|© UNICEF Kenya/2006/ Cockburn|
|Medical Superintendent Dr. Khadija Abdalla cares for a malnourished child in Garissa Provincial Hospital’s paediatric ward.|
By Malini Morzaria
GARISSA, Kenya, 5 September 2006 – At Garissa Provincial Hospital in the remote North Eastern Province of Kenya, one doctor has had a big impact on local health. With help from UNICEF, Medical Superintendent Dr. Khadija Abdalla has transformed the small rural hospital into a highly efficent institution.
At first glance, the 220-bed hospital looks much like any other in rural Kenya. But Garissa now employs almost thirty medical professionals, including physicians, dentists, surgeons, pharmacists, eye specialists and four interns. Before 2003, the hospital had only four medical officers, with no specialists except the visiting surgeons sent by the Rotary Club.
“Initially, I lobbied Muslim doctors, explaining that their people are suffering and that something needs to be done,” explained Dr. Abdalla. “Slowly, I pushed for Garissa Provincial Hospital to become an internship training centre, so we have all the facilities to do competent training.”
Garissa is located in one of the areas which was hardest hit by the recent droughts. In February, UNICEF launched an emergency appeal for $16 million, a portion of which was earmarked for health care.
Benefits of good management
There are very few medical doctors providing care in rural Kenya compared to the vast North Eastern Province’s population of about one million people. Most medical personnel do not want to be based in remote areas, and those who are employed there often stay only a short time before changing districts.
Proper management has been integral to Garissa’s success. Dr. Abdalla believes the key lies in having a pre-existing organizational structure firmly in place. That way, when a department head leaves, the systems continue to run smoothly.
“I have a good team who embraced the changes once they saw the impact on people’s lives. As a team, we listen to feedback and make changes if mistakes have been made, so it is an evolving process,” emphasized Dr. Abdalla. She also stressed the importance of involving the staff in the decisions and creating an environment of openness and accountability.
However, programmes are still needed to ensure that the community takes full advantage of Garissa. Local health clinics must be educated on when to send patients to hospital. The rates of maternal deaths in rural Kenya are still high.
“People are referred too late to the hospital and often there is a lack of diagnosis,” Dr. Abdalla explained. “UNICEF is helping us to do outreach and training for clinic personnel so that we can reduce maternal mortality and offer better medical services.”
While there is still work to be done, UNICEF Programme Officer Golicha Hussein points out the importance of Dr. Abdalla’s work, saying, “It is a model of how one person, who has the drive, can turn around a facility from a derelict building into an efficiently running government hospital.”