The site I chose for my 10 weeks of community service was westlands health center; a small government run clinic in the heart of westlands off Waiyaki way. It is regulated by the local city council in conjunction with the Nairobi County government. The center was opened on 20th June 1974 since; has a clear vision to be a leader in the provision of sustainable, acceptable, affordable and accessible health-care to all Nairobians whilst the mission is to provide quality, curative, preventive and rehabilitation health-care to all the residents of Nairobi.
The center acts on its vision and mission statements by operating 5 days a week; from Monday to Friday from 8am to 5 pm, excluding public holidays, and is a cost free government subsidized clinic open to all individuals. It has various departments such as: a general out-patient area, a clinic with a laboratory, Voluntary Counselling and Testing (VCT), pharmacy, child welfare and lastly a maternity and antenatal clinic. All patients seeking treatment or tests are first required to enlist at the clinic entrance and undergo a general check-up prior to the relevant department being visited. The Clinic currently has an administrator by the name of Jemimah Ayodi. The administrator was changed during the duration of our community service, as they were transferred by the county government to another location.
The clinic is run and regulate by the Nairobi city Council in conjunction with the Nairobi County Government. Apart from the funding and allowances received from the Kenyan government, the center is also a recipient of aid in the form of medicine and contraceptives from bodies such as the United Nations Family Planning Agency (UNFPA), USAID,and many more international non-governmental organizations and donors that contribute to the running and continued work of the health center.
The westlands Health center was a designated center that myself, and a select 15 other students has chosen to be part of for the next 10 or so weeks of our spring semester. An honest review and look-back at day 1 makes me feel somewhat disheartened, because of the state of the facility, and the work seeming to be a little too manual. However, from week 1, myself and a fellow student enrolled in the antenatal and maternity clinic, and instantly realized that community service is a key aspect for every person wishing to step into the professional world. I instantly realized the need for humility when serving a person; whether they were sick, pregnant, or bringing their child for a check-up, I understood that I was playing a part in someone’s life, by helping them get crucial services.
One key aspect that caught my eye while working at westlands health center and that I found very displeasing; was the number of patients turned away every single day. From week 1 to the last week worked, we saw only a certain number of patients (ranging from 40-70) to be seen on a given day in certain departments. This was due to the understaffed nature of the clinic; and saw pregnant women, sick old people, and even infants, all turned away or told to seek help in another clinic. I found this disheartening.
Although I worked in a number of departments and changed the department every 2 weeks, due to the Corona Virus pandemic; was asked by the clinic to stop attending the community service for personal safety reasons. This meant I would not be able to finish my hours required; but moreover; this service that I had begun to feel entitled to help out in, was no more. I found this particularly strange as the service had become part of a daily routine; and helping take blood- pressure, measuring and interacting with children; and getting to know and work with the center’s staff was becoming a part of my daily life.
Learned Experiences/ Gained Knowledge
A lot of key take-away experiences can be observed from the time worked in the westlands health Center. The many different departments had us as students divided into the various departments with a bi-weekly change. I worked in the following departments and learnt the following key aspects:
Laboratory- it is very simple and costs very little money to do blood tests and test for hepatitis (A&B) as well as tuberculosis (TB), cholera and HIV (AIDS) in a cheap simply stocked laboratory in a few minutes.
Triage- Key metrics before seeing a doctor are blood pressure, temperature, and height for almost every illness before any testing is done
Antenatal- pregnancy check-ups are done every 5 weeks, and on Fridays; pregnancy classes for young women wishing to get pregnant, and the already pregnant are held.
Pharmacy- Provides prescription medication as well as repetitive prescription medication from NGO and Government donor subsidies Free of charge to all.
Front Entrance- Uses manual records to keep all daily recorded patients in alphabetic order.
