Kijabe Hospital: Breadth and Scope of Services

History

AIC Kijabe Hospital (‘the Hospital’) is a non-profit hospital located in Kijabe, Kenya.  Kijabe is located within the Rift Valley escarpment, in a rural area located about 60 kilometres northwest of Nairobi.  The Hospital was founded in 1915 by missionaries from Africa Inland Mission (AIM),

Due in part to the high quality of health care provided and the compassionate mission of the hospital to treat any patient, regardless of social status or ability to pay, the hospital grew quickly and has become a centre of excellence and compassion highly regarded worldwide.

Between 1915 and 1980, the Hospital grew from being a small health outpatient care facility serving the immediate Kijabe area to providing in-patient services to patients from across Kenya.  A maternity ward, operating theatre, in-patient ward, and nursing school were added.  Training programs followed, including internships for family medicine and surgery and establishment of a nursing school in the 1990s.  Healthcare provision and partnerships expanded with establishment of dental services, paediatric services for crippled children (through a partnership with CURE international), paediatric general surgery and neurosurgery (through a partnership with Bethany Kids Africa) and HIV/AIDS care (through partnerships with PEPFAR and others).

In the 1970s, the Africa Inland Church (AIC), a large church denomination in Kenya, assumed ownership and management responsibility for the Hospital from AIM.  The Hospital staff of over 700 now come from all parts of Kenya and Africa, including a number of volunteer missionaries from overseas.

The Hospital today

The hospital operates as a non-profit institution and is funded primarily hospital fees charged to patients who can afford them, as well as by donations.  At the present time, it has 265 in-patient beds and serves approximately 110,000 out-patients per year.

Surgery

Surgery is a major focus area for the Hospital, and it performs more than 9,000 surgeries annually, and is the second busiest surgical centre in Kenya.  The Hospital specialises in the following areas of surgery:  general, paediatric, paediatric neurosurgery, plastic and reconstructive, orthopaedic, ENT, and obstetrics and gynecology.

As described below, a key component of the Hospital’s compassionate care for refugees includes general surgical care, provided both in the refugee camps during clinical visits by Hospital surgeons, and at the Hospital.  About 300 refugees in need of specialty surgical care not available at refugee camps are flown to AIC Kijabe Hospital annually.

Children

Caring for children (including the care of orphans and vulnerable children—OVCs) is a critical component of the Hospital’s compassionate mission.  The Hospital provides outpatient care to 25,000 children annually, of which nominally 30% are malnourished.  More than 13,000 immunizations are provided per year.  In 2010, more than 2,000 babies were delivered.

Children with disabilities are one of the Hospital’s primary areas of focus.  Through its partnership with Bethany Kids, the Hospital treats children with:

-Neurological problems including spina bifida, hydrocephalus, encephalocele, and brain tumours.  With over 250 surgeries for spina bifida and 500 surgeries for hydrocephalus performed each year, Kijabe Hospital has the largest volume of surgeries for these conditions in Africa, and possibly worldwide;
-Intestinal problems including anorectal malformations, Hirschsprung’s disease and intestinal anomalies;
-Intra-abdominal, abdominal wall and chest conditions;
-Tumors;
-Urological problems including hypospadias, bladder exstrophy, and urethral valves;
-Ear, nose and throat (ENT) problems including cleft lip and palate, neck masses, and cystic hygroma;
-Burn and extremity reconstructive surgery.

There is little or no provision for paediatric surgical care for children in most communities across sub Saharan Africa. Amidst desperate poverty and lack of sufficient medical specialists, most children with such conditions cannot find adequate care. AIC Kijabe Hospital seeks these children out and cares for them by:

-Operating Bethany Kids at Kijabe Hospital;
-Regularly visiting over 15 mobile clinic sites across Kenya to screen for children who need care and for follow-up;
-Caring for refugees in the camps located in Kenya which house people from neighbouring countries (which cannot be named for security reasons);
-Providing medical care and rehabilitation for children at Joy Town Primary School (a school for children with physical disabilities);
-Training African nurses, doctors and surgeons in paediatric and rehabilitative surgery;
-Creating media programs to educate people across Kenya in the prevention and care of children who have surgical problems and disabilities.

Refugees, Orphans, and Vulnerable Children (OVCs)

Aid agencies and the Government of Kenya have established several refugee camps along the northern Kenya border to provide support and care to refugees fleeing the political chaos and drought in a neighbouring country.

