the Medtronic Labs team to help launch the Maisha Mapya pilot programme at Sagam. There they trained teams of Community Health Volunteers to use the new app for patient blood pressure monitoring.

Friday morning we had our second ED scavenger hunt of the month. The turn out for this one was better than the first. We managed to increase the participants from 6 to 11 respectively. The hunt consisted of 4 teams searching for eight different items around the Emergency Department. The winner was determined by the fastest and most accurate team. This hunt was won by our Nurse Titus and Christine who finished in 5 minutes and 36 seconds and got a near perfect score (only lost half a mark on one question). 

On Friday evening, part of the AIHT team launched the online Continuous Professional Development (CPD) online platform for medical doctors at the offices of the Kenya Medical Practitioners and Dentists Board (KMPDB). This online platform is hosted on AIHT’s website and was set up in collaboration with McMaster University’s Machealth platform and Witwatersrand University to offer intensive courses written by clinicians for clinicians. Overall the event was very successful with the CEO of KMPDB (Kenya Medical Practitioners and Dentist Board) Dr. Daniel Yumbya and and the Chair of Kenya Medical Association, Dr. Jackie Kitulu in attendance.

EDUCATION

Teaching Rounds: Dr. Taha is on planned leave until September 21st, 2018. . Teaching rounds will continue upon his return.

Residency and Internship Program Update

We continue to receive a high request of inquiries from medical officer interns applying to our internship programme and will update the team once the Kenya Medical Practitioners and Dentists Board (KMPDB) and the Ministry of Health (MOH) confirm placement of additional interns. A recent medical school graduate from Uganda, Leju Modi, has joined SCH and we expect addition interns and pre-interns to arrive in the coming weeks.

Hospital Education

The hospital-wide CME last week was lead by visiting psychiatry resident Richa who lead a discussion on identifying and treating patients. Clinical CMEs have been modified to be interactive sessions on specific diseases. Each day of the week our clinicians have been going through an image/clinical finding of the day lead by Dr. Taha and in the next few weeks our clinicians will attend ATLS sessions to increase comfort with trauma management.

September 7th, 2018 - September 14th, 2018

SCH Physicians: Dr. Nyamogo (OB-GYN), Dr. Alwar (Paediatrics), Dr. Ligeyo (Orthopaedic Surgery), Dr. Taha Yusufali (Surgery)

Family and Emergency Medicine Residents: Dr. Charles Ochola, Dr. Richard Luate

Interns: Leju Modi

Visiting Resident: Dr. Richa Kalra

Program Coordinator: Leslie Ojeaburu

Assistant Program Coordinator: Sebastian Karlson

Fellow: None

Nursing Consultant: None

Visiting Consultant: None

HOSPITAL NEWS

Last week was a quiet one at AIHT with the administrative staff and program coordinators hard at work finalizing logistics for the Siaya scientific conference. Currently the division has 11 abstracts in the program. Ten of these will be presented at length through the symposium discussion and scientific sessions on Thursday of this week. This conference brings together over six different partner organizations, including KMET, Medtronic, Maseno University, MGH Division of Global Health and Human Rights, Sagam Community Hospital, and M-TIBA.

EDUCATION

Teaching Rounds: Dr. Taha is on planned leave until the end of September. Teaching rounds will continue upon his return.

Residency and Internship Program Update

We continue to receive a high request of inquiries from medical officer interns applying to our internship programme and will update the team once the Kenya Medical Practitioners and Dentists Board (KMPDB) and the Ministry of Health (MOH) confirm placement of additional interns. A recent medical school graduate from Uganda, Leju Modi, has joined SCH and we expect addition interns and pre-interns to arrive in the coming weeks.

Hospital Education

The nursing CME was lead by Titus Kwede who presented the first half of a two part series on maternal and perinatal death. The hospital-wide CME this week was lead by Abella and Lynette from KMET who discussed spillage cleanup and preventing infections in the hospital setting. Clinical CMEs have been modified to be interactive sessions on specific diseases. Each day of the week our clinicians have been going through an image/clinical finding of the day lead by Dr. Taha, and in the next few weeks our clinicians will attend ATLS sessions to increase comfort with trauma management.

August 31st, 2018 - September 7th, 2018

SCH Physicians: Dr. Nyamogo (OB-GYN), Dr. Alwar (Paediatrics), Dr. Ligeyo (Orthopaedic Surgery), Dr. Taha Yusufali (Surgery)

Family and Emergency Medicine Residents: Dr. Charles Ochola, Dr. Richard Luate

Interns: Leju Modi

Visiting Resident: Dr. Richa Kalra

Program Coordinator: Leslie Ojeaburu

Assistant Program Coordinator: Sebastian KarlsonFellow: None

Nursing Consultant: None

Visiting Consultant: None

HOSPITAL NEWS

Sagam was bustling with activity this week as everyone welcomed the Kombewa team for a week of Ketamine training. The week started off slowly due to delays from the ministry of health that lead to only Benjamin Modi, the Sagam medical officer intern, administering Ketamine for three gynecological cases conducted by Dr. Nyamogo on Monday. However, by Tuesday the Kombewa team was at Sagam Community Hospital bright and early in the morning, ready to learn. They took their preassessment test and listened to the Ketamine training presentation delivered by Javan. Afterwards, they were taken to the theater where they administered Ketamine in pairs for a diverse array of procedures including an emergency C/S, three herniorrhaphies, and an excision of a lymph node. The C/S was performed by Dr. Okeyo, a visiting medical officer and medical superintendent from Kombewa, along with Benjamin Modi. Dr. Taha performed the other cases for that day.

The next day, Javan gave the Helping Babies Breath presentation. This knowledge was quickly put to use with another emergency C/S in theater with the participants again providing Ketamine in pairs. That day participants also administered Ketamine for a TAH, laparotomy exploration that led to excision of an ovarian tumor, and a bilateral tubal ligation. On Thursday, Day 4, the participants took their post assessment quiz. Despite limited time to absorb the material fully, the majority of providers passed the assessment, with only one provider having to retake the assessment. The participants then had the opportunity to be the sole Ketamine providers during two C/S cases, a herniorrhaphy, and a skin grafting procedure.

By Friday, the participants were feeling confident as providers and started the day in the theater administering Ketamine for a prostatectomy, an epigastric herniorrhaphy, a TAH, and the evacuation of a molar pregnancy. In the afternoon the participants returned to the AIHT room where they went over the answers to the assessment exam and received certificates indicating their proficiency administering Ketamine in emergency procedures. After cake and a final round of photos, the week was over. Participants expressed enthusiasm for this training during the course of the week.

The clinical officer anesthetist from Kombewa that was observing this week mentioned that he was pleasantly surprised that Ketamine was able to be successfully administered for long procedures like the TAHs performed by Dr. Nyamogo. Though he still desired a longer training period to improve preparation for complications and he still wanted Ketamine to be placed in ministry policy, he also believed that being able to provide Ketamine during an emergency when an Anesthetist can’t be reached was very beneficial. Along with the anesthetists’ comments, one of the COs also mentioned that he and another CO trainee from Kombewa were now interested in getting further training as Anesthetist to enable them to better manage complications and administer more advanced anesthetics for complex procedures. We thank the Kombewa team for participating in this training and the full Sagam team for their hard work this week.

While all of this was going on, the ED department was busy improving their response to RRTs with an ED scavenger hunt held on Friday. Six members of the team participated in this event that placed teams of two against one another to accurately and quickly describe the location of key equipment and drugs that might be used during a rapid response. The winner of this scavenger hunt was the CO team of Brillian and Gabriel. They will receive a prize from the Sagam leadership team and will have their achievement immortalized in a photo in the ED department. Scavenger hunts and simulations are parts of the RRT preparation and readiness training program designed by Dr. Hiren Patel, Joseph Owur, and other fellows/team members at the Division of Global Health and Human Rights at MGH.

Present for this very busy week was Dr. Richa Kalra, a psychiatry resident from New York. She joined the Sagam team on Monday as a visiting physician. In the time she will be at SCH, she aims to learn about the mental health resources currently available in Sagam. She will also work to improve the pharmacy’s capacity to treat major psych cases and train clinicians and nurses on how to identify a psych emergency. In addition, she will be working with KMET and Dr. Sevgi Sipahi to understand the KMET model for responding to cases of Gender Based Violence (GBV). With this knowledge she hopes to set the groundwork for improving the resources available to victims of GBV in Sagam and hopes to create an advocacy film featuring GBV survivors. Mental illness and GBV are very prevalent within communities like Sagam. Many times these cases go unseen and untreated due to a lack awareness and/or limited capacity to address these complex cases. This makes Dr. Richa Kalra’s work particularly important for members of Sagam.

On Friday, SCH received a meeting from a national and regional team from the National Hospital Insurance Fund (NHIF) to review how services were going at the hospital and learn of the challenges we were experiencing. Led by NHIF Board Member, Akelo Misori, they were able to learn about the services we provide at Sagam, our experience with the new schemes like Linda Mama and secondary students cover as well as other challenges we are facing as a NHIF accredited hospital.

EDUCATION

Teaching Rounds

- Spontaneous Hemothorax

- Esophageal Injuries and Management

- Neck Masses Differentiation and Management

- Thyroid Diseases

- Treatment of Severe Pneumonia

- Rheumatoid Fever

- Blunt Abdominal Injuries

- Management of Severe Burns

- Intussusception

- Chronic Leg Wounds

- Skin Malignancies

Hospital Education

There was no hospital-wide or nursing CME this week due to Ketamine week. Clinical CMEs have been modified to be interactive sessions on specific diseases. Each day of the week our clinicians have been going through an image/clinical finding of the day lead by Dr. Taha and in the next few weeks our clinicians will attend ATLS sessions to increase comfort with trauma management.

August 24th, 2018 - August 31st, 2018

SCH Physicians: Dr. Nyamogo (OB-GYN), Dr. Alwar (Paediatrics), Dr. Ligeyo (Orthopaedic Surgery), Dr. Taha Yusufali (Surgery)

Family and Emergency Medicine Residents: Dr. Charles Ochola, Dr. Richard Luate

Interns: Leju Modi

Visiting Resident: None

Program Coordinator: Leslie Ojeaburu

Assistant Program Coordinator: Sebastian Karlson

Fellow: None

Nursing Consultant: None

Visiting Consultant: None

HOSPITAL NEWS

Four members of the Medtronic Labs team were in Sagam on Monday, August 27th till Wednesday, August 29th, helping to supervise continued research on blood pressure monitoring and prevention. They worked closely with the outreach team, screening members of Gem county along with Sagam’s community health volunteers.

They also participated in last week’s outreach in Ugunja. As part of their visit, they accompanied SCH management team to Siaya County to meet the Siaya County Health Management Team (CHMT) to sensitize them on our upcoming pilot progamme, Maisha Mapya, that will be testing the ability of wearable bands to monitor blood pressure and other key vitals in pregnant women. The pilot, being implemented at Sagam is set to begin in September and will last for one year targeting pregnant women in our ANC clinics and the surrounding community using our community health workers as a key component in monitoring the mothers. We look forward to implementing this important project and improving health outcomes for our mothers. 

Additionally, there was a blood drive held in the Sagam Community Hospital courtyard. Most of the Sagam staff offered blood to support surgeries and procedures around Siaya County.

The ESM-Ketamine team began preparations for the next ESM-Ketamine Week to be held from September 3 - 7, 2018. The training will target healthcare providers from Kombewa Sub-County Hospital in Kisumu County as part of the county’s efforts to improve quality of care in its public institutions; Kisumu is one of four counties in Kenya that has recently implemented universal health coverage (UHC) for all of its residents.

Hon. (HE) Anyang’ Nyong’o, the governor of Kisumu County, has been engaging with Sagam on how to support this effort in improving the care of health facilities in the County. Dr. Khama Rogo, founder of SCH, has been supporting this effort with support from Pharmaccess Foundation, which resulted in the County’s interest in ensuring that Kombewa Sub-County Hospital is able to provide quality surgical services, especially for their mothers. Many thanks to the team, Kisumu County leadership and Pharmaccess Foundation for their support of the upcoming training.

EDUCATION

Teaching Rounds (This Week and Previous Week)

- Spontaneous Hemothorax

- Esophageal Injuries and Management

- Neck Masses Differentiation and Management

- Thyroid Diseases

- Treatment of Severe Pneumonia

- Rheumatoid Fever

- Blunt Abdominal Injuries

- Management of Severe Burns

- Intussusception

- Chronic Leg Wounds

- Skin Malignancies

Residency and Internship Program Update

We continue to receive a high request of inquiries from medical officer interns applying to our internship programme and will update the team once the Kenya Medical Practitioners and Dentists Board (KMPDB) and the Ministry of Health (MOH) confirm placement of additional interns. A recent medical school graduate from Uganda, Leju Modi, has joined SCH and we expect addition interns and pre-interns to arrive in the coming weeks.

