Where do you start ? Beacons Of Hope
Where do you start to improve facilities, when there is so little to begin with ? Well, thank goodness for Save The Children and the work they do.
Kambini Dispensary – just two rooms housed under a corrugated iron roof. The reception room was used as the consultation area, and the rear room was used to store all commodities and everything else. The sloping roof meant that I could reach up and touch the tin and I burnt my fingertip! As in most of the health facilities we have visited, we had a discussion about the importance of temperature control for medicines, however that is a luxury when this is all you have.
Or Chebukwabi Dispensary , which was larger than Kambini but had some very rudimentary partitions. Here we discussed with the Nurse in Charge about the tidiness, lack of storage and familiar themes such as temperature control but it suddenly seemed irrelevant and facile to make such comments when she did not even have shelving to store medicines on. A basic cupboard was all that was present with improvised shelves using old boxes.
Or Chemses and Koshok (the dispensary we had to hike to previously – see “Gemba and a Coke please” ) Here there were no cupboards, racks or shelves, just boxes of items kept off the floor using some timbers.
At least here they have the potential – well constructed and large rooms. And so we have set our goals to improve from the ground up. We’ve been able to find at least one or two positives about every facility we’ve visited and the plan now is to take 5S(Sort, Set, Shine, Standardise and Sustain ) to the mountains and continue improving the basic management of storing and controlling medicines. Then as we engage with the facility leads, it will be a case of coaching and mentoring them on how to monitor and calculate consumption data. Ultimately, consumption data is the thing that will help them to provide hard evidence of their resource needs to the County management.