Lwala Community Clinic, Rongo Kenya: Providing primary health care and addressing HIV/AIDS in rural Kenya : Needs

Here is a video that Fred Ochieng' and Maurice Omondi Ochieng' shot of a woman who had to be taken to a nearby "clinic" in the middle of the night. A special night vision camera chronicles the journey.

http://www.youtube.com/watch?v=3V4Phs3KvDg

Estimated budget for year 1 US$60,000-US$90,000

Lwala Health Clinic Summary

 

 

 

 

 

 

 

 

 

 

 

 

 

2005

 

2006

 

2007

 

Total

Donations

  40,684.00

 

  21,619.24

 

  74,834.29

 

  137,137.53

Wire transfers

  32,322.44

 

  15,000.00

 

  26,000.00

 

    73,322.44

Balance

    8,361.56

 

    6,619.24

 

  48,834.29

 

    63,815.09

Needs

Two 8,000 liter rain water catchment tanks
Six 80W solar panels for lighting
Centrifuge (battery powered)
Stethoscopes 3
Blood Pressure Cuffs 3
Thermometers (oral, rectal) (10)
Needle destroyer (Safe case) 2
Sterilizing equipment 2 (solar autoclave)
Weighing scales (paediatric and adult)
Fetoscope
HIV rapid testing kits
small vaccination ice boxes
Two way radios
Solar-powered/Light microscope

Ambulance 4wdrive

Fencing off the compound



Obstetrics and Gynecology Equipment for Rural Clinic (Adapted from Western Australia)

Standard Minimum Obstetrics Equipment and Drugs for Births
For remote locations where emergency and unplanned births regularly occur.
· Gloves (sterile and unsterile)
· Syringes/needles/alcohol swabs/kidney dishes
· Tourniquet
· Blood specimen tubes (including cord blood)
· Cord clamps
· Obstetric cream/lubricant
· Antiseptic lotion eg: Cetrimide 0.5% solution
· Sterile delivery pack
· Suture set
· Suture material
· Single use and indwelling catheters
· Urine drainage bag
· Sterile Lignocaine Gel
· Sterile water for irrigation
· IV additive/allergy labels
· IV dressings and tape
· IV fluids
· IV cannula and giving set
· Sterile combine
· Sterile cotton balls
· Sterile gauze
· Modess
· Plastic aprons
· Safety glasses
· Masks
· Incontinence sheets
· Adult resuscitation trolley and drugs
· Tape measure
· Sphygmomanometer/Stethoscope
· Wall clock
· Maternal oxygen and suction equipment
· Airways
· Yankeur suction
· Hudson face mask and tubing
· Infant oxygen and suction
· 02 catheters (size 8 routine and size 6 on standby for premature) and tubing
· Y suction catheters (size 10) and tubing
· Bedside locker
· Tissues/drinking straws
· Emesis bowl
· Spare linen
Sonicaid
· Overhead light
· Rubbish bin
· Infant basket
· Neonatal resuscitation equipment comprising:
Þ Neonatal bags and masks
Þ Neonatal airways (various sizes)
Þ ETT tubes nasal 2.0 – 4.0:oral 2.0 –
3.5
Þ Laryngoscope (size 0 and 1)
Þ Introducer
Þ Magills forceps
Þ Neonatal drugs
Þ Cord scissors
Þ Baby name tags
Þ NG tubes (sizes 5, 6, 7 &8)
Þ Size 24 IV annula
Þ Suction tube
Þ Y-sucker s26, straight s10
Þ Oxygen catheter size 8 routine, size 6
on standby for premature
NEONATAL DRUGS
Naloxone 0.4 milligram in 1ml
Konakon 1 mg ampoules
NSA IV solution
10% Dextrose IV
5% Dextrose IV
1: 10, 000 Adrenaline ampoules
Sodium Bicarbonate 8.4% ampoules
Calcium Gluconate ampoule Igm in IOrnl
Cefotaxime
Gentamicin
Benzylpenicillin
Amoxil
Water for injection
Saline for injection
To stabilise infant prior to arrival:
Thermal pack
H/box perspex or incubator
Oxygen analyser
Oxygen saturation monito
Overhead radiant warmer