Hospital Education

There was a hospital-wide CME by Javan Imbamba on drug resistance. The weekly nurses CME was lead by Faith, who gave a presentation on molar pregnancy. Benta from the records department also shared a new Daily Recording sheet to improve data collection on patient flow. Clinical CMEs have been modified to be interactive sessions on specific diseases. Each day of the week our clinicians have been going through an image/clinical finding of the day lead by Dr. Taha and in the next few weeks our clinicians will attend ATLS sessions on Thursday to increase comfort with trauma management.

June 15th, 2018 - June 22nd, 2018

SCH Physicians: Dr. Nyamogo (OB-GYN), Dr. Alwar (Paediatrics), Dr. Ligeyo (Surgery), Dr. Taha Yusufali (Surgery)

Family and Emergency Medicine Residents: Dr. Charles Ocholla, Dr. Richard Luate

Interns: None

Program Coordinator: Phoebe Kelleher and Leslie Ojeaburu

Assistant Program Coordinator: Sebastian Karlson

Fellow: None

Nursing Consultant: Elise Perkins, RN

Visiting Consultant: None

HOSPITAL NEWS

This week Sagam was visited by a representative of the West Kenya Comprehensive Cancer Care Centre. They were looking to further build collaboration with Sagam hospital, improve the health records and information services system, and introduce Trustedocter, a collaborative platform linking clinicians around the world.

EMERGENCY DEPARTMENT UPDATE

The electronic medical record system continues to be working well. Our EMR upgrade is currently in progress. The updates will occur in three phases throughout the month which will include updating the EMR interphase, adding an import/export option for data collection, implementing reporting tools for the system, and allowing domain access to the EMR system. The first phase of the EMR integration, updating the EMR interface, has been complete. The second phase, adding an import/export option for data collection, is currently being worked on. Our EMR update is underway and should be completed within the next month. We are working on creating a separate phone line for incoming referral calls from other facilities; this line will be handled by the nurse covering in the Emergency Department.

EDUCATION

Teaching Rounds

- Injuries to the knee joint

- Spine injuries

- Hematuria management

- Prostate disease management

- Breast abscess

- Burns

Hospital Education

Kelsey, a nursing assistant visiting Sagam for the past two months, gave the nursing CME presenting on hand washing. Esther, a Sagam nurse, gave a hospital-wide CME this week on prenatal care. As requested by the clinicians, clinical CMEs will no longer occur on Fridays and will now be spread throughout the week until the return of our fellows.

June 8th, 2018 - June 15th, 2018

SCH Physicians: Dr. Nyamogo (OB-GYN), Dr. Alwar (Paediatrics), Dr. Ligeyo (Surgery), Dr. Taha Yusufali (Surgery)

Family and Emergency Medicine Residents: Dr. Charles Ocholla, Dr. Richard Luate

Interns: None

Program Coordinator: Phoebe Kelleher and Leslie Ojeaburu

Assistant Program Coordinator: Sebastian Karlson

Fellow: None

Nursing Consultant: Elise Perkins, RN

Visiting Consultant: None

HOSPITAL NEWS

We  at Sagam welcomed back Phoebe Kelleher, our veteran Program Coordinator, after her three week trip to the U.S. for a wedding. Her warm presence has been a staple for 7-months and we can’t wait to see the impact she will have on her final six-week tour through Sagam before grad-school.

Our visiting nurse has successfully implemented a new reporting sheet in the wards to improve prioritization and communication between shifts. We hope this organizational tool will make for more streamlined patient management.

Between June 11th and 13th, Sagam/AIHT welcomed Medtronic Labs as we continued finalizing preparations to launch a pilot on Hypertension in Pregnancy. As part of the effort, the Medtronic Labs team observed our ob/gyn clinic led by Dr. Nyamogo. In addition, they worked with Juddy, our Administrative Manager, Elizabeth, our Head Nursing Officer and Cecilia, the Nurse in Charge of our Maternal and Child Unit. In addition, they accompanied our community health workers on some of their home visits to observe some of their maternal patients.

EMERGENCY DEPARTMENT UPDATE

The electronic medical record system continues to be working well. Our EMR upgrade is currently in progress. The updates will occur in three phases throughout the month which will include updating the EMR interphase, adding an import/export option for data collection, implementing reporting tools for the system, and allowing domain access to the EMR system. The first phase of the EMR integration, updating the EMR interface, has been complete. The second phase, adding an import/export option for data collection, is currently being worked on. Our EMR update is underway and should be completed within the next month. We are working on creating a separate phone line for incoming referral calls from other facilities; this line will be handled by the nurse covering in the Emergency Department.

EDUCATION

Teaching Rounds

- Injuries to the knee joint

- Spine injuries

- Hematuria management

- Prostate disease management

- Breast abscess

- Burns

Hospital Education

Dr. Taha delivered a presentation on post-op wound care and surgical site infections at this week’s nursing CME. At the hospital-wide CME, clinical officer Donald Ameta gave the first of several lectures on bCPAP implementation. As requested by the clinicians, clinical CMEs will now be spread out throughout the week and will no longer occur on Fridays until a fellows return.

May 25th, 2018 - June 1st, 2018
 
SCH Physicians: Dr. Nyamogo (OB-GYN), Dr. Alwar (Paediatrics), Dr. Ligeyo (Surgery), Dr. Taha Yusufali (Surgery)
Family and Emergency Medicine Residents: Dr. Charles Ocholla, Dr. Richard Luate
Interns: None
Program Coordinator: Phoebe Kelleher and Leslie Ojeaburu
Assistant Program Coordinator: Sebastian Karlson
Fellow: None
Nursing Consultant: Elise Perkins, RN
Visiting Consultant: None
 
HOSPITAL NEWS
This past week was a very busy one for AIHT with the USAID teams visit and Ketamine Training Week at Sagam Community Hospital. On Friday May 25th, Monica and the team from KMET welcomed Dr. Thomas Burke, Moytrayee Guha, and Alicia Lightbourne from MGH along with a team from USAID, Venture Well, and ELMA. The team learned about the work KMET does to improve maternal health and empower Kenyan women. They were also able to meet the Deputy Governor of Kisumu, Dr. Matthew Ochieng Owili, to discuss the relationships KMET has built with local government.
Afterwards Monica and the rest of KMET directed everyone to JOORTH, where the team took a guided tour of the maternal ward and learned about the challenges faced in Kisumu’s largest referral hospital. The day ended with a presentation on the implementation of the UBT kits by Monica and an overview of the planned UBT research by Moytrayee.
On Saturday, MGH proceeded to hold a ESM-UBT and ESM-Ketamine Retreat with staff from KMET and SCH, respectively to discuss the status of both projects.
On Sunday, the USAID team and MGH leadership reconvened at Sagam Community Hospital where General Manager Debora Rogo highlighted Sagam’s rich history serving the local community and lead the team on a tour of the facility. In the afternoon, ESM-NRB champion Donald Ameta and trainer Julius Adika, were able to showcase the ESM-NRB implementation efforts in Siaya county. The presentation and demonstration were meet with enthusiasm by USAID and everyone in the room. This was a true testament to the importance of this intervention in reducing infant mortality.
Monday marked the first day of Ketamine Week training lead by Javan, Wenslaus, Juma, and Debora. The AIHT room was filled with teams from three facilities in Turkana, along with USAID and the MGH leadership team. Together they learned about Ketamine implementation and observed their first set of surgeries performed by Dr. Taha. The week proceeded with additional surgeries performed by Dr. Taha, Dr. Nyamogo, and Dr. Ligeyo, with the support of the Sagam theater team and under the watchful eyes of Wenslaus, Javan, and Juma. On Friday, a festive graduation ceremony was held and 6 additional providers were added to the ESM-Ketamine team, our first set from Turkana but likely not the last. Additional information about the week will be provided in the May Ketamine Week report.
 
 EDUCATION
 Teaching Rounds
-  Pulmonary embolism
-  Upper GI bleed
-  Hyperkalemia and its management
-  Animal bites
-  Management of malignant ascites
-  Liver cirrhosis
-  Patella fracture
-  Osteomyelitis
 Residency and Internship Program Update
 We continue to receive a high request of inquiries from medical officer interns applying to our internship programme and will update the team once the Kenya Medical Practitioners and Dentists Board (KMPDB) and the Ministry of Health (MOH) confirm placement of additional interns.
 Hospital Education
 No nursing, clinical, or hospital wide CME was held this week due to Ketamine Week.

May 4th, 2018 - May 11th, 2018

SCH Physicians: Dr. Nyamogo (OB-GYN), Dr. Alwar (Paediatrics), Dr. Ligeyo (Surgery), Dr. Ouma (Family Medicine) Dr. Taha Yusufali (Surgery)

Family and Emergency Medicine Residents: Dr. Charles Ocholla, Dr. Richard Luate Interns:

Program Coordinator: Phoebe Kelleher and Leslie Ojeaburu

Assistant Program Coordinator: Sebastian Karlson Fellow:

Nursing Consultant: Elise Perkins, RN

Visiting Consultant: Dr. Meiling Liu

HOSPITAL NEWS

This week the Christian Health Association of Kenya (CHAK) recognized Sagam Community Hospital for reaching our blood pressure screening targets. We are proud of our entire outreach team, especially Wenslaus, Cecelia, Elizabeth, and Dorothy, for their continued dedication to providing basic health care services to our surrounding communities.

In addition to the success of our blood pressure screenings during outreach, we are also teaming up with Medtronics to improve our screening targets here at Sagam. A team from Medtronic Labs visited this week during our NCD clinic to provide training and support on the new technology.

EDUCATION

Teaching Rounds

-Reviewed CXR for pneumothorax, necrotizing fasciitis, pneumoperitoneum.

- Cardiac ultrasound for pericardial effusion/tamponade

- Atrial fibrillation management

- Stroke management

- STEMI EKG

Hospital Education

Our visiting nurse, Elise Perkins, taught her first nurse’s CME this week on vital signs. Kashmir and the Theatre team on scrubbing procedures presented our Hospital-wide CME. Our clinical CME was taught by visiting physician Dr. Meiling Liu and focused on stroke care and atrial fibrillation.

April 20th, 2018 - April 27th, 2018

SCH Physicians: Dr. Nyamogo (OB-GYN), Dr. Alwar (Paediatrics), Dr. Ligeyo (Surgery), Dr. Ouma (Family Medicine) Dr. Taha Yusufali (Surgery)

Family and Emergency Medicine Residents: Dr. Charles Ocholla, Dr. Richard Luate Interns:

Program Coordinator: Phoebe Kelleher

Fellow: Dr. Ayesha Venkateswaran

HOSPITAL NEWS

This week Sagam Community Hospital welcomes an Emergency RN, Elise Perkins. Elise joins us from Massachusetts General Hospital, and will be here in Sagam for the next two months to provide teaching and consulting to our nursing staff. We’re excited to see all that she is able to accomplish during her time here.

This week also marks the end of Dr. Ayesha Venkateswaran’s first trip to Sagam as a part of the MGH Global Health Fellowship. Throughout her time here, she taught our clinicians many new skills including EKG and x-ray reading, musculoskeletal physical exam, integrative care practices and judicious use of health care resources. Dr. V has become a valued member of our team here, and we look forward to having her join us again in the autumn!

We also received a visit from the Reproductive Health team from Moi Teaching and Referral Hospital led by their ob/gyn, Dr. Liko Joseph. They were paying a courtesy visit as part of outreach to hospitals that refer patients to their hospital for further comprehensive care. We discussed further aspects of collaboration including training, research and referral.

EDUCATION

Teaching Rounds

- sickle cell anaemia

- acute urinary retention, obstructive uropathy

- acute kidney injury

- orchitis

- adverse effects of HIV antiretroviral therapy

- opportunistic infections in HIV/AIDS

- pulmonary and extrapulmonary TB

- appendicitis

- enteric (typhoid) fever

- H. pylori infection and peptic ulcer disease

- peripheral neuropathy

- trigeminal neuralgia

- delayed lactogenesis, galactagogues

- breast engorgement

- postpartum haemorrhage

Hospital Education

This week’s clinical CME took the form of a case study about ACE-inhibitors for hypertension management in CHF and DM and was led by Dr. Venkat.

April 13th, 2018 - April 20th, 2018

SCH Physicians: Dr. Nyamogo (OB-GYN), Dr. Alwar (Paediatrics), Dr. Ligeyo (Surgery), Dr. Ouma (Family Medicine) Dr. Taha Yusufali (Surgery)

Family and Emergency Medicine Residents: Dr. Charles Ocholla, Dr. Richard Luate Interns:

Program Coordinator: Phoebe Kelleher

Fellow: Dr. Ayesha Venkateswaran

HOSPITAL NEWS

AIHT and Sagam Community Hospital continue to train new providers on ESM-NRB in facilities throughout Siaya county. This week we visited Ambira Sub-County Hospital, where we were able to successfully train 13 new providers. We look forward to completing two additional trainings, at Bondo Sub-County Hospital and Yala Sub-County Hospital over the next two weeks.

