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A report of all the activities that were planned and executed to celebrate the first International Day to End Obstetric Fistula in Kenya that was marked at the Memorial grounds, MTRH; Eldoret East District, Uasin Gishu County on the 23rd of May, 2013.

DHMT ELDORET EAST moheldoreteast@yahoo.com

[Type the phone number] [Type the fax number]

Introduction

A decision to hold a commemoration of the international day to

end obstetric fistula was made in DRH and Uasin Gishu County

was chosen to host the national event.

Consequently, DRH dispatched Mrs. Elizabeth Washika (RH

Project Officer) to brief the CHMT, DHMT & MTRH on the same.

Objectives:

1. Commemorate the international day to end obstetric fistula.

2. Sensitize all stakeholders

3. Hold a free fistula camp at MTRH

Preplanning:

On 13/5/2013 a meeting was held at the DMOH’s office with the

presence of the RH project officer. (Attach Minutes)

A briefing was then done at the County DMS’ office on the same

day. The director was then of the view that we come up with a

programme, a budget, plan daily activities to culminate on

23/5/2013 and do invitation letters.

Quality of the planning process

Several meetings were then held at the DMOH’s office, MTRH’s

board room and at the County Director’s office and resolutions

made as per the attached minutes.

Due to the short notice given to hold the celebrations in UG

County, the planning process was rushed to beat the deadline

compromising the quality of deliberations in the DHMT meetings

that led to several oversights that would later affect the activity.

Social mobilization

Appropriateness

On 18/5/2013, radio announcements were made through Kass

F.M, Sayare F.M and Fish F.M in Swahili and Kalenjin dialects.

The MTRH team dispatched the PRO department to all churches

with the same message. The use of the vernacular radio stations

was appropriate as it reached a critical mass of the populace

owing to the number of calls received from Kenyans making

enquiries and seeking clarifications.

Two county leaders stakeholders meetings were also done and a

consultant OBSGYN (Dr. Chirchir) did a radio live show in a

Kalenjin radio station(KASS F.M.)

Quality

The quality of social mobilization was very good; the use of

radio announcements, churches and a road show had a net

effect of reaching a critical mass of the population. IEC

materials used had a clear message that the people clearly

understood i.e. brochures, banners and T-shirts.

60 HCWs were sensitized on recognition of OF, diagnosis,

treatment, referral and rehabilitation of OF patients.

Coordination

The activity was coordinated by the DHMT Eldoret east

district with the support of the county Director of Health

services and his team. The focal persons were:

Dr. Chirchir A. K - MTRH

Dr. Okumu - UNFPA

Dr. Kuria S. - DRH

Dr. Okoro Dan - UNFPA

Mr. Mely K. S - DRH – co Eld East.

The main mode of communication for the focal persons was

through phone calls and Emails.

Logistics

Timeliness and adequacy

The disbursement of funds took so long, most of the time

holding the DHMT at ransom. Indeed the funds were

received just 48 hours to the event.

The delay resulted in the late acquisition of the relevant

logistics and services, seriously straining the organizers.

Coordination

The logistics were coordinated by the DMOH Eldoret east

with the assistance of the DHMT members. It is important

to note that the two DRH – co from Eldoret west and

Wareng districts were involved in the exercise.

Launch

Coordination:

Flow of information

During the celebrations, ushers were placed in specific

sites to receive and direct visitors to their respective

designated sitting places. The master of ceremony did

also play a key role in guiding the proceedings based on

the day’s program provided. Protocol issues were taken

care of by the MTRH’s Public Relations Officer.

Transport and communication

The movement of the DHMT was largely confined to the

government provided means of transport; members

communicated using their own cell phones using airtime

provided for the exercise.

Decision making and execution

Decisions were made by the DHMT and executed by

delegated officers.

Availability of supplies at the venue

All the budgeted supplies were availed at the venue i.e.

sodas and water. Lunch was however served at the Hotel

Comfy for the invited guests only.

Challenges

- A short notice given for the preparation of the event

- Delayed disbursement of funds

- Lack of capacity by HCWs to diagnose OF.

- Use of MTRH as an entry point to the DHMT as opposed to

the partner working directly with the DHMT.

Lessons Learnt.

- There exists a critical mass of Kenyans suffering silently with

OF.

- There is a resilient work force both in MTRH & MOH who are

ready to work hard to alleviate suffering.

- A concerted effort is needed by both the ministry of Health

and partners to not just reach those in need of treatment and

surgery but to also curb the occurrence of OF’s and

Unnecessary perineal tears.

Recommendations

- The free screening, treatment and surgeries for OF’s should

be sustained at the MTRH. UNFPA should be encouraged to

continue funding the activity; in their absence another

partner be urgently sought to keep the momentum already

gathered. Consequently, DRH should recommend to the

State the need of including free treatment of obstetric

complications in the new free maternity services policy to be

implemented in the next financial year.

- The diagnosis, treatment and surgical management of OF be

incorporated in the existing curriculum for training HCWs on

EMoNC by DRH.

- A lot of capital intensive trainings, procurement of RH

equipments and facilitative support supervision are needed

to build capacity of staff in levels 2, 3 & 4 to provide

Emergency Obstetric Care; a uniform DRH approved

curriculum should be used in line with the National RH

Policy.

- A functional referral system should be put in place to avoid

the second and third delays; to address the first delay,

effective community maternal health programmes should be

put in place through the existing community strategy units.

PICTURE SPEAK

The Coca Cola comedians lead the procession.

Health workers lead a procession to the venue

The MTRH choir performs during the event

Members of the public follow the proceedings

A fistula survivor narrates her ordeal

Dr. A. K. Chirchir, a Fistula surgeon and HOD – RH (MTRH)

making his remarks.

Dr. J. SONGA (U.G County Director of Health Services)

makes his remarks.

Dr. Kibosia J. (Director MTRH) reading his speech.

Dr. Ali, UNFPA Country representative and Chief Guest

reading his speech

His Excellency the Deputy Governor U.G County reading his

speech

HCWs during the OF Sensitization meeting in Asis Hotel

Mrs. Rose Kogo, RH – co Eldoret West explains a point in

the sensitization meeting

Mrs. Jacinta Kamau (SNO – MTRH) facilitates during the

sensitization meeting

DMOH Eldoret East during the sensitization meeting

Dr. Wanjala (OBSGYN – MTRH) makes his closing remarks

during the sensitization meeting

Dr. SONGA J. (County Director Health Services) officially

closing the sensitization meeting

Acknowledgements

The DHMT Eldoret East District is deeply indebted to the

following people and organizations who made this activity a

success and we wholeheartedly thank them:

1. The UNFPA

2. Coca cola co. Ltd.

3. Dr. John Kibosia, Director MTRH

4. Dr. Jackson Songa, Director of Health Services, Uasin

Gishu County

5. Dr. Shiprha Ndiritu, Deputy Head; DRH

6. Dr. Okumu, RH/HIV/AIDs Specialist, UNFPA

7. Dr. Okoro Dan, Programme officer UNFPA

8. Dr. Ammon K. Chirchir, HOD – RH, MTRH

9. Mrs. Judith Maua, Project Officer, DRH

10. Mrs. Elizabeth Washika, Project officer, DRH.

The DHMT members of the three districts of UG County are

deeply appreciated for their immense contribution and sacrifice.

Report done by: MELY K. SAMSON

DRH – co

Eldoret East Disrict.