The local population has christened our clinic the Andersen Medical Centre. As far as I am concerned, Andersen was an unnecessary addition, however, everyone else thought differently. The people here are proud of their hospital. The name indicates that non-Kenyans are involved and that gives a high probability of good quality of care.

Over the years the clinic has been extended from 1 nurse with 2 jars of medicine to a properly developed instiution where many different services are available. At the moment, we offer the following:

• Outpatient care for adults
• Outpatient care for mothers and children: antenatal clinic, birth control, vaccinations, monitoring childrens’growth
• Laboratory
• Dental care
• Pharmacy
• Ultrasound
• Orthopedic clinic
• HIV/Aids centre with mobile clinic offering Aids medication.
• Treatment room for small surgical procedures
• Inpatient care: 16 beds
• Midwifery ward

Our facilities are used by 30,000 patients a year.

There are few other places in the are where patients can go to for medical help. There is a small government emergency treatment clinic in the village Chepchoina , 5 km away, which is sorely lacking in personnel and medicines or apparatus. There are a few private clinics, but the standard is abominable and often more harm is done than good. Then there are are the traditional medicine men. Some use herbs and in some cases they can be helpful. However, unfortunately the process is veiled in mystery, making it unclear what is going on. Also, lots of unhealthy practices are carried out by the traditional, generally illiterate, midwives.

Quacks and witchdoctors are abundant, whereby attempts are made at healing using all sorts of rituals and cursus. These methods are used to treat mental problems and even aids.

Because the uneducated local population is generally unaware of the consequences, these traditional healing methods are still popular. However, the results are often disastrous: children bleeding to death because the uvula has been cut out (traditional treatment for coughs), children dying of thirst because their teeth have been extracted (traditional treatment for diarrhoea), patients dying due to a mixture of herbal therapy and western medication, people dying of hunger because they have been cursed.

Patients who choose the regular form of treatment often ask for an injection, preferably followed by lots of different coloured tablets or capsules. Many of them have already diagnosed their problem and turn up to collect their medicines. You often hear: I’ve got a kidney problem, I’ve got stomach ulcers, I’ve got malaria. It’s difficult to get them to change their minds if the diagnosis can’t be confirmed.

We try to offer help in these difficult circumstances. It is not always easy. Despite the fact that our personnel has been wel educated in Kenya, the pressure from patients is difficult to resist. However, by offering good, consistent and responsible care the patients keep turning up in increasing numbers.

They come from near and far. From Uganda, from the Mount Elgon area, from the plains to the north, walking for hours to get to us. Some even come from Kitale, the nearest town 40 kilometers away, because they have heard about the quality of the care we offer.

The quality of care offered is attributed to the following factors:

• Good management ensures there are always enough personnel and medication available
• The support of SOK and the farm allows us to offer quality affordable care
• The personnel are highly involved and motivated to help the patients
• We help emergency cases until all possibilities have been exhausted. If, for example, a life saving operation is necessary, we ensure it takes place – not just by referring and hoping that everything will be ok. This is only possible beause of SOK’s financial help.
• By only employing qualified personnel
• If we can’t help a patient in our clinic, we refer them to other suitable institutions. There are specialists in Kitale: paediatricians, kinderarts, internist, surgeon, gynaecologist, ear, nose and throat specialist, eye surgeon
• If the patient needs specialist care we send them to Eldoret, 100 km away. At the hospital in Eldoret there are the following specialists: neuroligist, orthopedic surgeon, neuro surgeon, cardiologist, etc.
• X-rays can be made in Kitale, however, for a CT scan the patients have to travel to Eldoret.
• Radiotherapy can only be carried out in Nairobi and is unfortunately not possible due to the high costs. We can administer chemotherapy treatment; unfortunately without the additional treatment of radiotherapy or surgery it is often ineffective.
• We also work collaboratively for specific operations:
• Orthopedic operations for children are carried out in the Kijabe hospital close to Nairobi, 300 km away.
• Operations for cleftlip are performed in Kijabe of naar Eldoret Moi university hospital. Eye surgery is carried out in a mission hospital in Kakamega ( 150Km) or Kikuyu Eye Hopsital in Nairobi.( 300 km) Gynaecological operations for fistulae are carried out by the AMREF Flying Doctors in Eldoret or Ortum. ( 100 Km).
• Heart operations are performed in the Mater Hopsital in Nairobi.

Although we do have 16 beds, most of the patients are treated on an out-patient basis, thereby considerably lowering our operating costs.

We place emphasis on prevention, mainly by educating the population on common diseases. We hope that patients will then visit the clinic at an early stage, enabling quicker treatment and cure. Unfortunately we have a long way to go since many patients come to us much too late, making treatment more difficult and recovery slow.

Happily, the hospital has a positive influence on the lowering of mortality rates for new born children and their mothers, and also for malaria and tuberculosis.

The clinic is a beacon of hope for HIV/Aids patients where they have access to clear information and the necessary medication. Many patients that were in the terminal phase of the disease have been transformed by the treatment offered. Those extra years make an enormous difference to families with small children.

HIV positive mothers are all treated during pregnancy to prevent the disease being passed on to the unborn child.

The presence of the clinic gives the population a feeling of security and well being, especially in the rainy season when it is impossible to reach the nearest town..

Who in the wealthy west can imagine that a hospital was not within easy travelling distance – for example if you had an burst appendix, or a difficult childbirth? Or in the case of a child unconcious with fever or asthma attack?

Even though we can’t do everything a Dutch hospital can, we can still help 90% of the cases that come to use, and that clearly has a positive effect on the general health of the local population.

Dr. Bea Andersen