This week, SCH welcome back Mr. Washington Dinga from Medronic Labs to assist our staff in integrating the new programme and equipment into our NCD clinic and pharmacy. The Empower Health digital programme assists in managing hypertensive patients by tracking their BP measurements, managing drug prescriptions, and allowing clinicians to send text messages to patients through the portal. During his time at Sagam on Wednesday and Thursday, Mr. Dinga re-trained our nurses, clinicians and community health workers (CHWs) on the platform on the programme tablets and smartphones. He also observed enrollment of patients in the NCD clinic and in the pharmacy. 

SCH visited the village of Sawagongo for our weekly community outreach. The clinical team was able to  patients for services including blood pressure checks, HIV testing, cervical cancer screenings, and family planning services. SCH would like to extend thanks for the sponsors for this week: CHAK, M-TIBA, Jhpiego, the Rotary Club of Sagam, and KME.

EDUCATION

Teaching Rounds

- shoulder dislocation and reduction

- hyperkalaemia

- preeclampsia

- VTE and anticoagulation

- umbilical and inguinal hernias

Hospital Education

Our hospital-wide CME was presented by the emergency department and Dr. Taha as an RRT simulation this week. Our clinical CME was taught by Dr. Ayesha Venkateswaran as a case study focusing on reading chest x-rays and paediatric TB diagnosis and treatment. Elizabeth “Matron” Ogada lead the nurse’s CME on post-abortion care.

March 16, 2018 - March 23, 2018

SCH Physicians: Dr. Nyamogo (OB-GYN), Dr. Alwar (Paediatrics), Dr. Ligeyo (Surgery), Dr. Ouma (Family Medicine)

Family and Emergency Medicine Residents: Dr. Charles Ochola, Dr. Richard Luate

Interns: -

Program Coordinator: Phoebe Kelleher

Fellow: Dr. Ayesha Venkateswaran

HOSPITAL NEWS

Sagam Community Hospital completed our first KetamineTraining Week of 2018! We welcomed trainees from Lodwar County and Referral Hospital in Turkana, Victoria Hospital in Prince Albert Canada, and two of our own clinicians. Over the course of the week we were able to complete over 20 procedures under the use of Ketamine. We also implemented a new pilot assessment program developed by Dr. Sebastian Suarez at the Division of Global Health and Human Rights at Massachusetts General Hospital.

This week, we were joined by Dr. Tanya Rogo, the Associate Program Director, Department of Pediatrics, Bronx-Lebanon Hospital Center (New York, USA) and Clinical Assistant Professor of Pediatrics, Icahn School of Medicine at Mount Sinai. This was her second visit to Sagam to provide guest lecturers to our residents. 

We want to thank the many members of Sagam Community Hospital that helped accomplish this successful training week, especially our surgical staff, kitchen staff, our anesthetist Juman Jaqtone, and our trainers, clinical officers Javan Imbamba and Wenslaus Adenya.

EMERGENCY DEPARTMENT UPDATE

The electronic medical record system continues to be working well. An EMR update is scheduled to take place, and it is to be determined. 

The updates will occur in three phases throughout the month which will include updating the EMR interface, adding an import/export option for data collection, implementing reporting tools for the system, and allowing domain access to the EMR system. The first phase of the EMR integration, updating the EMR interface, has been complete. The second phase, adding an import/export option for data collection, is currently postponed until further notice.

EDUCATION

Teaching Rounds

• Keloid scars
• Sickle cell crisis
• CXR interpretation
• Postpartum haemorrhage
• Neonatal hypoglycemia

Residency and Internship Program Update

The interns continue to work together to adjust their schedules to optimize their learning experiences and exposure to the consultants. They have been refining their schedules to optimize everyone's exposure to all the rotations. They look forward to welcoming a new consultant next week.

Virtual e-learning classes taught by Dr. Hiren Patel will resume classes shortly.

We continue to receive a high request of inquiries from medical officer interns applying to our internship programme and will update the team once the Kenya Medical Practitioners and Dentists Board (KMPDB) and the Ministry of Health (MOH) confirm placement of additional interns.

Drs. Luate and Ochola received guest lecturers from Dr. Tanya Rogo.

Hospital Education

At our nurse’s CME this week, we welcomed back a team from KMET for a presentation on early childhood development with an emphasis on clinician care. Our hospital-wide and clinical CME were both postponed this week due to the KetamineTraining Week.

March 16 - March  23, 2018

SCH Physicians: Dr. Nyamogo (OB-GYN), Dr. Alwar (Paediatrics), Dr. Ligeyo (Surgery), Dr. Ouma (Family Medicine)

Family and Emergency Medicine Residents: Dr. Charles Ochola, Dr. Richard Luate

Interns: -

Program Coordinator: Phoebe Kelleher

Fellow: Dr. Ayesha Venkateswaran

HOSPITAL NEWS

Sagam Community Hospital completed our first KetamineTraining Week of 2018! We welcomed trainees from Lodwar County and Referral Hospital in Turkana, Victoria Hospital in Prince Albert Canada, and two of our own clinicians. Over the course of the week we were able to complete over 20 procedures under the use of Ketamine. We also implemented a new pilot assessment program developed by Dr. Sebastian Suarez at the Division of Global Health and Human Rights at Massachusetts General Hospital.

This week, we were joined by Dr. Tanya Rogo, the Associate Program Director, Department of Pediatrics, Bronx-Lebanon Hospital Center (New York, USA) and Clinical Assistant Professor of Pediatrics, Icahn School of Medicine at Mount Sinai. This was her second visit to Sagam to provide guest lecturers to our residents. 

We want to thank the many members of Sagam Community Hospital that helped accomplish this successful training week, especially our surgical staff, kitchen staff, our anesthetist Juman Jaqtone, and our trainers, clinical officers Javan Imbamba and Wenslaus Adenya.

EMERGENCY DEPARTMENT UPDATE

The electronic medical record system continues to be working well. An EMR update is scheduled to take place, and it is to be determined. The updates will occur in three phases throughout the month which will include updating the EMR interface, adding an import/export option for data collection, implementing reporting tools for the system, and allowing domain access to the EMR system. The first phase of the EMR integration, updating the EMR interface, has been complete. The second phase, adding an import/export option for data collection, is currently postponed until further notice.

EDUCATION

Teaching Rounds

Keloid scars

Sickle cell crisis

CXR interpretation

Postpartum haemorrhage

Neonatal hypoglycemia

Residency and Internship Program Update

The interns continue to work together to adjust their schedules to optimize their learning experiences and exposure to the consultants. They have been refining their schedules to optimize everyone's exposure to all the rotations. They look forward to welcoming a new consultant next week.

Virtual e-learning classes taught by Dr. Hiren Patel will resume classes shortly.

We continue to receive a high request of inquiries from medical officer interns applying to our internship programme and will update the team once the Kenya Medical Practitioners and Dentists Board (KMPDB) and the Ministry of Health (MOH) confirm placement of additional interns.

Drs. Luate and Ochola received guest lecturers from Dr. Tanya Rogo.

Hospital Education

At our nurse’s CME this week, we welcomed back a team from KMET for a presentation on early childhood development with an emphasis on clinician care. Our hospital-wide and clinical CME were both postponed this week due to the KetamineTraining Week.

Date: March 9, 2018 

SCH Physicians: Dr. Nyamogo (OB-GYN), Dr. Alwar (Paediatrics), Dr. Ligeyo (Surgery), and Dr. Ouma (Family Medicine)

Family and Emergency Medicine Residents: Dr. Charles Ochola, Dr. Richard Luate, Dr. David Wanikina Interns:

Program Coordinators: Phoebe Kelleher

Fellow: Dr. Ayesha Venkateswaran

HOSPITAL NEWS

This week Sagam Community Hospital and AIHT welcomed a team from KMET and PATH to present during our weekly hospital-wide CME. The presentation focused on early childhood development and inspired a passionate discussion with our hospital staff. This CME marked the beginning of a partnership between SCH, PATH, and KMET on improving care in early childhood development. In the coming weeks we plan to have staff trainings, presentations at our nurses and clinical CME, and new areas of our paediatric ward where children can engage and play. We’re grateful for the opportunity to be involved in such an innovative program.

Sagam Community Hospital also welcomed back one of our former consultants, Dr. Hiren Patel. Dr. Patel was integral in establishing our Rapid Response Team and improving our Emergency Care Center. We are happy to have him here this week to oversee some of our emergency simulations.

We are in the planning stages for our upcoming KetamineTraining Week and perfecting our curriculum. This month, we look forward to welcoming a team from Turkana and two nurses from Saskatchewan, Canada, whose colleagues we hosted back in December. March’s KetamineTraining Week will begin on March 19th.

EMERGENCY DEPARTMENT UPDATE

The electronic medical record system continues to be working well. An EMR update is scheduled to take place and it is to be determined. The updates will occur in three phases throughout the month which will include updating the EMR interfase, adding an import/export option for data collection, implementing reporting tools for the system, and allowing domain access to the EMR system. The first phase of the EMR integration, updating the EMR interface, has been complete. The second phase, adding an import/export option for data collection, is currently postponed until further notice.

Emergency Department simulations continue to run regularly at Sagam on Tuesdays and Thursdays.

EDUCATION

Teaching Rounds

- musculoskeletal exam of lumbosacral spine, hip, knee

- neurological exam of cranial nerves

- simulation of trauma RRT

Residency and Internship Program Update

The interns continue to work together to adjust their schedules to optimize their learning experiences and exposure to the consultants. They have been refining their schedules to optimize everyone's exposure to all the rotations. They look forward to welcoming a new consultant next week.

Virtual e-learning classes taught by Dr. Hiren Patel will resume classes shortly.

We continue to receive a high request of inquiries from medical officer interns applying to our internship programme and will update the team once the Kenya Medical Practitioners and Dentists Board (KMPDB) and the Ministry of Health (MOH) confirms placement of additional interns.

Hospital Education

Our hospital wide CME was presented by Abella and Edwin from KMET on early childhood development and the project being implemented with in partnership with PATH. The nurses CME was taught by Titus Kwede on Helping Babies Breathe, an ongoing project he’s leading to train our nurses on newborn resuscitation. Our consultant Dr. Ayesha Venkateswaran presented her first clinical CME this week, which covered EKGs.

March 2, 2018 - March 9, 2018

SCH Physicians: Dr. Nyamogo (OB-GYN), Dr. Alwar (Paediatrics), Dr. Ligeyo (Surgery), and Dr. Ouma (Family Medicine)

Family and Emergency Medicine Residents: Dr. Charles Ochola, Dr. Richard Luate, Dr. David Wanikina Interns:

Program Coordinators: Phoebe Kelleher

Fellow: Dr. Ayesha Venkateswaran

HOSPITAL NEWS

This week Sagam Community Hospital and AIHT welcomed a team from KMET and PATH to present during our weekly hospital-wide CME. The presentation focused on early childhood development and inspired a passionate discussion with our hospital staff. This CME marked the beginning of a partnership between SCH, PATH, and KMET on improving care in early childhood development. In the coming weeks we plan to have staff trainings, presentations at our nurses and clinical CME, and new areas of our paediatric ward where children can engage and play. We’re grateful for the opportunity to be involved in such an innovative program.

Sagam Community Hospital also welcomed back one of our former consultants, Dr. Hiren Patel. Dr. Patel was integral in establishing our Rapid Response Team and improving our Emergency Care Center. We are happy to have him here this week to oversee some of our emergency simulations.

We are in the planning stages for our upcoming KetamineTraining Week and perfecting our curriculum. This month, we look forward to welcoming a team from Turkana and two nurses from Saskatchewan, Canada, whose colleagues we hosted back in December. March’s KetamineTraining Week will begin on March 19th.

EMERGENCY DEPARTMENT UPDATE

The electronic medical record system continues to be working well. An EMR update is scheduled to take place and it is to be determined. The updates will occur in three phases throughout the month which will include updating the EMR interfase, adding an import/export option for data collection, implementing reporting tools for the system, and allowing domain access to the EMR system. The first phase of the EMR integration, updating the EMR interface, has been complete. The second phase, adding an import/export option for data collection, is currently postponed until further notice.

Emergency Department simulations continue to run regularly at Sagam on Tuesdays and Thursdays.

EDUCATION

Teaching Rounds

- musculoskeletal exam of lumbosacral spine, hip, knee

- neurological exam of cranial nerves

- simulation of trauma RRT

Residency and Internship Program Update

The interns continue to work together to adjust their schedules to optimize their learning experiences and exposure to the consultants. They have been refining their schedules to optimize everyone's exposure to all the rotations. They look forward to welcoming a new consultant next week.

Virtual e-learning classes taught by Dr. Hiren Patel will resume classes shortly.

We continue to receive a high request of inquiries from medical officer interns applying to our internship programme and will update the team once the Kenya Medical Practitioners and Dentists Board (KMPDB) and the Ministry of Health (MOH) confirms placement of additional interns.

Hospital Education

Our hospital wide CME was presented by Abella and Edwin from KMET on early childhood development and the project being implemented with in partnership with PATH. The nurses CME was taught by Titus Kwede on Helping Babies Breathe, an ongoing project he’s leading to train our nurses on newborn resuscitation. Our consultant Dr. Ayesha Venkateswaran presented her first clinical CME this week, which covered EKGs.

