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Partnerships breathe life to Universal Health Care agenda in Taita-Taveta

Mama Diana Wakio, 59, calls it a medical miracle. Medics in Taita-Taveta County call it duty. In July 2019 while digging a trench to demarcate her land at Ndashinyi village in Mwatate, her jembe struck a rotten tree stump in the ground unleashing a storm of broken shards.

One flying missile ripped through her left eye. She rushed to administer a remedy; dabbling the eye with salt solution and rubbing foul-smelling medicinal leaves on the inflamed skin. The ministrations seemed to work.

Days later, the swelling subsided; the pain retreated. Still, a halo of alarming reddish hue lingered around the eye. Neighbors assured her it would go away. “I believed them. I did not see the need to seek medical help,” she recalls.

That proved to be a terrible choice. Unknown to her, the impact had scarred her inner eye. It led to formation of a mass that hardened into a cataract. One year later, the cataract had morphed into a giant gelatinous mass that robbed her off her visual abilities.

“My left eye went blind. There was nothing but white solid blur to see. I was reduced to using the right eye,” she says.

Two years later, an outreach eye camp at her rural Msau Dispensary came to her aid. A local Community Health Volunteer (CHV) urged her to attend the camp. After a one-hour delicate operation by a team of eye specialists to remove the cataract, her sight was restored.

Mama Wakio equates the ability to see again to being given a second chance to look afresh at everything she always took for granted. She can now read her Bible and translate stories for her grandchildren.

“I never believed I would see again. I can now. My left eye feels like it has a better focus than the right one,” she says with a delighted laugh.

Her mirth after such a close shave with permanent blindness from cataract infestation is a testament to the sheer exhilaration for thousands of beneficiaries of sight-restoration program by Taita-Taveta County’s Eye Care Center.

Dr. Felix Kimotho, Medical Superintendent at Moi County Referral Hospital in Voi, calls the eye care program a ‘game-changer’ in fighting visual ailments and potential blindness in the region. This program is a direct result of establishment of a state-of-the-art Eye Center at the biggest health facility in the county.

“We are fighting against blindness that comes from eye infections. We have taken the campaign to the rural areas to reach as many people as possible,” he explained.

The establishment of the Eye Center at the referral hospital is a testament on how strategic partnerships in the health sector are promoting delivery of critical health services to rural areas. It is also a pointer to how the doctrine of Universal Health Care (UHC) in counties is being embraced through collaborative efforts by stakeholders.

The center was started in November 2020 after partnership between the county government and Fred Hollows Foundation. The latter donated advanced ophthalmology equipment worth Sh 6.2 million while the former invested in rehabilitating and furnishing a room where a modern theatre for operations was built.

To date, the center has conducted 572 cataract operations. Over 9,000 people have been screened for eye infections. This figure includes the number of people attended to in outreach camps and those who come at the facility.

Kimotho says they had a target of 900 surgical operations but Covid-19 disruptions saw the target missed. “We wanted to surpass the set target for surgical procedures but there were a lot of public-health restrictions due to Covid-19,” he explains.

Data collected shows the most prevalent eye ailment in the county is allergic conjunctivitis closely followed by cataracts and pseudo-exfoliation. Cases of glaucoma, conjunctival growth and corneal ulcers were also reported.

The medic discloses that plans are underway to do research on the prevalence of allergic conjunctivitis in the region. “We need to establish why there are high numbers on this ailment especially in low lands and whether it is related to dust and presence of impurities in the air,” he said.

The county has heavily invested in skilled personnel to support the eye care program. Already, a resident ophthalmologist is running the center at the referral hospital. The center also has three clinical officers and six nurses. A section of the staff is undergoing specialized courses in eye care. This is to allow for opening up of eye clinics in three other sub-county hospitals in the county.

“Once the staff is trained, they will be able to man eye clinics at our level four hospitals in Mwatate, Wundanyi and Taveta. Only the most severe cases will be referred to Voi while the rest can be treated locally,” he explained.

County Executive Committee Member (CECM) for Health John Mwangeka says the aim is to promote UHC and a wide range of health services available to the residents.

“Eye surgeries were being done outside the county or during eye camps. We can now do complex operations in our eye theatre. We can also do other delicate operations that were unavailable in the past,” he says.

One of the biggest obstacles to service delivery has been cost. A private health facility charges an average of Sh 70,000 for a simple cataract removal. With the high levels of poverty in the region, few if any can raise this amount.

Kimotho says the cost at the eye center is hugely subsidized at an average of Sh 7,000. He adds that patients covered under National Hospital Insurance Fund (NHIF) pay nothing. “We tell our people to register with NHIF because it caters for all the expenses for eye operations,” he notes.

The next phase for the Eye Center is to establish an Optical Shop where patients can get specialized glasses and frames. This move would minimize referring patients in need of eyeglasses to other facilities.

“We hope to have our own center for making glasses and frames for eye patients. This would eliminate the need for eye patients to travel elsewhere to buy those visual aids,” he said.

Such rewarding partnerships are not only confined to the field of eye-care. The County has collaborated with Kenya Hemophilia Association for provision of expensive blood supplements to help manage hemophilia and sickle cell blood disorders. The cancer center at Moi County Referral Hospital has partnered with International Cancer Institute to promote tele-medicine in diagnosis, management and treatment of cancer.

A collaboration between the National and County government through the Medical Equipment Leasing Project has seen the county get dialysis machines, a CT scan, a modern x-ray and mammogram.

By Wagema Mwangi


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