Rambura Health Center: Let's support their BASIC needs

Previous post (Day?#6)

International "Benefit" Tour - Africa Day #7

I wrote a few days ago about our visit to Rambura Health Center, in the Northern part of Rwanda. As I wrote then, Sextant has begun to mobilize to help this wonderful group of healers, and the 20,000 people whom they serve.?

This facility is essentially primary care and outpatient care. It provides extensive maternity and pediatric services and needed public health services such as vaccinations to the local communities. They provide services they can to any person, regardless of ability to pay.?

The hospital contains two “in-patient” units, or beds, for various kinds of care. The men’s room is a ward with five beds and a women’s ward with eight beds. Staff report that this space is completely inadequate to the need, as is the lack of beds. That is, if they had more beds, they would fill the rooms. Similarly, the women and pediatrics are in the same space, and staff would like to have them separated. The facility is brick, with flimsy plywood partition between rooms in many cases and sometimes block walls. The facility has no ability to isolate patients, which could be a problem with Ebola, as an example. There is a separate maternity building which is newer and in better condition.??

The health center has a separate health post they supported at one time, but they have no automobile for transportation so they are largely unable to do so now.?

Like all such district health centers, this one supports a District Hospital. BUT, the district hospital is 100km away, over difficult roads. AND, the health center has NO transportation.?

So, the first campaign I think we need is to help these folks with a vehicle (there are other reasons for this, see below). We are thinking that we will buy a vehicle and use it while constructing the work Sextant will do, and, at the end of the project, leave it to the facility. Initial estimates are that we will need approximately $35,000 for such a vehicle.?

A very small feeder from the utility serves the facility. It has no emergency backup. The Sisters report that the utility is very unreliable, and they rarely have electricity at night. With rain and erosion, trees often fall across the utility lines, interrupting already erratic services. They often find themselves delivering babies using the light from an iPhone.

Each room has one LED fixture, often with no bulb. Wiring is all installed without conduit. The service and all components are old, much-tapped through the years, and in poor condition. The facility has suffered from fires due to the truly hazardous wiring. Electricity is extremely expensive for them, roughly 180 Rwandan Francs per kwh (roughly $0.17/kwh).

They receive water from the public utility system. Supply is erratic and insufficient. They do collect rainwater, but they use this only for washing. They must carry water into the facility in jerry cans for other uses. There is no water treatment.??

The facility has no doctors on site, so they are not allowed to provide oxygen services. There is no oxygen of any kind here. When the electricity is down, which is often, they must use hand pumps to help patients.?

All ventilation is through openings on the exterior of the building, including vents, windows, doors, and openings. In this part of the country, it gets cold, and they have no ability to shield people inside from the wind, except to try to modulate by holding windows in place – though, there are no closers for windows. The heating system here, when available, is blankets.??

The laboratory refrigerator is not working. They could use a new vaccination refrigerator.??

The facility is required to transport medical waste to the district hospital for incineration. But, without a vehicle, they are unable to do this. Accordingly, the waste is accumulating in an abandoned kitchen. Other waste streams are incinerated on site in an old, poorly maintained incinerator.??

This facility and organization is an excellent example for what I am coming to think of as "Maslow’s Hierarchy of Health Facility Elements".?

The "basic" needs are numerous...

• repair to its building envelope
• reliable electricity
• more water and potable water
• more beds (including a birthing bed) and other equipment?

We are working now to put together a package of things we can do for them.?Appreciate your support.