February 9, 2018 - February 16, 2018

SCH Physicians: Dr. Nyamogo (OB-GYN), Dr. Alwar (Paediatrics), Dr. Ligeyo (Surgery), and Dr. Ouma (Family Medicine)

Family and Emergency Medicine Residents: Dr. Ochola, Dr. Luate, Dr. Shivachi, and Dr. David W., Dr Moseti

Interns: Dr. Mucheru

Program Coordinators: Phoebe Kelleher

Fellow: Dr. Vishaka Raguveer and Dr. Jennifer Makin

HOSPITAL NEWS

This week was a busy and interesting week for Sagam Community Hospital. Our clinicians encountered a host of interesting cases including Erythema Multiforme Minor, Cryptococcus Meningitis in Pregnancy and Schistosomiasis in an adult male. Our clinicians provided exceptional care and we are proud of their performance.

Dr David, a fourth year Family/Emergency Medicine Resident has completed the second week of a chronic disease rotation at Sagam Community Hospital. He has been providing a weekly lecture series on pain management and palliative care. He has expretly managed many complicated cases related to palliative care including dysphagia from esophageal carcinoma, stage IIIB cervical cancer with acute renal failure due to obstruction, and cardiogenic shock.

We continue to gain momentum in our weekly community outreaches. This week we visited the Mumboha Primary School in Luanda, and offered services including cervical cancer screenings, blood pressure screenings, HIV tests and family planning services. The outreach was in collaboration with our sponsors KMET, CHAK, Rotary Club of Sagam, ISILO, and M-Tiba.

EMERGENCY DEPARTMENT UPDATE

The electronic medical record system continues to be working well. An EMR update is scheduled to take place, and it is to be determined. The updates will occur in three phases throughout the month which will include updating the EMR interface, adding an import/export option for data collection, implementing reporting tools for the system, and allowing domain access to the EMR system. The first phase of the EMR integration, updating the EMR interface, has been complete. The second phase, adding an import/export option for data collection, is currently postponed until further notice.

Emergency Department simulations continue to run regularly at Sagam on Tuesdays and Thursdays.

EDUCATION

Teaching Rounds

Asthma Management, Cardiogenic Shock management, Acute Kidney Injury vs Acute Tubular Necrosis, Isolated Systolic Hypertension, pre-ecclampsia, hyperemesis gravidarum, endometritis, secondary infertility, polycystic ovarian syndrome, management of leiomyoma

Residency and Internship Program Update

The interns continue to work together to adjust their schedules to optimize their learning experiences and exposure to the consultants. They have been refining their schedules to optimize everyone's exposure to all the rotations. They look forward to welcoming a new consultant next week.

Virtual e-learning classes taught by Dr. Hiren Patel will resume classes shortly.

We continue to receive a high request of inquiries from medical officer interns applying to our internship programme and will update the team once the Kenya Medical Practitioners and Dentists Board (KMPDB) and the Ministry of Health (MOH) confirms placement of additional interns. Recently, we welcomed our newest resident, Dr. David, who has already made tremendous contributions to the hospital.

Hospital Education

This week’s hospital wide CME was presented by Ben from the Laboratory. His presentation was on the benefits of blood donation and the potential lives saved by blood donation. The clinical CME addressed Asthma, including differential diagnoses, treatment protocols, complications and symptom triggers. Our clinical officer Rispah gave the presentation. Our nurses CME was presented by Alice Ameka on gestational diabetes.

February 2, 2018 - February 9, 2018

SCH Physicians: Dr. Nyamogo (OB-GYN), Dr. Alwar (Paediatrics), Dr. Ligeyo (Surgery), and Dr. Ouma (Family Medicine)

Family and Emergency Medicine Residents: Dr. Ochola, Dr. Luate, Dr. Shivachi, and Dr. David W., Dr Moseti

Interns: Dr. Mucheru

Program Coordinators: Phoebe Kelleher

Fellow: Dr. Vishaka Raguveer and Dr. Jennifer Makin

HOSPITAL NEWS

This week was a busy and interesting week for Sagam Community Hospital. Our clinicians encountered a host of interesting cases including Erythema Multiforme Minor, Cryptococcus Meningitis in Pregnancy and Schistosomiasis in an adult male. Our clinicians provided exceptional care and we are proud of their performance.

Dr David, a fourth year Family/Emergency Medicine Resident has completed the second week of a chronic disease rotation at Sagam Community Hospital. He has been providing a weekly lecture series on pain management and palliative care. He has expretly managed many complicated cases related to palliative care including dysphagia from esophageal carcinoma, stage IIIB cervical cancer with acute renal failure due to obstruction, and cardiogenic shock.

We continue to gain momentum in our weekly community outreaches. This week we visited the Mumboha Primary School in Luanda, and offered services including cervical cancer screenings, blood pressure screenings, HIV tests and family planning services. The outreach was in collaboration with our sponsors KMET, CHAK, Rotary Club of Sagam, ISILO, and M-Tiba.

EMERGENCY DEPARTMENT UPDATE

Emergency Department simulations continue to run regularly at Sagam on Tuesdays and Thursdays.

EDUCATION

Teaching Rounds

Asthma Management, Cardiogenic Shock management, Acute Kidney Injury vs Acute Tubular Necrosis, Isolated Systolic Hypertension, pre-ecclampsia, hyperemesis gravidarum, endometritis, secondary infertility, polycystic ovarian syndrome, management of leiomyoma

Residency and Internship Program Update

The interns continue to work together to adjust their schedules to optimize their learning experiences and exposure to the consultants. They have been refining their schedules to optimize everyone's exposure to all the rotations. They look forward to welcoming a new consultant next week.

Virtual e-learning classes taught by Dr. Hiren Patel will resume classes shortly.

We continue to receive a high request of inquiries from medical officer interns applying to our internship programme and will update the team once the Kenya Medical Practitioners and Dentists Board (KMPDB) and the Ministry of Health (MOH) confirms placement of additional interns. Recently, we welcomed our newest resident, Dr. David, who has already made tremendous contributions to the hospital.

Hospital Education

This week’s hospital wide CME was presented by Ben from the Laboratory. His presentation was on the benefits of blood donation and the potential lives saved by blood donation. The clinical CME addressed Asthma, including differential diagnoses, treatment protocols, complications and symptom triggers. Our clinical officer Rispah gave the presentation. Our nurses CME was presented by Alice Ameka on gestational diabetes.

December 29, 2017 -  January 5, 2018

SCH Physicians: Dr. Nyamogo (OB-GYN), Dr. Alwar (Paediatrics), Dr. Ligeyo (Surgery), and Dr. Ouma (Family Medicine)  

Family and Emergency Medicine Residents: Dr. Ochola, Dr. Luate, Dr. Shivachi, and Dr. Moseti

Interns: Dr. Mucheru 

Program Coordinators:  Joseph Owuor and Phoebe Kelleher

HOSPITAL NEWS

It has been a busy week clinically at Sagam Community Hospital. We had a high number of births, and our outpatient clinics resumed regular hours following the holiday season. We applaud the strong efforts of the emergency department staff and the customer care staff. 

Our ward nurse in charge Titus Kwede continues to educate his staff by conducting trainings in Helping Babies Breathe to strengthen newborn resuscitation knowledge throughout the hospital. As his efforts to educate his nursing staff progress, he hopes to cover ESM-NRB bCPAP training in the coming weeks. 

We are looking forward to an exciting month of January! In the following weeks we will be welcoming a new Global Health Leadership fellow, staff from the Division of Global Health and Human Right at Massachusetts General Hospital, and a researcher from T. H. Chan Harvard School of Public Health. We wish them safe travels and are excited to work alongside them when they arrive in Sagam!

EDUCATION

Teaching Rounds

This weeks teaching rounds were a collaborative effort of all the Clinical Officers. Topics included reporting in the EMR, reading EKGs, antibiotics and antibiotic resistance, and osteomyelitis. 

Residency and Internship Program Update

The interns continue to work together to adjust their schedules to optimize their learning experiences and exposure to the consultants. They have been refining their schedules to optimize everyone's exposure to all the rotations. They look forward to welcoming a new consultant next week. 

Virtual e-learning classes taught by Dr. Hiren Patel will resume classes after the holidays.     

We continue to receive a high request of inquiries from medical officer interns applying to our internship programme and will update the team once the Kenya Medical Practitioners and Dentists Board (KMPDB) and the Ministry of Health (MOH) confirms placement of additional interns. 

Hospital Education

This week’s hospital wide CME was taught by Rogers, our equipment technician. Rogers included a video focusing on how to properly store and utilize oxygen tanks in the hospital. The nursing CME was cancelled. This weeks clinical CME was taught by our Clinical Officer Javan Imbamba, and the CME focused on the improvements in the EMR system. 

December 9th - December 15th 

SCH Physicians: Dr. Nyamogo (OB-GYN), Dr. Alwar (Paediatrics), Dr. Ligeyo (Surgery), and Dr. Ouma (Family Medicine) 

Fellows: Dr. Kemi Adegoke and Dr. Revathi Ravi 

Family and Emergency Medicine Residents: Dr. Ochola, Dr. Luate, Dr. Shivachi, and Dr. Moseti

Interns: Dr. Mucheru 

Program Coordinators:  Joseph Owuor and Phoebe Kelleher

HOSPITAL NEWS

This week was another exciting week at Sagam Community Hospital and the AIHT. This week we hosted our ESM-NRB re-training in the AIHT. In total we re-trained 20 healthcare providers from our five facilities Madiany, Ambira, Yala, Bondo and Sagam. The training was a huge success, and we would like to thank everyone involved in making the re-training possible. 

A special thanks to the Medical Superintendents of Madiany Sub-County District Hospital, Bondo Sub-County District Hospital, Ambira Sub-County District Hospital, and Yala Sub-County District Hospital. We were also pleased to welcome our guests from Amerif, Mr. Sam Musau, TB coordinator for the county of Alego, Ms. Maureen, and TB coordinator for Gem Sub County, Ms. Damaris. Our CO Javan, Mr. Were from comprehensive care clinic, and Juddy our office administrator warmly welcomed the team. During their meeting SCH and the team discussed infection prevention primarily focused on TB education, prevention, and treatment. 

SCH also hosted its annual hospital wide staff meeting and appreciation luncheon. During the meeting SCH thanked all of the staff for their continued hard work especially during a year that was filled with many health strikes. All departments were recognized for their hard work and a luncheon was provided for the staff. We are thankful for our staff, and we look forward to beginning a new and promising year.  

EMERGENCY DEPARTMENT UPDATE

The electronic medical record system continues to be working well. An EMR update is scheduled to take place, and it is to be determined. The updates will occur in three phases throughout the month that will include updating the EMR interphase, adding an import/export option for data collection, implementing reporting tools for the system, and allowing domain access to the EMR system. The first phase of the EMR integration, updating the EMR interface, has been complete. The second phase, adding an import/export option for data collection, is currently postponed.

Emergency Department simulations continue to run regularly at Sagam on Tuesdays and Thursdays.

EDUCATION

Teaching Rounds

Topics included meningitis in the newborn, antibacterial management, diabetic management, gender based violence, decompensated congestive heart failure, AIDS and opportunistic infections. 

Residency and Internship Program Update

The interns continue to work together to adjust their schedules to optimize their learning experiences and exposure to the consultants. They have been refining their schedules to optimize everyone's exposure to all the rotations.

This week’s virtual e-learning was taught by Dr. Hiren Patel and focused on ultrasound, E-FAST examination, blunt vs. penetrating trauma, pericardial effusion, and parcentisis. We plan on hosting our last virtual e-learning for the year next week, and we will resume classes after the holidays.     

Hospital Education

The nursing CME was given by Samwel Orondo, our theatre nurse in charge. Many thanks to him and the team for an interactive session. The clinical CME was taught by Dr. Kemi Adegoke and focused on antepartum bleeding in 2nd and 3rd trimester. 

Date: November 25th - December 1st

SCH Physicians: Dr. Nyamogo (OB-GYN), Dr. Alwar (Paediatrics), Dr. Ligeyo (Surgery), and Dr. Ouma (Family Medicine)

Fellows: Dr. Kemi Oadegoke and Dr. Revathi Ravi

Family and Emergency Medicine Residents: Dr. Ochola, Dr. Luate, Dr. Shivachi, Dr. Wanikina, and Dr. Moseti

Interns: Dr. Mule, Dr. Akonyu, Dr. Suheil, and Dr. Mucheru

Program Coordinators:  Joseph Owuor and Phoebe Kelleher

Volunteer: Ms. Nicole Agutu

HOSPITAL NEWS

SCH would like to welcome back our global health fellows Dr. Revathi Ravi, our Medicine and Pediatrics Specialist, and Dr. Kemi Oadegoke, our OB-GYN specialist. In addition, we would like to welcome back our program coordinator Joseph Owuor, and our new program coordinator Phoebe Kelleher to Sagam. We would also like to appreciate our volunteer Ms. Nicole Agutu for her hard work at SCH, and we wish her the best in her future endeavors as she concludes her time at Sagam. 

