St. Joseph Mission Hospital Migori Description

St. Joseph Mission Hospital Migori is under the Catholic Diocese of Homa-Bay that provides comprehensive medical and surgical services and facilities in aligning with the requirements of the Department of Health Service Support of Public Health Ministry. 

It is situated within Migori Municipality in Migori District of Nyanza Province, Western Kenya. The hospital started as a dispensary in 1974 at St. Joseph Catholic parish Migori by –Rev. Fr. Knap. In 1974 a partnership was formed between the Catholic Diocese of Kisii, Dutch Government under MEMISA an NGO in Holland and the Kenya Government to construct what was then known as Ombo Mission Hospital.

In 1981, the hospital was officially opened by the former President Daniel Toroitich Arap Moi. In 1991 the partnership between the Diocese and the Government came to an end, the hospital was left in the hands of Catholic Diocese of Kisii and later the Diocese of Homa-Bay.

The Dutch Government through MEMISA still played an active role. In 1999 MEMISA still played an active role.1999 MEMISA pulled out and since then the Hospital has been solely run by the Catholic Diocese of Homa-Bay.

The Hospital is run by the Board of Governors headed by Rt. Rev. Bishop Phillip S. Anyolo, the Bishop of the Catholic Diocese of Homa-Bay.

Vision

To be a modern center of excellence in provision of quality and affordable health care for all according to the Catholic faith.

Mission

To provide holistic quality, affordable and accessible health care services through outreach, networking, creation of linkages and partnerships and professional training through observing the Catholic faith and upholding the sanctity of human life.

St. Joseph Mission Hospital Migori Contacts

                            St. Joseph Mission Hospital Migori

Nearest Town: Migori Town
P.O. BOX 250 – 40400 Suna Migori – Kenya
Tel: +254-059-20213
Mob: 0722454556 / 0722146383
Fax: +254-059-2023
Email: admin@stjmh.co.ke
Web: http://www.stjmh.co.ke/

Status: Operational
Number of Beds: 161
Number of Cots: 4

St. Joseph Mission Hospital Migori Services

In-Patient Services

Patients are admitted through the casualty and patient support center. Mothers in labor come directly to the labor ward. Care is provided by a team of 2 medical officers, one Gynaecologist, nurses of different cadres, and support staff.

The wards include:

Maternity

The wards admits mothers in labor. antenatal mothers with complications and patients with gynecological conditions.

General ward

This comprises medical and surgical patients. The patients are further divided into male and female.

Pediatrics wards

The wards admits children below 15 years of age. Children who have gone surgery are also nursed in this ward.

Malaria and its complication of anemia is the leading cause of morbidity and mortality in the pediatric ward. HIVAIDS related complications are the leading causes of morbidity and mortality in medical wards. Obstetric emergencies are the leading indications for operations.
Obstructed labor and eclampsia were the commonest causes of maternal mortality.

The hospital also has two operating theatres handle most of the surgical procedures this include;

Elective surgical operations

1. Amputation of extremities
2. Herniorrhaphy
3. Appendectomy

Elective Gynecological procedures

1. Hysterectomy
2. Cystectomy
3. VVF repair
4. Colporraphy and perineorraphy

Emergency operations

1. laparotomies
2. obstetric

There is need for a high dependency unit and a modern anesthetic machine

Out-Patient Services

Outpatient services are offered at the Casualty, Maternal Child Health Clinic (MCH), Patient Support Centre, Dental clinic, and the Eye clinic. The Laboratory, Pharmacy, Physiotherapy, and X-ray departments complement the services offered.

Casualty

The casualty operates 24 hourly. Each shift is manned by a clinical officer, a nurse, and 2 support staff. Medical officers also attend to the patient during the day and are on call from 5 pm and over the weekends. It is the entry point for inpatient except for antenatal mothers in labor who go straight to the labor ward for admission. On average the casualty see 35 patients per day on average.

Maternal Child Health

The clinic offers services to mothers and children. The clinic has one nurse and one support staff. It operates from 8 am to 5 pm, from Monday to Friday. The Child Welfare clinic (CWC) immunizes against childhood diseases and monitors growth of children under five years. An average of 18 children are seen per day.

The Antenatal clinic (ANC) attends to pregnant mothers. On average it sees 5 mothers per day. It does not offer modern methods of family planning.

Pharmacy

The department is run by 4 pharmaceutical technologists on regular employment and 3 on locum, and one support staff. The main pharmacy serves both outpatient and inpatient. A smaller pharmacy serves clients at the patient support center The department operates from 8 am to 7 pm. There is a dispensing room at the casualty that caters to patients after 7pm. The pharmacy stocks essential medicines as per the national guidelines.