ADULT OBSTETRIC DRUGS
Celestone Chronodose ampoules
Magnesium Sulphate for injection
Nifedipine tablets 10mg
Ergometrine 0.5mg in 1ml
Syntometrine
Syntocinon (10 units)
Sodium Citrate
- 1% Lignocaine ampoules
- Salbutamol Obstetric 5mg in 5ml ampoules
- Diazepam ampoules 10mg/2rnl
- Hydrallazine 20mg
- Diazoxide – 300mg in 20ml
- Gelofusine
- 4% and 1/5 IV fluids
- Normal Saline fluids
- Hartmanns solution 500 and 1000mls
- 5% Dextrose IV fluids
- Narcotics
- Maxolon 10mg in 2ml ampoules
- Antibiotics
Resuscitation drugs as per adult resuscitation trolley

Drug List adapted from Partners in Health and UN Millenium Project in Sauri Kenya

 DRUG LIST Lwala Clinic 

1 Anaesthetic and rescuscitative agents  
 Diazepam injection 5mg/ml
 Ethylchloride spray 100ml
 Oxygen  
 Lignocaine HCL 2%(50ml) 30 bottles
2 Analgesics,antipyretics and NSAIDS  
2.1 Non Opiods  
 Asprin tabs 300mg
 Indomethacin tabs 25 mg
 Paracetamol suspension 120mg/5ml
 Paracetamol tabs 500mg 
 Meloxicam tabs 7.5 mg(for people with peptic ulcer disease)
2.2 Opiods  
 Pethidine hydrochloride injection 100mg/vial
 Dihydrocodeine tartate tabs 30mg
3 Anti-allergics and drugs used in anaphylaxis  
 Adrenaline tart inj 0.1% 1ml
 Chlorpheniramine inj 10mg/ml
 Chlorpheniramine syrup 2mg/5ml 60ml
 Chlorpheniramine tabs 4mg 
 Hydrocortisone inj 100mg base
 Prednisolone tabs 5mg
4 Antidote and substances used in poisoning  
4.1 General  
 Charcoal,activated 5g powder
 Ipecacuanha syrup
4.2 Specific  
 Atropine sulphate injection 1mg/ml
 Pralidoxime mesylate inj 200mg/ml
5 Anti-convulsants  
 Carbamazepine tabs 200mg
 Diazepam injection 5mg/ml or 10mg/2ml
 Phenobarbitone tabs 30mg
 Phenobarbitone injection 200mg/ml
 Phenytoin sodium caps/tabs 50mg
 Phenytoin sodium inj  50mg/ml 5ml
6 Anti infective drugs
6.1 Antihelminthics  
 Mebendazole susp 200mg/5ml
 Mebendazole tabs 100mg
 Albendazole susp 400mg/5ml
 Albendazole tabs 200mg
 Praziquantel tabs 600mg
6.2a Antibacterials - Oral liquids  
 Amoxyllin susp 125mg/5ml
 Ampiclox syrup 250mg/5ml
 Cotrimoxazole susp 200:40/5ml
 Erythromycin ethyl succinate syrup 200base/5ml
 Metronidazole syrup 200mg/5ml
6.2b Antibacterials - Oral tabs/caps  
 Amoxyl caps 250mg or 500mg
 Chloramphenicol caps/tabs 250mg
 Ampiclox caps 250mg
 Cotrimoxazole tabs 400:80
 Doxycycline HCL caps 100mg
 Erythromycin stearate tabs 250mg
 Nalidixic acid tabs 500mg
 Nitrofurantoin sodium tabs  100mg
 Ciprofloxacin tabs 250/500mg
 Tetracycline HCL caps 250mg
6.2c Antibacterials injectibles
 Benzyl penicillin inj 1MU/5MU
 Fortified procaine pennicillin inj 4MU
 Metronidazole inj 500mg
 Ceftriaxone inj 500mg/250mg
 Gentamycin inj 80mg/2ml
6.2d Anti-leprosy and Anti-Tuberculosis drugs  
 Streptomycin injsulphate inj 1g 
 Rifater tabs (Rifampicin + Isoniazid + Pyrazinamide)
 Rifinah tabs(Rifampicin + Isoniazid)(150mg+75mg) 
 Ethambutol HCL tabs 400mg
 Isoniazid + Ethambutol tabs (150mg + 400mg)
 Dapsone tabs 100mg
  