 Preparations continue as we get ready to host a ESM-Ketamine training anesthesiologists, ob/gyns and nurses from Saskatchewan, Canada from December 4 - 8, 2017.

 EMERGENCY DEPARTMENT UPDATE

 The electronic medical record system continues to be working well. An EMR update is scheduled to take place, and it is to be determined. The updates will occur in three phases throughout the month that will include updating the EMR interphase, adding an import/export option for data collection, implementing reporting tools for the system, and allowing domain access to the EMR system. The first phase of the EMR integration, updating the EMR interface, has been completed. The second phase, adding an import/export option for data collection, is currently postponed.

Emergency Department simulations continue to run regularly at Sagam on Tuesdays and Thursdays.

EDUCATION 

Teaching Rounds

Topics included congestive heart failure both decompensated and compensated states, AIDS, sickle cell disease, diabetes management, COPD exacerbations, DVT in malignancy, asthma and osteomyelitis.

 Residency and Internship Program Update

The interns continue to work together to adjust their schedules to optimize their learning experiences and exposure to the consultants. They have been refining their schedules to optimize everyone's exposure to all the rotations.

 This week we also completed our second successful virtual e-learning taught by Dr. Hiern Patel. Topics included principles of ATLS, in depth review on how to conduct a proper primary and secondary survey, triage cases, C spine precautions, and a NEJM article that compared the sensitivity and specificity of the NEXUS vs the Canadian C spine rules.

Hospital Education 

This week’s hospital wide CME focused on head injuries and was taught by Dr. Salim Mucheru. This week’s clinical CME was taught by Dr. Revathi Ravi and focused on Einthoven’s triangle and understanding the axis of an EKG. As part of the presentation Dr. Ravi had volunteers from the clinician group model Einthoven’s triangle, and trainees learned  how to describe the vectors of each EKG lead, the natural electrical activity of the heart, and identify pathology based on abnormal axis measurements. Individuals left with a more tangible sense of what the leads of the EKG describe, the electrical activity of the heart, and the axis potentials it produces. 

November 18th - November 24th

SCH Physicians: Dr. Nyamogo (OB-GYN), Dr. Alwar (Paediatrics), Dr. Ligeyo (Surgery), and Dr. Ouma (Family Medicine)

Program Coordinators:  Joseph Owuor and Phoebe Khelleher

Family and Emergency Medicine Residents: Dr. Ochola, Dr. Luate, Dr. Shivachi, Dr. Wanikina, and Dr. Moseti

Interns: Dr. Mule, Dr. Akonyu, Dr. Suheil, and Dr. Mucheru

Volunteer: Ms. Nicole Agutu

HOSPITAL NEWS

Sagam Community Hospital’s emergency department and daily operations continue to normalize, and our dedicated hospital staff continues to provide care to its patients and to the wider community. This week SCH hosted a blood drive in conjunction with the Kisumu Branch of the Kenya National Blood Transfusion Service. We thank all of our staff and visitors that donated blood to help deal with shortages that we are experiencing in the region. We are grateful for this opportunity to improve the care of our patients at Sagam and beyond. We would like to thank and appreciate our laboratory team Eric, Ben, and Josephine for making the necessary arrangements for a successful blood drive. In total, we were able to donate twenty-eight pints of blood.

Preparations continue as we get ready to host a ESM-Ketamine training anesthesiologists, ob/gyns and nurses from Saskatchewan, Canada from December 4 - 8, 2017. We also look forward to welcoming our MGH family.

EMERGENCY DEPARTMENT UPDATE

The electronic medical record system continues to be working well. An EMR update is scheduled to take place, and it is to be determined. The updates will occur in three phases throughout the month that will include updating the EMR interphase, adding an import/export option for data collection, implementing reporting tools for the system, and allowing domain access to the EMR system. The first phase of the EMR integration, updating the EMR interface, has been complete. The second phase, adding an import/export option for data collection, is currently postponed due to elections.

Emergency Department simulations continue to run regularly at Sagam on Tuesdays and Thursdays.

EDUCATION

 Residency and Internship Program Update

The interns continue to work together to adjust their schedules to optimize their learning experiences and exposure to the consultants. They have been refining their schedules to optimize everyone's exposure to all the rotations.

 Hospital Education

This week’s hospital wide CME was taught by Were, HIV counselor, and focused on HIV testing. Our Clinical Officer Javan Imbamba taught this weeks clinical CME, and the CME focused on tachycardia.

November 11th - November 17th

SCH Physicians: Dr. Nyamogo (OB-GYN), Dr. Alwar (Paediatrics), Dr. Ligeyo (Surgery), and Dr. Ouma (Family Medicine)

Program Coordinators:  Joseph Owuor and Phoebe Khelleher

Family and Emergency Medicine Residents: Dr. Ochola, Dr. Luate, Dr. Shivachi, Dr. Wanikina, and Dr. Moseti

Interns: Dr. Mule, Dr. Akonyu, Dr. Suheil, and Dr. Mucheru

Volunteer: Ms. Nicole Agutu

 HOSPITAL NEWS

This week marked the sixth week of the ongoing lab technicians strike, however, nurses and clinical officers from public hospitals continue to resume work together for the second week since the nurse’s strike. As a result, SCH’s emergency department continues to normalize, and SCH’s dedicated hospital staff continues to provide care to its patients and to the wider community. SCH continues to hold discussions with Sagam’s Rotary Club to help in facilitation and support for our weekly outreaches in Siaya County as the general election just concluded.

The Kenya Obstetrical and Gynecological Society (KOGS) recently held a sensitization forum on November 15th,  to discuss the ESM-UBT and ESM-Ketamine innovation in Kisumu, Kenya.  The AIHT team in collaboration with the head of Reproductive and Maternal Health Service Unite (RMHSU), Dr. Joel Gondi brought together 16 members of KOGS drawn from Kisumu, Bungoma, Kakamega, Garissa, Turkana, Homa Bay, Vihiga, Busia and Migori Counties. A main objective of the forum was to to discuss the best strategies to accelerate rollout, data collection, reporting, uptake, and scale-up of both the ESM-UBT and ESM-Ketamine innovations. The forum also focused on sensitizing KOGS members on maternal health lifesaving innovations. Keynote speakers from AIHT, KOGS, RMHSU, and KMET discussed challenges maternal and reproductive health professionals faced and possible solutions to fill the gaps in the health system.

It was an exciting time in Sagam this week as we launched the e-learning for our Family and Emergency Residents with Dr. Hiren Patel, who is based at Massachusetts General Hospital (MGH). E-learning is an innovative way of learning that allows teaching to occur even when students and faculty are not in the same country, time zone or jurisdiction. Many thanks to the entire team, including Dr. Ouma of Maseno University and Dr. Patel for their support.

Preparations have also began as we get ready to host a ESM-Ketamine training anesthesiologists, ob/gyns and nurses from Saskatchewan, Canada from December 4 - 8, 2017. We also look forward to welcoming our MGH family back to Sagam.

EMERGENCY DEPARTMENT UPDATE

The electronic medical record system continues to be working well. An EMR update is scheduled to take place over the course of the month.  The updates will occur in three phases throughout the month that will include updating the EMR interphase, adding an import/export option for data collection, implementing reporting tools for the system, and allowing domain access to the EMR system. The first phase of the EMR integration, updating the EMR interface, has been complete. The second phase, adding an import/export option for data collection, is currently postponed due to elections.

Emergency Department simulations continue to run regularly at Sagam on Tuesdays and Thursdays

EDUCATION 

Residency and Internship Program Update

The interns continue to work together to adjust their schedules to optimize their learning experiences and exposure to the consultants. They have been refining their schedules to optimize everyone's exposure to all the rotations.

Hospital Education

This week’s hospital wide CME was taught by Nurse Julius Adika, and focused on management of intestinal obstruction. Our Clinical Officer Javan Imbamba taught this weeks’ clinical CME, and the CME focused on bradycardia.

October 14th -  20th 

SCH Physicians: Dr. Nyamogo (OB-GYN), Dr. Alwar (Peds), Dr. Ligeyo (Surgery), and Ouma (FM) 

Program Coordinator:  Joseph Owuor

Family and Emergency Medicine Residents: Dr. Ochola, Dr. Luate, Dr. Shivachi, Dr. Shiramba, Dr. Wanikina, Dr. Moseti

Interns: Dr. Mule, Dr. Akonyu and Dr. Suheil

HOSPITAL NEWS

On October 20th, Kenyans throughout the country celebrated the national holiday Mashujaa Day, also known as Heroes' Day ("mashujaa" is Swahili for "heroes"), to honour all those who contributed towards the struggle for Kenya's independence or positively contributing in the post independence of Kenya. For us, our heroes are the staff, consultants, volunteers, interns, fellows, coordinators, partners, residents, locums, students, and community health workers at SCH. We welcomed back some of the Family and Emergency Medicine Residents to SCH as part of their rotations. 

The staff’s heroic efforts have been on full display, especially during the current ongoing nurse, clinical officer, and lab technicians strikes. This week marked the twenty-first week of the ongoing nurse’s strike, sixth week of the Clinical Officers (COs) strike, and one month of the lab technicians strike. SCH’s dedicated hospital staff continues to help manage high influx of patients, especially our maternity patients and mothers, and providing care to the wider community. It has been difficult, overwhelming, and tough for them under such circumstances, but the SCH staff have truly been our heroes. Asante Sana! We salute all of you!

Despite the fact that our outreaches are on hiatus due to the run up to the general election, we have began planning discussions with Sagam’s Rotary Club to help in facilitation and support for our weekly outreaches in Siaya County and beyond. Led by their President, Mr. Sammy Ojenge, they will be assisting in engaging with local leadership in the various constituencies. We will have an update on resumption of our outreaches once the upcoming general election is concluded.

SCH continues to host thirteen 3rd year nursing students from the Kenya Medical Training College (KMTC) in Siaya for their practical rotations. We also received news that the students would go on a break during the next week during the upcoming general election and return the week after. Discussions continue with KMTC-Siaya as we arrange to host 1st year students as well. 

In addition, this week SCH hosted Monica Oguttu, Executive Director at KMET, and Penina Ocholla, from Great Lakes University, on establishing a capacity building programme for nurses to assist in addressing some of the challenges they face in provision of quality care. The proposed programme will launch in Siaya. Feedback from the consultation meetings with the Siaya County Health Management Team will be communicated once confirmed.

SCH also warmly received a visit from our partners, the Center for Public Health and Development (CPHD) and Hewa Tele. CPHD and Hewa Tele. support our clinical services at SCH through the provision of oxygen and surgical and emergency equipment. They were accompanied by a team from the Joint Medical Store (JMS), the leading private pharmaceutical story in Uganda, who came to learn more about how we provide oxygen with support from CPHD and Hewa Tele. 

The CPHD/Hewa Tele team was represented by Dr. Steve Adudans (Executive Director), Mr. Rowland Wanyama (Marketing and Operations Director), and Mr. Thadew Ogutu, (biomedical engineer). The JMS team was represented by Dr. Bildard Baguma (Executive Director) and Mr. Emmanuel Higenyi (Director-Technical Services). SCH is thankful for the visit from CPHD, Hewa Tele, and JMS. We look forward to our continued strong partnerships towards providing quality care to patients not only in Sagam but across East Africa as well. 

EDUCATION

Hospital Education

The hospital wide CME last week was hosted by laboratory and focused on medical waste disposal. The clinical CME focused on hypertension and was taught by Dr. Richard Luate, our second year Family and Emergency Medicine Resident.

Date: September 9nd - September 15th

Fellow: Dr. Makin 

SCH Physicians: Dr. Nyamogo and Dr. Alwar

Program Coordinator:  Joseph Owuor

Family and Emergency Medicine Residents: Dr. Ochola and Dr. Luate

Interns: Dr. Mule, Dr. Akonyu and Dr. Suheil

HOSPITAL NEWS

This week marked the fifteenth week of the ongoing nurses’ strike. The government gave the nurses an ultimatum to resume duty or face termination with no effect. The nurses union has communicated that they will not do so. An end to the strike seems unlikely until the new election is held. Meanwhile, Sagam Community Hospital (SCH) continues to work hard to provide care to the wider community. SCH is the only non-governmental hospital offering surgical services in Siaya County, and the number of obstetric emergency surgeries has more than doubled with women arriving in obstructed labor for several days. The September-October season is typically a high season for deliveries. 

We are thankful to have many hands on deck to help at this time. Our Family and Emergency Medicine residents, Drs. Charles Ochola and Richard Luate continue to provide high quality care at the hospital. Dr. Wanikina, a third year resident finished up his Emergency Medicine rotation this week. In addition, Dr. Daniel Misian and Dr. Olive Akinyi have completed their internship rotations and are now getting their logbooks signed off. Dr. Maryanne Nyamogo, the OBGYN, has been assisting in the GYN clinic, operating and seeing patients at SCH. This week, she taught the hospital wide CME and focused on monitoring maternal patients during labour. 