I worked in various departments every 2 weeks; however also shifted as surges in demand were required. Due to the corona virus outbreak, myself alongside my fellow colleagues; were advised to stop work at the center by the management and our lecturer. As a result, I managed to clock 68 hours in westlands health center. My activities involved:
- Blood pressure and weight recording at the antenatal clinic
- Blood pressure, weight, BMI, Pulse, Temperature and height recording at the triage
- Patient record filling at the entrance desk
- Filling medicines and arranging medication in the pharmacy on shelves and in the store
- Record entry in the laboratory
- Food Handling license stamping and record entry in the laboratory office
While working at the triage, many times, myself alongside a fellow student, were left to record only 40, 50, or 60 patients depending on the number of doctors available at a time. Many times we had to turn waiting sick people after reaching the set limit. This invoked a response, arguing and even saddened people who were frustrated and would should at the center staff. The only time we had exceptions to this number, is once a week when children from the Jacaranda Special needs school arrived. They would jump the queue due to their medical conditions and disorders, and after much struggle to stop them fidgeting; would send them to see a doctor. But their constant fidgeting gave inaccurate blood pressure readings, and prompted them to come back to the triage again for repeated blood pressure readings.
The clinic, although established in 1974, has a strong link to both the Kenyan government and its objectives, as well as several Non-Governmental Organizations. Firstly, it is in line with the Kenyan Vision 2030 under pillar of public sector and services reforms, with the task of serving quality health-care to the public. Furthermore, under the Kenyan constitution, Article 43, section 1, Part a, every person has the right to highest attainable standard of health and access to health-care services with an inclusion to reproductive health-care. The clinic, being a government subsidized and run clinic; falls in line with all these mentioned regulations and objectives. The government has several centers countrywide to achieve these goals.
Furthermore, millennium goal 5 on improving maternity care and goal 6 on combating malaria, HIV and other diseases are achieved through the clinic and Sustainable development goal 3 of good health-care as well is a key part of the task of the health-center and its operation.
The health center also receives aid and donations from a variety of Non-Governmental organizations. Some of these are;
- US Aid- An initiative by the American government; across the globe to provide aid and assistance. Its vision is to foster sustainable development and enhance human dignity globally, achieved through humanitarian situation response, health-care and monetary aid, and dispute resolution across the globe. It donates medication and equipment to the health center.
- United Nations Family Planning Agency (UNFPA)- This initiative by the United Nations is aimed at helping educate the population on safe sexual interactions through contraceptive usage. It donates numerous medication and contraceptives to the health center; and helps in curbing in spread of Sexually Transmitted Diseases (STD’s)
Conclusion and Recommendations
The roughly 8 weeks spent at the westlands health center; were an eye opening and learning experience for myself. I firstly got to interact and understand that health-care is a necessity for all individuals of society, and a resource that people would travel from far and wide to access. In my time at the clinic, I also learnt the necessity of humility in a working environment and space. It is absolutely crucial to respect everyone, and work hand in hand with colleagues to make any venture successful, and carry out the daily tasks.
I also understood the need to be a critical thinker; one of USIU-Africa’s core values; in times of dispute, and when uncertainties occurred in the health center. This showed me that indeed the community service was an essential part of every undergraduate student’s degree program, as it not only prepared us for the professional world, but also put some necessary skill into practice.
We as students working at the health-center, had noticed a number of key issues and problems at the clinic that we wished to address. These were in the line of their lack of blood pressure and temperature equipment’s for patient check-ups; and had proposed a donation from a combined contribution. This was to be done in goodwill at the end of our tenure, and we await further instructions from our course lecturer.
Another key problem we had noticed at the clinic was an actual possibility to make additional revenue for the maintenance and running of the health-center. The center has a large parking space with several taxis and private vehicles parked in the vicinity. A recommendation was a daily parking fees to be charged of 100 shillings per vehicle per day. This would not only raise revenue, but also help assist in the smoother running and maintenance of the center. It would help overcome the understaffing problem, and even the hygiene issues can be sorted.
I understand the work done at the health-center was a learning experience and a preparation to the professional business world. I largely benefitted from the experience and highly applaud and thank the management and faculty of USIU-Africa for not only providing the platform, but also continually allowing students the opportunity. I furthermore thank the management of the westlands health-center for the amazing opportunity and their cooperation through this course and experience. I put out the recommendations above with a strong belief that they will be used solely to improve the health-center and its facilities, and have no reservations or bad intentions whilst proposing them. Throughout my time spent at the health-center, I feel a strong attachment to the clinic due to the close connection built with its staff, and furthermore, the time spent helping view patients showed me a need to give back to society was essential! I valued the time spent and feel it was indeed productive and helped me expand my worldview in a variety of ways!