Most of the medical supplies are sourced from MEDS (Mission for essential drug supply) a church organization that supplies medical supplies to faith-based organization at subsidized rates. The pharmaceutical and therapeutics committee ensures that the drug supply chain is well managed. It also encourages rational use of drugs. The pharmacy collaborates with the main pharmacy at Migori District Hospital to ensure drugs do not expire on them. We do hope in the future to fully stock the pharmacy to enable it sale drugs to other consumers apart from the hospital clients.

Mortuary

The mortuary is run by two staff from 8 am to 5 pm from Mondays to Sundays. It has the capacity to hold 8 bodies. The staff are able to embalm bodies and undertake basic preserving techniques. There is need to expand the mortuary.

The bodies preserved come both from within and without the hospital. There are plans to increase the capacity of the mortuary.

Laboratory

The laboratory has three technologists and three technicians. It is operational 24 hours a day throughout the week. It serves both outpatient and inpatient. Most of its operations are manual. There is need to equip the lab with modern machines and also increase the number of staff. The lab performs on average 80 tests per day.

The following tests are done routinely

Haematological

1. Haemoglobin estimation
2. White blood cell count
3. Complete haemogram
4. Esr
5. Grouping and x-match
6. Sickle cell test
7. Peripheral blood film
8. Platelet count
9. Red blood cell count
10. Coombs test
11. Cd4 cell counts

Clinical chemistry

1. Liver function tests
2. Renal functions
3. Widal
4. Brucellin
5. VDRL
6. ASOT
7. Rheumatoid factor
8. HBsag
9. HIV rapid tests
10. CSF analysis
11. Pregnancy test
12. Blood sugars
13. Uric acid
14. urinalysis

Microbiology

1. Culture and sensitivity tests
2. ZN staining for AAFBs
3. High vaginal swabs
4. Cryptococcocal ag assay
5. Indian ink operation

Parasitology

1. Blood slide for malaria parasites
2. Stool for ova and cyst

Other tests

1. Seminalysis

Dental Clinic

The clinic has been operational since 1996. It was then supported by the doctor bank of Sweden through Kenya Ear Foundation. In 2005 the KEF pulled out. In 2006 the Doctor bank of Sweden agreed to continue the support to the clinic. The objective of the clinic is to offer affordable high-quality dental care and to alleviate dental caries and periodontal disease in school-going children. The clinic is run by volunteer dentists who work on a rotational basis for 6 weeks, an oral health technicians and one support staff. Primary school children are treated free of charge.

The Doctor bank pays a minimal fee for the children’s treatment and transport. Adults pay subsidized fees. Currently, the total number of 25 patients are seen daily. During their stay, the dentist performs dental procedures and do screening in schools. They also bring with them some supplies used at the clinic. Most dental procedures are done at the clinic. The clinic has a modern dental chair and x-ray unit installed by the doctor’s bank. The procedures are done include,

1. Free dental check-up
2. Root canal treatment
3. Extractions
4. Permanent and temporary fillings
5. Composite restoration
6. Scaling
7. Intraoral radiographs

The dentists are accommodated at the guest house and at the dentist’s house in the staff quarters. The patient attendance is still low and the clinic is yet to be self-sustainable. Strategies are being put in place to attract more patients.

The patient support center 

The provision of antiretroviral(ARVs) drugs for HIV/AIDS patient was started at the hospital in 2002 as an outpatient clinic. Then a monthly dose of the drugs would cost Ksh 3500. This was quite expensive for the majority of our patients.

In September 2004 the hospital was considered as one of the sites that would be funded through AIDS RELIEF by PEPFAR(Presidents Bush program for Aids relief in Africa). AIDS RELIEF is a consortium of organizations providing support to various hospitals offering care to HIV/AIDs patients. The Catholic Relief Services (CRS) is directly responsible for the program at the hospital.

Since 2004 the clinic has grown into a comprehensive care center whose objective is to provide comprehensive HIV care and restore hope to our clients. We hope the center will evolve into an ART training site. This center is run by one medical officer, 5 clinical offices, two pharmaceutical technologists, 10 nurses, two social workers, 3 data officers, one driver and one support staff.

Currently, the center provides care for a total of 3632 patients. 3092 adults and 540 are children. Of the adults 1738 are on ARVs. Of the children, 156 are on ARVs. A total of 80 clients are seen daily at the center.