In addition, Dr. Alwar has been assisting in running our pediatric clinic. Dr. Wameyo, an OBGYN and faculty from Maseno University, has even been booking laparoscopic surgeries at the hospital! Dr. Omoto, Assistant Dean for the residency at Maseno University, also plans to book a laparoscopic case next week. We are hopeful that during this period of strike, interns from public hospitals such as Siaya, which are closed, will rotate at Sagam to provide assistance and continue their training. Sagam Hospital has applied for a new class of interns. We are hopeful that the incoming class may start in one month and will overlap with our current interns Dr. Akonyu, Dr. Suheil, and Dr. Mule in order to orient properly.

This week we would like to congratulate Monica Oguttu on her appointment to lead the Health Task Force by Governor Nyong’o of Kisumu County. Our partnership with KMET has been fruitful and we continue to strive towards improving the lives of Kenyans. Meanwhile, Sagam and the African Institute for Health Transformation continues to be a center of learning excellence. It has been determined that sub-county wide continuing medical education events will be implemented and will occur on a monthly basis at Sagam Hospital with attendance by staff from public hospitals.

We are also excited to announce that the hostel construction was completed this week! We are incredibly thankful to everyone that made the construction possible. We have embarked on final clean up and furnishing, and an official grand opening is being planned for this month! In addition, we are excited to announce that construction for the CT imaging building is underway.  

SCH traveled to Nyabeda for community outreach in Siaya County this week. Comprehensive services were offered including: blood pressure check, cervical cancer screens, family planning, HIV testing, pediatric vaccinations, and vision services. 

September  (2nd - 8th)   -2017

Fellow: Dr. Makin 

SCH Physicians: Dr. Nyamogo and Dr. Alwar

Program Coordinator:  Joseph Owuor

Family and Emergency Medicine Residents: Dr. Ochola and Dr. Luate

Interns: Dr. Mule, Dr. Akonyu and Dr. Suheil

HOSPITAL NEWS

This week marked the fifteenth week of the ongoing nurses’ strike. The government gave the nurses an ultimatum to resume duty or face termination with no effect. The nurses union has communicated that they will not do so. An end to the strike seems unlikely until the new election is held.

 Meanwhile, Sagam Community Hospital (SCH) continues to work hard to provide care to the wider community. SCH is the only non-governmental hospital offering surgical services in Siaya County, and the number of obstetric emergency surgeries has more than doubled with women arriving in obstructed labor for several days. The September-October season is typically a high season for deliveries. 

We are thankful to have many hands on deck to help at this time. Our Family and Emergency Medicine residents, Drs. Charles Ochola and Richard Luate continue to provide high quality care at the hospital.

Dr. Wanikina, a third year resident finished up his Emergency Medicine rotation this week. In addition, Dr. Daniel Misian and Dr. Olive Akinyi have completed their internship rotations and are now getting their logbooks signed off. Dr. Maryanne Nyamogo, the OBGYN, has been assisting in the GYN clinic, operating and seeing patients at SCH. This week, she taught the hospital wide CME and focused on monitoring maternal patients during labour. 

In addition, Dr. Alwar has been assisting in running our pediatric clinic. Dr. Wameyo, an OBGYN and faculty from Maseno University, has even been booking laparoscopic surgeries at the hospital! Dr. Omoto, Assistant Dean for the residency at Maseno University, also plans to book a laparoscopic case next week.

We are hopeful that during this period of strike, interns from public hospitals such as Siaya, which are closed, will rotate at Sagam to provide assistance and continue their training. Sagam Hospital has applied for a new class of interns. We are hopeful that the incoming class may start in one month and will overlap with our current interns Dr. Akonyu, Dr. Suheil, and Dr. Mule in order to orient properly.

This week we would like to congratulate Monica Oguttu on her appointment to lead the Health Task Force by Governor Nyong’o of Kisumu County. Our partnership with KMET has been fruitful and we continue to strive towards improving the lives of Kenyans. Meanwhile, Sagam and the African Institute for Health Transformation continues to be a center of learning excellence.

It has been determined that sub-county wide continuing medical education events will be implemented and will occur on a monthly basis at Sagam Hospital with attendance by staff from public hospitals.

We are also excited to announce that the hostel construction was completed this week! We are incredibly thankful to everyone that made the construction possible. We have embarked on final clean up and furnishing, and an official grand opening is being planned for this month! In addition, we are excited to announce that construction for the CT imaging building is underway.  

SCH traveled to Nyabeda for community outreach in Siaya County this week. Comprehensive services were offered including: blood pressure check, cervical cancer screens, family planning, HIV testing, pediatric vaccinations, and vision services. 

 June  23 -2017

SCH Laparoscopic Surgery Camp

This week Sagam Community Hospital (SCH) hosted a laparoscopic surgery camp in conjunction with the Kenya Society for Endoscopic Specialities (KESES) from June 1 - 3, 2017. Doctors from KESES and other Nairobi-based hospitals attended the camp and 8 laparoscopic procedures were successfully completed. Other participants included faculty from Maseno University’s School of Medicine, residents from the FEM programme, a doctor from   Moi Teaching and Referral Hospital in Eldoret as well as two nurses from Nakuru.

 Laparoscopic procedures prove to be life saving and the future is promising for using the innovative procedure at SCH. This week, SCH also traveled to Kodiaga for community outreach in Siaya County. Comprehensive services were offered including: blood pressure check, cervical cancer screen, family planning, HIV testing, pediatric vaccinations, and vision services. SCH would also like to welcome Dr. Mindy Sherman, a senior pediatrician and pediatric emergency physician, and Hana Haver, a fourth year medical student.

Research Update

ESM-Ketamine: Our next ESM-Ketamine Week is June 12 - 16, 2017 and then  in September 2017. 

ESM-Newborn Resuscitation Bundle (ESM-NRB): This pillar includes a bubble-Continuous Positive Airway Pressure (bCPAP) device designed by our team, and a hospital-level pulse oximeter. bCPAP continues to be used clinically on newborns with great success. 

Our engineering team is continuing to make improvements on the device, with initial implementation being planned for Kenya in one week. Implementation in Zambia is planned for the end of this year. The training in Kenya took place on May 25th and May 26, 2017 and focused on 5 facilities in Siaya County. The first day of the training took place at AIHT followed by an on-site visit to the facilities on the second day.

Fred Hollows Foundation (FHF): In mid 2016, AIHT was selected by FHF to conduct a survey on its activities in Kenya in regard to increasing the uptake of cataract surgeries and eye services. AIHT has completed the county evaluation and situational analysis across the nine (9) target counties and submitted the report. AIHT has also completed the national evaluation and has submitted the first draft to FHF. AIHT will be presenting the National Report to FHF in Nairobi on Friday, June 9, 2017.

Teaching Rounds

Topics included unstable angina, tetanus, septic wounds management, meconium aspiration syndrome, endometriosis, hematometra, pressure ulcer prevention and management, severe malaria, H, Pylori diagnosis and treatment, complications of constipation, management of the at risk neonate, cholelithaisis, schistosomiasis, and DKA.

Internship Program 

The interns continue to work together to adjust their schedule in order to optimize their learning experience and exposure to the consultants. They have been refining their schedule in order to optimize everyone's exposure to all of the rotations. We had a meeting with Maseno University and discussed the residents who will be rotating at Sagam in the coming months.

Hospital Education

This week’s hospital-wide CME was given by Daniel, MOI and focused on emergency response systems. Clinical CME this week was cancelled due to laparoscopy training.

Fellow: Dr. Kemi Adegoke 

Visiting Physician: Dr. Mindy Sherman

Visiting Medical Student: Hana Haver

Program Coordinators:  Joseph Owuor and Gabriella Wuyke

HOSPITAL NEWS

This week marked the twenty-seventh day of the ongoing nurse’s strike. Sagam Community Hospital (SCH) has continued to work hard to provide care to the wider community. We are thankful to have many hands on deck to help at this time. SCH traveled to Kamenya for community outreach in Siaya County. Comprehensive services were offered including: blood pressure check, cervical cancer screen, family planning, HIV testing, pediatric vaccinations, and vision services.

SCH received a visit from one of its partners, Essilor, which had trained our community health workers as vision ambassadors. The community health workers provided feedback how the distribution of glasses was going. In addition, the team recognized the best performing community health workers as follows: Jane, Gladys and Tony.

This week SCH also said goodbye to Dr. Mindy Sherman, a senior pediatrician and pediatric emergency physician, and Hana Haver, a fourth year medical student. SCH is grateful for their help during their time at Sagam especially during the nurses strike. Asante Sana!

The electronic medical record system continues to be working well. An EMR update is scheduled to place over the course of the month.  The updates will occur in three phases throughout the month which will include updating the EMR interphase, adding an an import/export option for data collection, implementing reporting tools for the system, and allowing domain access to the EMR system.

RESEARCH UPDATE

ESM-Ketamine 

The ESM-Ketamine research team is continuing to work on  several studies / manuscripts surrounding the ESM-Ketamine work. Two manuscripts reporting on ESM-Ketamine use for gynecologic operative procedures and for procedural sedation (at Siaya County Hospital) have been submitted for peer review. Two manuscripts, reporting on ESM-Ketamine use for operative orthopedic procedures and for supporting reproductive health procedures (with a focus on areas of humanitarian crisis) are currently in progress. A qualitative study of surgeons performing abdominal laparotomies has been developed, local collaborators are being involved, and the IRB submission process been initiated. 

ED registry (Pediatric) - A literature review was completed. The initial draft of the paper will be in process once REDCap data is available. 

ESM-STK – Literature review underway.  Efforts continue to maximize this service to the community and understand barriers. Clinicians continue to be retrained on how to diagnose STEMIs on EKG as well as when to get a EKG. 

Fred Hollows Foundation (FHF): In mid 2016, AIHT was selected by FHF to conduct a survey on its activities in Kenya in regard to increasing the uptake of cataract surgeries and eye services. AIHT has completed the county evaluation and situational analysis across the nine (9) target counties and submitted the report. AIHT has also completed the national evaluation and has submitted the first draft to FHF. AIHT held a presentation for FHF to present the national report on Wednesday, June 14, 2017. They received feedback from the FHF team which will be incorporated into the final draft to be submitted this week.

EDUCATION

Teaching Rounds

Topics included labor curve, ovarian cysts and cancer, cerebral malaria, fibroids, LEEPs, syncope, RTAs, determining gestational age, oxytocin use, hysterectomy, bCPAP use, and C-sections.  

Residency and Internship Program Update

The interns continue to work together to adjust their schedule in order to optimize their learning experience and exposure to the consultants. They have been refining their schedule in order to optimize everyone's exposure to all of the rotations. We had a meeting with Maseno University and discussed the residents who will be rotating at Sagam in the coming months.

Hospital Education

This week’s hospital-wide CME was given by nurse Brain on appropriately documenting and interpreting a labor curve. 

May 27th - June 2nd

Fellows: Sarah Villegas, Kemi Adegoke

Visiting Physician: Dr. Mindy Sherman

Visiting Medical Student: Hana Haver

Program Coordinators:  Joseph Owuor and Gabriella Wuyke

HOSPITAL NEWS

 This week Sagam Community Hospital (SCH) hosted a laparoscopic surgery camp in conjunction with the Kenya Society for Endoscopic Specialities (KESES) from June 1 - 3, 2017. Doctors from KESES and other Nairobi-based hospitals attended the camp and 8 laparoscopic procedures were successfully completed. Other participants included faculty from Maseno University’s School of Medicine, residents from the FEM programme, a doctor from Moi Teaching and Referral Hospital in Eldoret as well as two nurses from Nakuru. Laparoscopic procedures prove to be life saving and the future is promising for using the innovative procedure at SCH. This week, SCH also traveled to Kodiaga for community outreach in Siaya County. Comprehensive services were offered including: blood pressure check, cervical cancer screen, family planning, HIV testing, pediatric vaccinations, and vision services. SCH would also like to welcome Dr. Mindy Sherman, a senior pediatrician and pediatric emergency physician, and Hana Haver, a fourth year medical student.

EMERGENCY DEPARTMENT UPDATE

 The electronic medical record system continues to be working well. Interns, clinical officers, and nurses continue to be trained on the proper usage of the C-arm taught by Javan Imbamba and Joseph Owuor. An emergency room video is currently in the process of being produced to assist and direct patients when they come for treatment at the Hospital. The video highlights the process of registration, nurse triage, seeing a doctor for treatment, and departments for further testing.

RESEARCH UPDATE

 Our research teams are continuing to work on projects centered around the Division Pillars as follows: 

 ESM-Ketamine - Our next ESM-Ketamine Week is June 12 - 16, 2017 and then we shall break until September 2017.

 ESM-UBT-  Progress is being made with implementing the ESM-UBT project in India, in addition to Kenya and Tanzania. Discussions are underway to expand the ESM-UBT project to Honduras and other countries in South America.

