A Calling To Care for the Sick and Weak

A Calling To Care for the Sick and Weak

Esther manages commodity supplies with meticulous record keeping {Photo credit: Y. Otieno/MSH.}Photo credit: Y. Otieno/MSH.

This is the advice that Esther Wahome, a registered community health nurse in a Kenyan health facility, gives to her clients when they come to the tuberculosis (TB) clinic. Within a short time, Esther dispenses the drugs to the patient, provides health care advice and updates her records.

Esther’s TB clinic clients are usually referred to Kayole II sub-district hospital from Toto Bora and other smaller health care centers. Kayole II, located on the outskirts of Nairobi, provides free health services and receives nearly 300 outpatients each day.

During a routine supervisory visit conducted by the USAID-funded, MSH-led, Health Commodities and Services Management (HCSM) Program, Esther, a mother of two, spoke about her work at the Kayole II TB Clinic, which she has been running for the last three months.

“I like serving in the TB clinic because I get to see patients who are weak regain their strength. Sometimes the patients come in when they are so weak and close to skin and bones that at times I wonder where to inject them. Seeing patients thrive fulfills me and is my joy,” says a smiling Esther.

HCSM works with the Ministry of Health in Kenya to strengthen systems that deliver health care commodities and related services. HCSM also supports facilities in public, private, and faith-based organizations through training, mentoring, and providing tools that enable better accounting and managing of commodities to help minimize stock outs and ensure access. Kayole II is one of the facilities in HCSM priority districts and one of the larger public hospitals.

The nurses here serve in different clinics --- family planning, maternity, prevention of mother-to-child HIV transmission, child welfare, antenatal and postnatal, and comprehensive care clinics on a three to six month rotational basis. Esther says the TB clinic, where she has served multiple several times, is her favorite.

Esther runs the TB clinic on Monday and Friday every week. Before opening her clinic, she gives health talks on nutrition, prevention, signs and symptoms of TB.

She has been a nurse for the past 15 years and at one point, she almost went into teaching.

“My father was a teacher and he wanted me to be a teacher. But from class three, I knew I always wanted to be a nurse,” says Esther.

So what inspired her to get into nursing?

“As a young girl, my elder brother, the first born in our family was a nurse; and, incidentally, he also married a nurse. I visited the two during school holidays and I just admired the work that both my brother and sister-in-law did --- caring for people who cannot pay you back. That’s how I look at nursing --- a calling to care for the weak and sick.”

In addition to caring, a healthcare worker has to be organized and keep their records up to date to ensure that patients get the medication they need.

“For me the worst thing is to have patient come in and not get medication,” Esther said.

This is something that she hasn’t dealt with thanks to her keenness in record keeping. Esther explains that to manage her commodity supplies, she maintains a commodity tracking system which has monthly records with the beginning balance, closing balance, quantities ordered, positive and negative adjustents; and expiry dates of commodities.

Although at times the TB clinic may lack some medication, they are always in communication with the District TB and Leprosy Coordinator who directs them to other facilities that have the medication they need as they wait for their facilities deliveries.

“I have enough drugs in my store and based on my records, I can estimate how much I will need for the following month. We have also developed networks and work as a team with other facilities and exchange then replace drugs so that no patient leaves without receiving treatment,” she explained.

“Sometimes our consumption may be more than our registered patients because of the transit patients. But our records help to ensure that there is no loss of TB drugs. Every time I get something from our stores, I record it in my bin card. It makes my work easier.”

Kayole II residents are happy that Esther pursued her dream of becoming a nurse.

Esther’s advice to those who wish to join her profession: to be a nurse you need to have a caring heart.

Yvonne Otieno is MSH's communications specialist with the Health Commodities and Services Management (HCSM) program.

Health Commodities and Services Management (HCSM) is a USAID-funded program with a five year implementation period (April 1, 2011-March 31, 2016). The program focuses at the national level on strengthening systems that deliver health care commodities and services for key public health priorities, especially HIV/AIDS, malaria, TB, and reproductive health.

 

Comments

CIEMes
Out of the 300 a day out patients, what is the proportion of female to male patients at Esther Wahome's Kayole II TB clinic? By the overall appearance of the MSH website, it seems the only TB sufferers are women and children. Have all the man died of TB or are they miraculously immune to TB because nobody seems to mention them anywhere or let alone have photos of them? HCSM works with the Ministry of Health in Kenya to strengthen systems that deliver health care commodities and related services. But how can I find out exactly how HCSM works with Ministry of Health? HCSM also supports facilities in public, private, and faith-based organizations through training, mentoring, and providing tools that enable better accounting and managing of commodities to help minimize stock outs and ensure access. Where can I access information about the sort of tools HCSM provides to Faith based organizations? The nurses here serve in different clinics — family planning, maternity, prevention of mother-to-child HIV transmission, child welfare, antenatal and postnatal, and comprehensive care clinics on a three to six month rotational basis. Is the comprehensive clinic also a women/children focused clinic just like the other 5 mentioned clinics? Often, there are Kenyan Women who have the right "caring heart and ability to do nursing" but due to scores at school and the ever increasing high level competition in Kenya for nursing, those right women often miss out. It would be great if there were alternative pathways for training women who have the right aptitude and heart but relatively uncompetitive grades. How can MSH help in this dilemma?
Rachel Hassinger
@CIEMes, thank you for the thoughtful comments. We have forwarded your questions to our HCSM staff in Kenya. Please allow a day or two for a more detailed response. Best regards
Yvonne Otieno
@CIEMes, thank you for sharing the thoughtful comments. This particular story is focused on the clinic where Esther works --- a clinic that focuses on all TB patients: women, men, and children. The support provided and services offered at the clinic target all TB patient groups without discriminating against any particular group. The HCSM project works with the Kenya Ministry of Health to ensure commodities and medicines along with services are being delivered to the patients. A lot of the support is directly to the various departments within the Ministries of Health. HCSM works with the Ministry to roll out interventions that build capacity of health workers and institutions to manage health commodities. These are done through trainings, provision of manual and electronic commodity tools, job aids and other checklists. Implementation of these approaches and tools are led by the Ministries of Health to ensure stock-outs are minimized at health facilities. The comprehensive care clinic is not a women/children focused clinic; it serves all patient groups. The human resource crisis has been identified as a critical issue in the health sector. Training of health workers to meet the increasing demand for health services is being addressed by other partners on the ground. HCSM has worked with the main training institutions to ensure that management of commodities is incorporated as one of the critical modules of the training curriculum at pre-service level. A number of training institutions are reviewing their curricular to ensure this is incorporated. The project has also given their inputs in various initiatives aimed at reviewing the policies that address the health sector human resource challenges.

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