The center offers the following services at the clinic and the community,

At the clinic

1. Antiretroviral treatment
2. Voluntary counseling and testing
3. Treatment of opportunistic infections
4. Tuberculosis treatment and follow up. Adherence counseling
5. Treatment preparation seminars to patients before ARVs initiation
6. Nutritional support to HIV patients
7. Review of inpatients with HIV
8. Prevention of mother to child transmission of HIV (PMTCT)

At the community

1. Training of community health workers (CHW).To date, a total of 80 CHW have been trained. They make home to clients in care
2. Adherence strengthening through support groups and home visits
3. Decentralization of services through establishment of satellite clinics. There are satellite clinics at Rapogi (800 clients on care), Arombe (150) and Ulanda (100)
4. Formation of pediatrics support groups. The children meet once a month and discussions on adherence and disclosure are held with them.
5. Diagnostic testing and counseling to HIV exposed children during home visits
6. Community mobilization in churches, women groups, orphanages, and schools
7. Networking with the Ministry of Health to identify decentralization sites
8. Referrals to a community-based organization(CBOs), and other nongovernmental organization(NGOs) for the support Orphans and Vulnerable Children (OVC)
9. Tracing of missed appointments to maintain these to less than 14 days

Physiotherapy

The department has two physiotherapists and one plaster technician. They attend to both outpatient and inpatient. They also attend to children with cerebral palsy at the hospital. The cerebral palsy program is sponsored by the Lilian foundation. The program to date offers occupational therapy to seven children.

The staffs also assist the medical officers in the management of some orthopedic cases. The department needs modern equipment to improve its capacity. The staff at the department do an average of 6 physiotherapy sessions per day.

The Eye Clinic

The clinic was started in 1994 through sponsorship by Christoffelblinden Mission International(CBM) a non Governmental organization in Germany. Saving and restoring of sight was done by surgeons from Kikuyu, Tenwek, and Sabatia eye units. This was done through eye camps conducted three times a year. Due to the restructuring of CBM direct sponsorship by the organization stopped.

Up to 2007, the clinic was run by a clinical officer who is also an ophthalmic assistant, a nurse, and a support staff. Currently, only the clinical officer runs the clinic from Monday to Friday.
The clinic attends to patients with eye problems both at the hospital and also at selected outreach mobile centers. The clinic attends to an average of 2 clients per day.

The outreach program of the clinic has been temporarily stopped due to financial constraints as there is no longer direct support by CBM. The clinic has however continued to partner with the Tenwek mission hospital eye unit.

The eye clinic is unable to perform any operations at the hospital. The majority of patients screened for surgery are unable to pay for the cost of surgery.

X-Ray

The department started functioning in February 1983. It provides imaging services(x-rays and ultrasonography) to the hospital patients and also to patients referred from other private clinics and hospitals. An average of 350 clients is seen at the department per month.
The department has one radiographer and one support staff. They work from 8am to 5pm from Monday to Friday. After 5 pm and on weekends the radiographer is on call.

Some of the skeletal radiographic examinations include:

1. Upper limbs
2. Lower limbs
3. Pelvic girdle
4. Vertebral column
5. Chest
6. Shoulder girdle
7. Skull
8. Mouth and neck

It also performs specialized examination using contrast media. Such investigations include:

1. Intravenous urography
2. Barium meal
3. Barium swallow
4. Hysterosalpingography
5. Fistulography
6. Oral cholecystography
7. Micturating cystography
8. Cryptography

Ultrasound imaging done include:

1. Obstetrics
2. Pelvic pathology
3. Othe abdominal viscera

The departments needs a main x-ray machine unit. At the moment it uses a mobile unit.

Overview of Mission Hospital in Kenya

The missionaries played a very key role in the provision of healthcare in Kenya before independence which led to the establishment of mission hospitals that have continued to serve the Kenyan population to date. Mission hospitals are faith-based institutions that provide health care. These hospitals were established by Christian missionaries.

1. Curative and preventive care and promotion of health of the people in the county;
2. Quality clinical care by a more skilled and competent staff than those of the health centers and dispensaries;
3. Treatment techniques such as surgery not available at health centers;
4. Laboratory and other diagnostic techniques appropriate to the medical, surgical, and outpatient activities of the district hospital;
5. Inpatient care until the patient can go home or back to the health center;
6. Training and technical supervision to health centers; as well as a resource center for health centers at each Mission hospital;
7. Twenty-four-hour services;

1. Obstetrics and gynecology;
2. Child health;
3. Medicine;
4. Surgery, including anesthesia;
5. Accident and emergency services;
6. Non—clinical support services;
7. Referral services;
8. Contribution to the district-wide information generation, collection planning, implementation, and evaluation of health service programs.