ESM-Newborn Resuscitation Bundle (ESM-NRB): This pillar includes a bubble-Continuous Positive Airway Pressure (bCPAP) device designed by our team, and a hospital-level pulse oximeter. bCPAP continues to be used clinically on newborns with great success. Our engineering team is continuing to make improvements on the device, with initial implementation being planned for Kenya in one week. Implementation in Zambia is planned for the end of this year. The training in Kenya took place on May 25th and May 26, 2017 and focused on 5 facilities in Siaya County. The first day of the training took place at AIHT followed by an on-site visit to the facilities on the second day.

 Fred Hollows Foundation (FHF): In mid 2016, AIHT was selected by FHF to conduct a survey on its activities in Kenya in regard to increasing the uptake of cataract surgeries and eye services. AIHT has completed the county evaluation and situational analysis across the nine (9) target counties and submitted the report. AIHT has also completed the national evaluation and has submitted the first draft to FHF. AIHT will be presenting the National Report to FHF in Nairobi on Friday, June 9, 2017.

EDUCATION

Teaching Rounds

Topics included unstable angina, tetanus, septic wounds management, meconium aspiration syndrome, endometriosis, hematometra, pressure ulcer prevention and management, severe malaria, H, Pylori diagnosis and treatment, complications of constipation, management of the at risk neonate, cholelithaisis, schistosomiasis, and DKA.

Residency and Internship Program Update

The interns continue to work together to adjust their schedule in order to optimize their learning experience and exposure to the consultants. They have been refining their schedule in order to optimize everyone's exposure to all of the rotations. We had a meeting with Maseno University and discussed the residents who will be rotating at Sagam in the coming months.

Hospital Education

This week’s hospital-wide CME was given by Daniel, MOI and focused on emergency response systems. Clinical CME this week was cancelled due to laparoscopy training.

2017  May 20- 27

Fellows: Sarah Villegas, Kemi Adegoke 

Visiting Physicians: Dr. Taha Yusufali, Dr. Cristobal Barrios, Dr. Megan Lundeberg

Program Coordinators:  Joseph Owuor and Gabriella Wuyke

HOSPITAL NEWS

This week Sagam Community Hospital (SCH) hosted two trainings in the AIHT. The first training was lead by Mr. Raphael Okumu from the Essilor Group. The vision ambassador training was tailored towards community health workers (CHWs) at SCH. The training taught CHWs the importance of vision and providing quality eye tests and glasses to community members during community outreaches. A two day ESM-NRB training was also hosted in the AIHT. Master trainers from Kisumu and Nairobi lead the training and a total of 28 people were trained that included nurses, clinical officers and pediatricians.

Trainees came from Yala Sub-County Hospital, Ambria Sub-County Hospital, Bondo Sub- County Hospital, Madiany Sub-County Hospital, and SCH. During the first day of training, all the members were taught and trained on the use of the ESM- NRB bundle. On the second day of training, master trainers went to each facility where the trainees demonstrated their knowledge of the use of the ESM- NRB. This week SCH also traveled to Muhoho for community outreach in Siaya County. Comprehensive services were offered including: blood pressure check, cervical cancer screen, family planning, HIV testing, and pediatric vaccinations. SCH would also like to thank our UC Irvine guests, Dr. Barrios and Dr. Lundeberg for their services at SCH and we look forward to seeing them again in the near future. 

At the beginning of the week (Monday, May 22, 2017), AIHT made a presentation to the Siaya County Health Management Team (CHMT), which includes the public officers in the county in charge of health. During this meeting, AIHT had an opportunity to present on the various current and forthcoming research and learning initiatives at SCH/AIHT and discuss ways of further collaboration as part of the Memorandum of Understanding (MOU) between SCH and Siaya County.

Finally, the team is supporting the hospital as it prepares for the upcoming laparoscopic surgery camp, to be held in conjunction with the Kenya Society for Endoscopic Specialties (KESES) from June 1 - 3, 2017.

RESEARCH UPDATE

Our research teams are continuing to work on projects centered around the Division Pillars as follows:  

The ESM-Ketamine research team is continuing to work on  several studies / manuscripts surrounding the ESM-Ketamine work. Two manuscripts reporting on ESM-Ketamine use for gynecologic operative procedures and for procedural sedation (at Siaya County Hospital) have been submitted for peer review. Two manuscripts, reporting on ESM-Ketamine use for operative orthopedic procedures and for supporting reproductive health procedures (with a focus on areas of humanitarian crisis) are currently in progress. A qualitative study of surgeons performing abdominal laparotomies has been developed, local collaborators are being involved, and the IRB submission process has been initiated. 

ED registry –REDCap backlog has been completed and charts are being entered as patients are discharged. Quality improvement efforts continue to ensure data entry is complete. 

ED registry (Pediatric) - A literature review was completed. The initial draft of the paper will be in process once REDCap data is available. 

ESM-STK – Literature review underway.  Efforts continue to maximize this service to the community and understand barriers. Clinicians continue to be retrained on how to diagnose STEMIs on EKG as well as when to get a EKG. 

ESM-Newborn Resuscitation Bundle (ESM-NRB) : This pillar includes a bubble-Continuous Positive Airway Pressure (bCPAP) device designed by our team, and a hospital-level pulse oximeter. bCPAP continues to be used clinically on newborns with great success. Our engineering team is continuing to make improvements on the device, with initial implementation being planned for Kenya in one week. The kit is in its final stages of assembly. Implementation in Zambia is planned for the end of this year.  The training in Kenya took place on May 25th and May 26, 2017 and focused on 5 facilities in Siaya County. The first day of the training took place at AIHT followed by an on-site visit to the facilities on the second day.

Fred Hollows Foundation (FHF): In mid 2016, AIHT was selected by FHF to conduct a survey on its activities in Kenya in regard to increasing the uptake of cataract surgeries and eye services. AIHT has completed the county evaluation and situational analysis across the nine (9) target counties and submitted the report. AIHT has also completed the national evaluation and has submitted the first draft to FHF. AIHT will be presenting the National Report to FHF in Nairobi on Friday, June 9, 2017.

EDUCATION

Teaching Rounds

Topics included unstable tacchycardias and indications for cardioversion, J point elevation, presentations of typhoid, indications for cesarean section, pediatric pneumonia, acute chest syndrome in sickle cell patients, differential of a pancreatic mass, management of sepsis, altered mental status and delirium in the elderly, and neonatal sepsis. 

Residency and Internship Program Update

The interns continue to work together to adjust their schedule in order to optimize their learning experience and exposure to the consultants. Now that they are a few weeks into their current rotation, we are able to dive into , more detail during teaching rounds. They have been refining their schedule in order to optimize everyone's exposure to all of the rotations. 

Hospital Education

This week’s hospital-wide CME was given by Dr. Meghan Lundeberg from UCI and focused on the management of shock and hemorrhage in trauma., Clinical CME this week was EKG and Image of the week. The image was a blood film showing trypomastigotes in the laboratory diagnosis of African Trypanosomiasis (African Sleeping Sickness) which led to a discussion of the symptoms, demographics, and treatment of the disease. The EKG focused on a review of how to read an EKG and a discussion on how to determine the axis.

 2017 May 13th

This week we welcomed back Dr. Kemi Adegoke our OB-GYN fellow. Sagam Community Hospital also hosted UC Irvine guests, Dr. Barrios and Dr. Lundeberg. Ketamine week was held this week and training was provided to two providers from Turkana County and two from SCH. In addition to Ketamine week, we welcomed visiting Kenyan physicians,

Emergency Department Update

The electronic medical record system continues to be working well. Interns, clinical officers, and nurses continue to be trained on the proper usage of the C-arm taught by Javan Imbamba and Joseph Owuor. An emergency room video is currently in the process of being produced to assist and direct patients when they come for treatment at the Hospital. The video highlights the process of registration, nurse triage, seeing a doctor for treatment, and departments for further testing.

Teaching Rounds

Topics included management of heart failure, cryptococcal meningitis, TB meningitis, management of tremors, hyponatremia, CVA, femur fractures, casting, and pain crisis in sickle cell anemia.

Residency and Internship Program Update

The interns continue to work together to adjust their schedule in order to optimize their learning experience and exposure to the consultants. Now that they are a few weeks into their current rotation, we are able to dive into more detail during teaching rounds. They have been refining their schedule in order to optimize everyone's exposure to all of the rotations.

Hospital Education

This week’s hospital-wide CME was on TB in children, its diagnosis and management, Clinical CME followed up on last week’s CME and focused on vasopressors and their use.

2017 May 6 -12 

Fellows: Jonathan Steer, Revathi Ravi, and Sarah Villegas

Program Coordinators:  Joseph Owuor and Gabriella Wuyke

HOSPITAL NEWS

This week SCH held a community outreach in Kodiaga. The outreach was a success thanks to the efforts of community health workers and hospital staff. The community welcomed SCH with open arms, and took full advantage of the services SCH had to provide. A total of 242 patients received services including blood pressure testing, HIV testing and counseling, family planning services, cervical cancer screening, and clinical consultations. Ketamine Week is scheduled to kick off this upcoming Monday, May 15th-19th.

EMERGENCY DEPARTMENT UPDATE

The electronic medical record system continues to be working well. Interns, clinical officers, and nurses continue to be trained on the proper usage of the C-arm taught by Javan Imbamba and Joseph Owuor. An emergency room video is currently in the process of being produced to assist and direct patients when they come for treatment at the Hospital. The video highlights the process of registration, nurse triage, seeing a doctor for treatment, and departments for further testing.

RESEARCH UPDATE

Our research teams are continuing to work on projects centered around the Division Pillars as follows:  

The ESM-Ketamine research team is continuing to work on  several studies / manuscripts surrounding the ESM-Ketamine work. Two manuscripts reporting on ESM-Ketamine use for gynecologic operative procedures and for procedural sedation (at Siaya County Hospital) have been submitted for peer review. Two manuscripts, reporting on ESM-Ketamine use for operative orthopedic procedures and for supporting reproductive health procedures (with a focus on areas of humanitarian crisis) are currently in progress. A qualitative study of surgeons performing abdominal laparotomies has been developed, local collaborators are being involved, and the IRB submission process been initiated. 

ED registry (Pediatric) - A literature review was completed. The initial draft of the paper will be in process once REDCap data is available. 

ESM-STK – Literature review underway.  Efforts continue to maximize this service to the community and understand barriers. Clinicians continue to be retrained on how to diagnose STEMIs on EKG as well as when to get a EKG. 

ESM-Newborn Resuscitation Bundle (ESM-NRB) : This pillar includes a bubble-Continuous Positive Airway Pressure (bCPAP) device designed by our team, and a hospital-level pulse oximeter. bCPAP continues to be used clinically on newborns with great success. Our engineering team is continuing to make improvements on the device, with initial implementation being planned for India and Kenya in two weeks. The kit is in its final stages of assembly. Implementation in Zambia is planned for the end of this year.  The training in Kenya is set to take off at the end of May 2017.

Fred Hollows Foundation (FHF): In mid 2016, AIHT was selected by FHF to conduct a survey on its activities in Kenya in regard to increasing the uptake of cataract surgeries and eye services. AIHT has completed the county evaluation and situational analysis across the nine (9) target counties and submitted the report. AIHT has also completed the national evaluation and will be submitting the first draft to FHF.

EDUCATION

Teaching Rounds 

Topics included meconium aspiration, status epilepticus, child abuse, febrile seizure, buruli ulcer, TB meningitis, toxoplasmosis, and syphilis.

Residency and Internship Program Update

The interns continue to work together to adjust their schedule in order to optimize their learning experience and exposure to the consultants. Now that they are a few weeks into their current rotation, we are able to dive into more detail during teaching rounds. They have been refining their schedule in order to optimize everyone's exposure to all of the rotations. 

Hospital Education

This week’s hospital-wide CME was DHIS2, District Health Information Services version 2. It is a comprehensive system that allows customer care to uploading disease demographics to a central database. Clinical CME was done by Javan CO and Daniel MOI and focused on the diagnosis and treatment of sepsis.

April 8th-14th

HOSPITAL NEWS

All of the staff and clients were in great spirits as the holiday weekend was entered. Sagam Community Hospital.

(SCH) continues to provide quality care to the wider community. This week SCH traveled to Wagai for community outreach in Siaya County, and eye, ear, and throat services were also provided. 

EMERGENCY DEPARTMENT UPDATE 

The electronic medical record system continues to be working well. During the course of the month interns, clinical officers, and nurses will be trained on the proper usage of the C-arm taught by Javan Imbamba and Joseph Owuor

RESEARCH UPDATE

Our research teams are continuing to work on projects centered around the Division Pillars as follows: !! The next monthly training will be April 24-28, 2017 at Sagam. This was postponed from the original date (April 17 - 21, 2017) due to the Easter Holiday period. 

EDUCATION 

Teaching Rounds 

Topics included premature rupture of membranes, augmentation of labor, pelvic inflammatory disease, vaginal cuff dehiscence, antibiotic selection for cellulitis, electrolyte replacement, and cardiomyopathy. 

Residency and Internship Program Update 

The interns continue to work together to adjust their schedule in order to optimize their learning experience and exposure to the consultants. They are gearing up to move to their new rotations on Monday: Of late there has been focus on documentation and the fellows have been striving to improve the interns’ notes. 