6.3 Anti-fungals  
 Clotrimazole cream 1% 15gms
 Clotrimazole vaginal pessaries 100mg
 Griseofulvin tabs 125mg
 Fluconazole tabs 200mg
 Nystatin oral suspension 100,000IU/ml
6.4 Anti protozoal agents(mainly antimalarials)  
 Quinine sulphate tabs 300mg
 Quinine HCL inj 300mg
 Proguanil(paludrine) tabs100mg 25
 Amodiaquine syrup 50mg/5ml
 Amodiaquine tabs 200mg
 Dihydro-artemisinin syrup 10mg/5ml
 Dihydro-artemisinin tabs 60mg
 Sulphadoxine/Pyrimethamine 500mg/25mg
 Sulphadoxine/Pyrimethamine 250mg/12.5mg suspension
7 Anti-hypertensives  
 Hydralazine inj 20mg/ml
 Hydralazine tabs 24mg
 Propranolol tabs 40mg
 Frusemide tabs 40mg
 Digoxin inj 0.5mg/2ml
 Digoxin tabs 0.25mg
 Nifedipine tabs 20mg
8 Dermatological preparations  
 Calamine lotion
 Bezyl benzoate lotion
 Clotrimazole cream 1% 15gms
 Gentian violet crystals powder 10gms
 Silver sulphurdiazine cream 500gms
9 Disinfectants and antiseptics  
 Cetrimide 15% and Chlorhexidine gluconate
 Lysol(cresol and soap solution)
 Hydrogen peroxide 6% (20 vols)
 Methylated spirit
 Chlorhexidine gluconate solution 5% 
 Povidone Iodine 10% 
 Sodium hypochlorite soln 4-6%
10 Diuretics
 Frusemide inj 20mg/ml
 Frusemide tabs 40mg
11 Gastro-intestinal drugs
 Compound magnesium trisilicate tabs 1.5
 Oral Rehydration Salts (WHO formulation)
 Loperamide caps 2mg
 Hyoscine N-Butylbromide inj 20mg/ml
 Hyoscine N-Butylbromide tabs 10mg
12 Hormones,Endocrine drugs and contraceptives  
 Hydrocortisone sodium succinate inj 100mg base
 Contraceptives low oestrogen 30mcg
 Insulin and anti-diabetic agents  
 Chlorpropamide 250mg tabs
 Glibenclamide tabs 5mg
 Insulin lente 100iu
 Insulin soluble 100iu
 Metformin tabs 500mg/850mg
13 Vaccines  
 Anti snake venom sera inj
 BCG dried vaccine powder
 Pentavalent vaccine
 Hepatitis B vaccine
 Measles vaccine
 OPV (Oral Polio Vaccine)
 Rabies vaccine Diploid vaccine
 Tetanus toxoid vaccine
 Tuberculin PPD vaccine
14 Opthalmologic,ENT preparations  
 Chloramphenicol ear drops 5%
 Chloramphenicol eye drops 0.5%
 Hydrocortisone eye drops 1%
 Tetracycline eye ointment 1%
15 Oxytocics and antioxytocics  
 Oxytocin inj 5IU/ml
 Ergometrin maleate inj 500mg/ml
16 Psychotherapeutic drugs
 Amitriptylline hydrochloride tabs 25mg
 Chlorpromazine HCL tabs 25mg/100mg
 Chlorpromazine HCL inj 50mg/2ml
 Diazepam tabs 5mg
17 Respiratory tract drugs
 Salbutamol inhaler 0.1mg/dose
 Aminophylline inj 250mg/10ml
 Salbutamol inj 0.5mg/ml
 Salbutamol syrup 2mg/5ml 100mls
 Theophylline tabs
 Salbutamol tabs 4mg
18 Solutions for water,electrolyte,acid,base disturbance  
 Calcium gluconate inj 10% 10ml
 Darrows solution 1/2 strength (500ml)
 Dextrose inj 50% w/v (50ml)
 Hartmans solution (500mls)
 Normal saline inj 0.9% (500mls)
 dextrose 5%/10% solution w/v (500mls)
 Sodium Bicarbonate inj 8.4%
 Water for injection
19 Vitamins and Minerals
 Ferrous sulphate compound tabs 200mg
 Folic acid tabs 5mg
 Vitamin A Retinol tabs 100,000IU
 Multivitamin tabs
 Multivitamin syrup 100ml
 Vitamin B complex tabs