University of Eastern Africa Baraton, Kenya
Student assignment – Master’s Degree in Global Health Care
EMERGENCY PLAN IN A LOCAL HEALTH FACILITY
IN RURAL KENYA
Student:
Dorcas Adega-Ayodo
Name of Study Unit:
GHED
Assignment name
and/or number:
Midcourse Assignment
Date:
08-01-2015
Reference guidance:
When referring to this document, please indicate the name of the author, publishing year, title of the document and the text: This document is originally published and available at: repository.ueab.ac.ke Accessed: Date.
Document synopsis:
The article describes the emergency plan for a sub health centre in Rural Kenya. With
limited resources in terms of personnel and finance, they make good use of locally
available resources and ensure a referral system to transfer cases they cannot deal
with. Examples include using of sand box to deal with fire outbreaks since they lack
fire extinguishers. The sand boxes are also easier to use as most locals have no
training in the use of the extinguishers. It details the innovative aspect of dealing with
emergencies even in remote settings.
Table of contents
Hospital emergency plan ......................................................................................... 4
Q1 What emergency plan do they have? ............................................................................... 4
Q2 How are they equipped for emergencies? ........................................................................ 5
Q3 What are the major risks and how do they prevent them? ............................................... 5
List of references ..................................................................................................... 7
HOSPITAL EMERGENCY PLAN
Q1 What emergency plan do they have?
An emergency plan Bware sub health centre is a facility that caters for a catchment area covering 14,845 people. Until recently, it was still a dispensary and was upgraded to a sub health
centre although this has not yet been gazette. Bware sub health centre is about 4-7km from
other health facilities of its cadre, which include Thim Jope, God Jope, Nyasoko and Kolwal
health centres. It has a patient turn over of 30-100 patients per day, mainly outpatients. Its
inpatient capacity is about 8-10 beds which focuses mainly on obstetric cases. The center has
a total of 12 staff members; 2 clinical officers, 3 registered nurses, 2 peer educators, 1 data
clerk, 3 surbordinate staff and 1 watchman.
The Kenyan 1 public health system consists of the following levels of health facilities: national
referral hospitals, provincial general hospitals, district hospitals, health centres, and dispensaries. The network of health centres provides many of the ambulatory health services. Health
centres generally offer preventive and curative services, mostly adapted to local needs. Dispensaries are meant to be the system’s first line of contact with patients, but in some areas, health
centres or even hospitals are effectively the first points of contact. Dispensaries provide wider
coverage for preventive health measures, which is a primary goal of the health policy.
As a health centre, Bware sub health center caters mainly for local needs. Its laid down emergency plan focuses mainly on obstetric care. The procedure for handling obstetric emergencies
is referral to the district level. An ambulance is sent from the district level to offer transport for
those with difficulty in delivery.
For fire emergencies, they have in place sand boxes at strategic points that can be easily used
by anyone, including locals for putting out fire. There are plans to have fire drills with evacuation routes and collection points for the staff. This idea was proposed after the interview we
had in order to enhance disaster preparedness.
With the current Ebola epidemic, plans for preparation for any incidence have been rolled out
by the government under the 2 ‘Emergency plan of Action (EPoA), Kenya: Ebola virus disease
preparedness.’ Since Bware sub-health centre is not at a border point, the government has not
4
equipped them with necessary equipment for containing the situation, but the health workers
have been briefed on how to identify cases and report. As such, the health centre acts as a
surveillance post in the event of disease. They do not have space for isolation in case this is
necessary and as such can only identify and report.
There is still no concrete plan for emergencies during conflict. This was the case during the 4
post election violence during which the health centre was closed since the workers could not
get transportation to their work place, nor security to and from work. This is an aspect that can
be planned for in future.
Q2 How are they equipped for emergencies?
An emergency is a sudden occurrence demanding immediate action due to epidemics, natural
or technological catastrophes. Planning for emergencies is vital to ensure adequate response
and minimize losses.
At Bware, the following measures have been taken to deal with emergencies.
a) Construction of two houses to allow for 24hr presence of resident nurses. This makes
it possible to handle emergencies more effectively.
b) Adequate referral system to allow for quick transfer of patients. This is slightly impeded
as they rely on the ambulance from the district.
c) Ramps at the main exit to ease the movement of non-ambulatory patients.
d) Sand boxes placed at strategic points to enable extinguishing of possible fires.
e) Trained community health workers (lay health workers) who are called upon to help in
case of an upsurge in patients. An example is their training in the use of 3 RDT (Rapid
diagnostic test) kits to test for malaria in areas without electricity. Stocking of food for
malnutrition in the event of a major catastrophe. The food is donated by USAID.
f)
Distribution of nets to prevent malaria.
g) Presence of sterilizing kits to prevent infection. These kits were donated by the Kenya
Red Cross.
Q3 What are the major risks and how do they prevent them?
The major risk in this area is that of malaria infection. Malaria infection posts the highest number of cases.
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Strategies to prevent this trend include:
1. Outreach to peoples homes in order to educate them on how to reduce breeding of mosquitoes. This includes keeping grass short, cutting down of bushes and draining of stagnant water.
2. Health seminars at the centre held twice a week to increase awareness on malaria prevention.
3. Net distribution to the locals. Over 2062 bed nets have been distributed moreso too
homes with children under 5 and to pregnant women.
4. Residual insecticide spraying in homes to reduce the population of mosquitoes.
5. The introduction of 3 RDT (Rapid Diagnostic Test) kits for prompt diagnosis of malaria.
6. Training of community health workers to test and treat people with malaria in their
homes.
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LIST OF REFERENCES
1. http://dhsprogram.com/pubs/pdf/spa8/02chapter.pdf
2. Emergency Plan of Action (EPoA). Kenya: Ebola Virus Disease Preparedness. International Federation of Red Cross and Red Crescent Societies
3. Malaria Diagnosis: A Guide for Selecting Rapid Diagnostic Test (RDT) kits. 1st Edition.
Unicef
2007
http://www.unicef.org/french/supply/files/Guidance_for_ma-
laria_rapid_tests.pdf
4. Sisaye S. L.,Violent Civil Conflict and its Impact on Health Outcomes: A Closer Look
at Kenya’s 2007-2008 post-election violence. University of Virginia, 2009 Submitted
to the Graduate Faculty of the Graduate School of Public in partial fulfillment of the
requirements for the degree of Master of Public Health University of Pittsburgh 2013
http://d-scholarship.pitt.edu/18136/1/Sisaye_ETD- 2013.pdf
5. 5. Melab Vutagwa Amwayi, Nurse-in-Charge, Bware Subhealth Center