Hospital Education 

The hospital-wide CME was given by Jacky, one of the clinical officers, on a morbidity and mortality case.

Clinical CME was cancelled due to the holiday but will pick up again next week 

April 1st - April 7th 

Fellows: Jonathan Steer and Revathi Ravi

Program Coordinators:  Joseph Owuor and Gabriella Wuyke

HOSPITAL NEWS

Sagam Community Hospital (SCH) continues to provide quality care to the wider community. This week SCH traveled to Asembo for community outreach in Siaya County. Repairs and updates continue to be carried out throughout the Hospital on some of the medical machines in the emergency department and the theatre. 

Fred Hollows Foundation (FHF): In mid 2016, AIHT was selected by FHF to conduct a survey on its activities in Kenya in regard to increasing the uptake of cataract surgeries and eye services. AIHT has completed the county evaluation and situational analysis across the nine (9) target counties and submitted the report. AIHT has began the national evaluation. On Monday, March 27, 2017, AIHT presented the findings from the county evaluation and situational analysis to FHF staff representing the national, regional (Africa) and headquarters (Australia). AIHT received feedback on the report which they are currently incorporating in the draft report for final submission to FHF

EDUCATION

Teaching Rounds

Topics included Parkinson's syndrome, Fitz Hugh Curtis Syndrome, acute and chronic pancreatitis, heart failure, sickle cell disease, and QT Prolongation.

Residency and Internship Program Update

The interns have made their first switch this week to their new departments in the hospital, rotating between obstetrics, gynecology, pediatrics, surgery, emergency medicine, internal medicine and critical care patients in the high dependence unit every two weeks. The fellows continue to reinforce their medical education with daily journal review articles, discussion topics, and readings from texts from the AIHT library which they have been carrying with them and reading between patient care. 

Hospital Education

The hospital-wide CME was given by the Laboratory Department on anemia. It involved educating participants on the details of a full hemogram and how it can be used to interpret the different types of anemia. Clinician CME this week was lead by Dr. Revathi Ravi, reviewing QT-prolongation and methodology for EKG readings. We discussed in depth Einthoven’s triangle and ended with the image of the week, a picture of small bowel obstruction in a 72 year old female caused by ingestion of a plastic ball in her small intestines. 

November 18th - 24th

SCH Physicians: Dr. Nyamogo (OB-GYN), Dr. Alwar (Paediatrics), Dr. Ligeyo (Surgery), and Dr. Ouma (Family Medicine) 

Program Coordinators:  Joseph Owuor and Phoebe Khelleher

Family and Emergency Medicine Residents: Dr. Ochola, Dr. Luate, Dr. Shivachi, Dr. Wanikina, and Dr. Moseti

Interns: Dr. Mule, Dr. Akonyu, Dr. Suheil, and Dr. Mucheru 

Volunteer: Ms. Nicole Agutu

HOSPITAL NEWS

Sagam Community Hospital’s emergency department and daily operations continue to normalize, and our dedicated hospital staff continues to provide care to its patients and to the wider community. This week SCH hosted a blood drive in conjunction with the Kisumu Branch of the Kenya National Blood Transfusion Service. We thank all of our staff and visitors that donated blood to help deal with shortages that we are experiencing in the region. We are grateful for this opportunity to improve the care of our patients at Sagam and beyond. We would like to thank and appreciate our laboratory team Eric, Ben, and Josephine for making the necessary arrangements for a successful blood drive. In total, we were able to donate twenty-eight pints of blood.

Preparations continue as we get ready to host a ESM-Ketamine training anesthesiologists, ob/gyns and nurses from Saskatchewan, Canada from December 4 - 8, 2017. We also look forward to welcoming our MGH family 

EMERGENCY DEPARTMENT UPDATE

The electronic medical record system continues to be working well. An EMR update is scheduled to take place, and it is to be determined. The updates will occur in three phases throughout the month that will include updating the EMR interphase, adding an import/export option for data collection, implementing reporting tools for the system, and allowing domain access to the EMR system. The first phase of the EMR integration, updating the EMR interface, has been complete. The second phase, adding an import/export option for data collection, is currently postponed due to elections.

Emergency Department simulations continue to run regularly at Sagam on Tuesdays and Thursdays.

EDUCATION

Residency and Internship Program Update   The interns continue to work together to adjust their schedules to optimize their learning experiences and exposure to the consultants. They have been refining their schedules to optimize everyone's exposure to all the rotations. 

Hospital Education

This week’s hospital wide CME was taught by Were, HIV counselor, and focused on HIV testing. Our Clinical Officer Javan Imbamba taught this weeks’ clinical CME, and the CME focused on tachycardia. 

 December 29, 2017 -  January 5, 2018

SCH Physicians: Dr. Nyamogo (OB-GYN), Dr. Alwar (Paediatrics), Dr. Ligeyo (Surgery), and Dr. Ouma (Family Medicine)  

Family and Emergency Medicine Residents: Dr. Ochola, Dr. Luate, Dr. Shivachi, and Dr. Moseti

Interns: Dr. Mucheru 

Program Coordinators:  Joseph Owuor and Phoebe Kelleher

HOSPITAL NEWS

It has been a busy week clinically at Sagam Community Hospital. We had a high number of births, and our outpatient clinics resumed regular hours following the holiday season. We applaud the strong efforts of the emergency department staff and the customer care staff. Our ward nurse in charge Titus Kwede continues to educate his staff by conducting trainings in Helping Babies Breathe to strengthen newborn resuscitation knowledge throughout the hospital. As his efforts to educate his nursing staff progress, he hopes to cover ESM-NRB bCPAP training in the coming weeks. 

We are looking forward to an exciting month of January! In the following weeks we will be welcoming a new Global Health Leadership fellow, staff from the Division of Global Health and Human Right at Massachusetts General Hospital, and a researcher from T. H. Chan Harvard School of Public Health. We wish them safe travels and are excited to work alongside them when they arrive in Sagam!

EDUCATION

Teaching Rounds

This weeks teaching rounds were a collaborative effort of all the Clinical Officers. Topics included reporting in the EMR, reading EKGs, antibiotics and antibiotic resistance, and osteomyelitis. 

Residency and Internship Program Update

The interns continue to work together to adjust their schedules to optimize their learning experiences and exposure to the consultants. They have been refining their schedules to optimize everyone's exposure to all the rotations. They look forward to welcoming a new consultant next week. 

Virtual e-learning classes taught by Dr. Hiren Patel will resume classes after the holidays.     

We continue to receive a high request of inquiries from medical officer interns applying to our internship programme and will update the team once the Kenya Medical Practitioners and Dentists Board (KMPDB) and the Ministry of Health (MOH) confirms placement of additional interns. 

Hospital Education

This week’s hospital wide CME was taught by Rogers, our equipment technician. Rogers included a video focusing on how to properly store and utilize oxygen tanks in the hospital. The nursing CME was cancelled. This weeks clinical CME was taught by our Clinical Officer Javan Imbamba, and the CME focused on the improvements in the EMR system. 

February 22nd.

The ongoing dispute between the Kenya Medical Practitioners, Pharmacists and Dentists Union and the Kenya Government has now passed the two month mark. Sagam Community Hospital continues to work hard to provide care to referrals and the community at large. SCH continues to collaborate with Siaya County in the handling of emergency cases and surgeries to ensure that the patients that arrive for care receive what they need through our referral system. We are thankful to the SCH staff, residents and interns with support from various consultants within Kenya and MGH that are supporting this effort.

Visiting Medical Students

Last week we said goodbye to Jessica Vdweijden (a Dutch visiting medical student) who has been here for the last three months. Jessica is returning to the Netherlands to work on research with plans to continue her medical school while obtaining a PhD. She has been fantastic, actively participating in rounds, assisting in surgeries, and attending outreaches. In addition, she and Stefanie, another visiting medical student, created a video to educate patients on triage and the ER. This video is currently in the final editing process. Much gratitude to them both!

Emergency department Update

Due to the strike the Emergency Room continues to see more volume while running a full High Dependency Unit with extension into the other ER beds due to the large acuity we are experiencing. The emergency department is utilizing the new electronic medical records system which has been many months in the making. The medical students have completed a script for a movie to play in the waiting room to explain to the patients the flow and workings of the emergency department.

February 21st.

All of the staff and clients were in great spirits as the holiday weekend was entered. Sagam Community Hospital (SCH) continues to provide quality care to the wider community. This week SCH traveled to Wagai for community outreach in Siaya County, and eye, ear, and throat services were also provided.

Emergecy Department Update

The electronic medical record system continues to be working well. During the course of the month interns, clinical officers, and nurses will be trained on the proper usage of the C-arm taught by Javan Imbamba and Joseph Owuor.

Research Update

Our research teams are continuing to work on projects centered around the Division Pillars.

Education /Teaching Rounds

Topics included premature rupture of membranes, augmentation of labor, pelvic inflammatory disease, vaginal cuff dehiscence, antibiotic selection for cellulitis, electrolyte replacement, and cardiomyopathy.

Residency and Internship Program Update

The interns continue to work together to adjust their schedule in order to optimize their learning experience and exposure to the consultants. They are gearing up to move to their new rotations on Monday: Of late there has been focus on documentation and the fellows have been striving to improve the interns’ notes.

Hospital Education

The hospital-wide CME was given by Jacky, one of the clinical officers, on a morbidity and mortality case. Clinical CME was cancelled due to the holiday but will pick up again next week.

February 19th.

Fellows: Dr. Sarah Villegas and Dr. Kemi Adegoke 

Visiting Physician: Dr. Mindy Sherman

Visiting Medical Student: Hana Haver

Program Coordinators:  Joseph Owuor and Gabriella Wuyke

HOSPITAL NEWS

This week marked the sixth day of the ongoing nurse’s strike. Sagam Community Hospital (SCH) has continued to work hard to provide care to the wider community; SCH is the only non-governmental hospital offering surgical services in Siaya County, and the number of obstetric emergency surgeries has more than doubled. We are thankful to have many hands on deck to help at this time. 

This week, SCH also traveled to Asembo for community outreach in Siaya County. Comprehensive services were offered including: blood pressure check, cervical cancer screen, family planning, HIV testing, pediatric vaccinations, and vision services. 

RESEARCH UPDATE

Our research teams are continuing to work on projects centered around the Division Pillars as follows:  

The ESM-Ketamine research team is continuing to work on  several studies / manuscripts surrounding the ESM-Ketamine work. Two manuscripts reporting on ESM-Ketamine use for gynecologic operative procedures and for procedural sedation (at Siaya County Hospital) have been submitted for peer review. Two manuscripts, reporting on ESM-Ketamine use for operative orthopedic procedures and for supporting reproductive health procedures (with a focus on areas of humanitarian crisis) are currently in progress. A qualitative study of surgeons performing abdominal laparotomies has been developed, local collaborators are being involved, and the IRB submission process been initiated. 

Fred Hollows Foundation (FHF): In mid 2016, AIHT was selected by FHF to conduct a survey on its activities in Kenya in regard to increasing the uptake of cataract surgeries and eye services. AIHT has completed the county evaluation and situational analysis across the nine (9) target counties and submitted the report. AIHT has also completed the national evaluation and has submitted the first draft to FHF. AIHT will be holding another presentation on the National Report for FHF in Nairobi on Wednesday, June 14, 2017. 

EDUCATION

Teaching Rounds

Topics included different types of cardiac phenomenon on EKGs, tetanus, uterine rupture, pre-eclampsia/eclampsia, cervical and breast cancer, sepsis, cephalohematomas, and indications for induction of labor.

Residency and Internship Program Update

The interns continue to work together to adjust their schedule in order to optimize their learning experience and exposure to the consultants. They have been refining their schedule in order to optimize everyone's exposure to all of the rotations. We had a meeting with Maseno University and discussed the residents who will be rotating at Sagam in the coming months.

February 11th  2017

This week marked the end of the thirteenth week of the ongoing Kenya doctors strike. Sagam Community Hospital (SCH) has continued to work hard to provide care to the wider community; SCH is the only non- governmental hospital offering surgical services in Siaya County, and the number of obstetric emergency surgeries and scheduled surgeries has more than doubled. We are thankful to have many hands on deck to help at this time.

Sagam expanding services

Sagam is continuing to expand its services provided. Doctors Shikha Kapil and Hiren Patel have continued hospital wide education for BLS and ACLS. We have invited Dr. Gregory Ganda, a Kenyan Gynecologic Oncologist, to operate at Sagam. Last Saturday a radical hysterectomy was performed at Sagam, the first one in many years. The entire hospital worked hard to provide superior pre-, intra- and postoperative care. There are plans to continue cancer surgeries on Fridays at Sagam. In addition, we are continuing to work on providing laparoscopy at Sagam. The initial trial of laparoscopy proved the light too dim to visualize within the abdomen. We will be contacting technicians for assistance so we can begin laparoscopy at Sagam.

Outreach

This week the SCH community outreach team went to Mumias where we ran another successful clinic, thanks to the tremendous efforts of the nurses from our Hospital.

16 JANUARY 2017