The Hospital, in cooperation with the UNHCR (the United Nations High Commissioner for Refugees) and GTZ (Gesellschaft für technische Zusammenarbeit, a relief organisation of the German government), provides surgical and paediatric care for between 700 and 1000 refugee and OVCs annually.  This is provided through clinical trips by doctors to the refugee camps six times per year (600-800 patients annually), and having the most desperate surgical cases flown from the camps to Kijabe Hospital (100-200 patients annually).

Due to its compassionate mission, the Hospital has a reputation within this war-torn country as a place where they feel at home and are cared for with dignity.  This word-of-mouth referral system exists throughout East Africa, and has been observed first-hand by the Hospital’s physicians while travelling in the wider refugee diaspora in Great Britain, Scandinavia, and the USA.

An additional focus of excellence in compassionate care is in the Hospital’s intentional provision of language translators from this country.  This has proven to be an essential component of care for refugees who are suffering and linguistically isolated, and who face insurmountable administrative challenges in seeking care at a national Kenyan hospital due to their refugee status.  Additionally, chaplaincy services are provided in their language, allowing the Hospital to attend to their spiritual needs in a way not achievable by any other facility.

HIV/AIDS Care

Through its ‘AIDSRelief’ program, the Hospital provides comprehensive care to those infected with or affected by HIV infection.  Care is coordinated from Kijabe and an emphasis is placed on community support, home-based care and helping patients to access medication and care close to their homes through a network of six community care sites:  Marira, Thigio, Naivasha, Njabini, and Githunguri.

The Hospital currently provides care for more than 8,000 HIV positive patients, with 68% receiving anti-retroviral (ARV) therapy.

500 of these patients (13%) are children.

Community-Based Care and Newborn Health

The Hospital supports community-based primary health care facilities in Marira, Naivasha, Nduriri, Siyiapei, Mukeu, and Eastleigh.  The Hospital runs the first two facilities as satellite primary health care centres for the community, and provides clinical supervision and mentorship to the latter four.

Additionally, the Hospital reaches out to the most disadvantaged through promoting neonatal and maternal health and by sharing the love of Christ to the most vulnerable in the community through the Newborn Health Project Kijabe.  The chief goal of this project is to reduce newborn mortality and morbidity in disadvantaged regions surrounding Kijabe.  During a study in 2008, the Project found that 80% of the women in these regions delivered at home.  Only about 20% of these women were attended by a semi-skilled birth attendant, with 35-70% receiving unskilled help from a neighbour or relative.  Every tenth mother delivers completely on her own.

Lack of knowledge about safe motherhood and newborn care is the key factor in maternal and newborn health issues.  Accordingly, the Project actively does research to develop best practices in delivering health care to the least served segment of Kenya’s population and works to develop sustainable linkages with health care delivery systems at the district and tertiary care levels.

Since its inception two years ago, the Newborn Health Project Kijabe has provided training for over 12,000 people, and seen a 10-fold rise in the number of births attended by a semi-skilled birth attendant in the target regions (from 61 to 632).

Palliative Care Services

Life-limiting illnesses which have no cure are an increasing health problem for Kenya.  The Hospital runs a Palliative Care Centre which seeks to offer relief from pain and suffering as well as support for the families of such patients.  Services offered include inpatient and outpatient consultation, monthly day-care and bereavement support groups, home-based care, and education and training for health care and voluntary community workers.

Training

Training is a strategic priority at AIC Kijabe Hospital, and staff have a keen awareness that they are building tomorrow’s health care leaders today.  As a result of this aggressive training emphasis, 10 of the hospital’s senior-level consultants are Christian Kenyan physicians and surgeons.  Many others have been trained who now serve their communities across Kenya and in a number of other African countries.  Current training at the Hospital includes:

-40 Kenya Registered Nurse (RN) graduates per year;
-East Africa’s only Registered Nurse Anaesthetist graduates (10 per year);
-Kenyan Medical Officer interns (8 per year, with 60 interns graduated since 1996);
-Clinical Officer interns (3 per year), and
-Postgraduate training for African doctors in the following specialties:  orthopaedics (5); general surgical (2); paediatric surgery (4); paediatric neurosurgery (1); Family Medicine (3); and others rotating through from other African training institutions.