Once in a while at Murang’a Level 5 Hospital the gynecologist strays into other departments to say hi. On Monday 26th March 2018 I strolled into the Renal – Dialysis Unit. HE Hon. Uhuru Kenyatta officially opened the unit on my birthday in 2016, but it had been functional for some time before that.
Meet Kyura. She is a renal nurse employed by Murang’a County Government to work in the Renal dialysis Unit at Murang’a County Hospital. Two other gentlemen are present in a unit teeming with clients. I stroll in and find nine patients on the nine dialysis-machines. They were undergoing hemodialysis. I was informed that there were four more dialysis clients waiting in the flanks for their turn. The unit was impressively clean and the clients looked happy.
I asked Kyura to explain to me something on one of the patients. She was so busy documenting the progress of the clients she did not heed to my inquisition. The nursing shortage in the unit was obvious.
I ‘gota’ one of the patients who was on dialysis. I noticed that he had 2 intravenous cannulas on his left forearm. They are connected to the dialysis machine via pipes. Blood is flowing in and out of them.
“So who is putting the canulas nowadays?” I asked, knowing that the gurus of inserting the hemodialysis cannulas Dr Davis Ombui & Dr James Kahura had returned to school to learn how to put the cannulas better. I was informed that there was a new cannula guru in town called Dr Wambui. She was the physician Muran’ga Level V Hospital and the latest consultant to arrive. I was also informed that another cannulation guru was Dr Mueni Mark. She was the medical officer & physician-to-be. Her specialization in the near future would be subject to the county releasing her for further studies. Cannulation was key to hemodialysis. I was informed that an arterio-venous shunt cannulation could be fashioned for a more efficient dialysis session. One of the clients had an arterio-venous shunt. The vein was visible large. “Can Dr Mueni do a arterio venous shunt cannula?” I asked. “No. We send them to Kenyatta National Hospital to the vascular surgeon” he said. This is a case for stepping up specialization training.
Indeed some good work is going down in the public health sector. Dialysis was a pet project of Dr. James Kahura, physician Murang’a level V Hospital. He is now well on his way to becoming a renal physician, a sub-specialization of medicine. The County Government of Murang’a took the project up well. It had its teething problems but eventually Dr. James Kahura, Dr. Davis Ombui and a nursing cohort were trained at the renal unit at Kenyatta National Hospital. This team operationalized the dialysis unit that is doing great work to date.
The solutions to our public health problems lie within us. The doctors & nurses & other human resource for health must be supported to improve health provision in public health facilities.
The government support requested for health workforce to actualize UHC is:
- Employing adequate staff in all the health facilities
- Facilitating training of medical personnel in skill development
- Supporting specialization and sub-specialization of health workers
- Providing medical commodities and supplies to the health facilities to run
- Acknowledging the good work done by health workforce by providing all the necessary incentives to increase productivity.
“The ability of a country to meet its health goals depends largely on the knowledge skills, motivation and deployment of people organizing and delivering health services” – WHO