ANNUAL NARRATIVE REPORT 2012
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Annual Narrative Report 2012

Country / Area:

Kenya

Project Name:

University of Nairobi

Department of Ophthalmology

Period covered by this report

From:

To:

1st January 2012

31st December 2012

A case study is available for the period of this report, for donor reporting

Yes

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Author(s):

Professor  Dunera  R. Ilako  (Chairman)

Winnie Kasina  (Administrator)

 

    Image:Staff and students perfoming surgeries in outreach :   

 

 

 

 

 

1. Executive summary

 

The Department of Ophthalmology, University of Nairobi is inspired and grateful for the committed support it continues to receive from Sight Savers International. Through our growing network of dedicated partners and our expanding group of students training in Ophthalmology, we are making strides in the fight against avoidable blindness by providing eye care in the most underserved regions within Kenya.

 

This report  for the period January 2012 to December 2012 attests to the continuing fulfillment to be beacon of light to bring to all in need the highest quality of ophthalmologic practice. It represents the work and dedication of many who contributed their time, treasure and talent.

 

By every measure this year proved to be an unprecedented period of activity, growth and accomplishments for the Department of Ophthalmology. The department was able to achieve all its objectives and activities for the year of 2012.

 

Members of the department attended several conferences/workshops both local and international

 

The department also recruited three more members of the academic staff, Dr. Lucy Njambi Dr. Nyamori and Dr. Muchai Gachago.

 

Several members of the department and postgraduate students attended the OSEA conference in August from 22nd -24th held in Uganda. Postgraduate students also presented papers during the conference.

The department had the pleasure of receiving a team from Sight Savers in August 2012 to conduct a Quality Assurance Systems assessment in the area of HReH.

 

Intake of 11 postgraduates for the academic year 2012/2013 was conducted during this period and the students reported on 3rd September 2012.

 

7 Final year postgraduate students sat for their final University examinations and graduated. They were posted to various hospitals.

 

 

Community outreach programmes have always been an indispensable element of the Department of Ophthalmology. 18 free surgical eye camps and more than 900 surgeries were conducted in marginalized areas of Litein, Kitui, Mwingi and Garissa.

 

The department participated in various national/regional global prevention of Blindness activities (VISION 2020) and continuous medical education (CMEs).They participated in the annual OSEA conference 2012 held in Kampala, Uganda where 6 postgraduate students presented quality papers.

 

34 Postgraduate students sat for their University examinations in August and 19 for the International Council of Ophthalmology (ICO) examinations in April 2012and performed exemplary.

 

34 students benefited from scholarships from Sight Savers International (SSI), Light for the World (LFTW), Christoffell Blinden Mission (CBM), Lions Bavaria and Vision Mundi, which have enabled them to undertake their studies successfully and achieve their dream of becoming an Ophthalmologist. 

 

Through the partnership with Sight Savers and other partners,18  postgraduate students were able to complete their elective terms in various regions as well as participate in outreach activities  as per the 2012 program plans/budget.

 

There was effective management of the budgets and timely delivery of outputs relating to the program. Resources allocated were utilized efficiently as per the set budget lines.

 

The department is grateful for the support it has received from Sight Savers through various supports such as elective term, outreach and support on capacity building, which have helped in ensuring that the objectives of the department are meet timely. Your support enables us to continue to eradicate preventable and treatable blindness

 

 

 

 

 

 

 

2. Progress against objectives, outcomes and indicators

Objectives planned during this period were:

 

  1. Provide quality eye care training , conduct research and clinical services
  2. Provide sustainable quality eye care services to underserved population in 4 counties through outreach services.
  3. Develop academic staff and students through participation in CME/CPD activities (national/regional/international)
  4. Participate in VISION 2020 activities and enhance networking.

 

 

  1. Provide quality eye care training to potential Ophthalmologists,undertake research and clinical services

 

  1. Quality eye care training:

 

  • The department continued to train 34 postgraduates and graduated 7 Ophthalmologists during the period.
  • Visiting guest lecturers:

The department had visiting lecturers- Dr. Bopp a specialist in Vitreo retinal, Professor Alfred Sommer of the Johns Hopkins University in Baltimore, Maryland, USA, accompanied by Dr. J. Peter Campbell, a fellow in the Dana Institute of the Johns Hopkins. They joined the department on the Teaching Ward Rounds in Ward 9D.

The Department was also visited by Dr. A.K. Sineadza, alumni of the UoN Department of Ophthalmology and a Vitreo-Retinal Surgeon based in Kitwe, Zambia.

Professor Karim Damji of the University of Alberta in British Columbia in Canada. He gave a series of lectures on several aspects of glaucoma. He also donated some funds for the procurement of Bevacizumab (AVASTIN®) to be used by residents in their management of neovascular glaucoma.,

Dr. Amos Kibata Githeko gave a series of modules on the management of common medical and surgical retinal problems.

 

Image:Professor Alfred Sommer, and Dr. J. Peter Campbell, joins in ward round in ward 9D               Dr. Bopp teaching students on vitreo retinal

.

 

  • New equipment:

The Department was delighted to receive an Indirect Laser Machine from the Hospital for Sick Children, Canada, courtesy of the Daisy Eye Foundation, UK. It was presented by Dr. Helen Dimaras accompanied by staff from the Daisy Eye Foundation – Kenya. This laser machine will be highly useful in the management of retinoblastoma, a common childhood cancer of the eye. The arrival of the laser machine brought joy to the department and all residents who will, from now onwards, improve their mastery of the indirect laser machine and also witness the improved changes in the lives of their young patients,

          

Image: Prof Omwadho Charles OA, Dean School of Medicine receives a laser machine donate by Daisy's Eye Cancer fund

  1. Clinical skills:

 

  • Students in Year I, II and III received their instruments as per their cost plans and this further enhanced efficient and effective teaching and training on their clinical skills.
  • The department cooperated closely with training partners during elective term rotations and enhanced international exposure and co-operation whereby 18 postgraduate students on elective term were attached in various hospitals - Tenwek Mission hospital, Kikuyu Eye Unit, Garissa District Hospital, Light house Eye centre, Kwale District Eye Hospital and L V Prasad Eye Institute (LVPEI)  in India among others .

 

  • We had 3 postgraduate students from Muhimbili University of Health and Allied Sciences (MUHAS), Tanzania attended their elective term in the department from 1st to 30th June 2012.

               

                 Image: Dr. B. Moorgawa, Dr. A. Baria and Dr.  S. Vaitha from MUHAS during

                       elective term in the department

 

  • During this period 2 of our residents – Dr. Catherine Kareko (sponsored by LFTW) and Dr. Millicent Bore attended their elective term at L.V. Prasad Eye Institute in Hyderabad, India from 1st June to 30th June 2012.

     

       Image: Dr. Kareko attending to a patient under tutilage of consultant at L.V. Prasad eye hospital in India

Image: Dr Bore attending to a patient under tutilage of consultant at L.V Prasad eye hospital in India

 

  • 34 postgraduate students participated in the outreach safaris and were able to improve on their clinical and surgical skills through undertaking cataract surgeries among other eye surgeries done under the tutelage of 7 consultants.

 

  1. Research:
  • 7 postgraduate students presented their thesis papers on various topics which were accepted by the University out of which 6 of the papers were presented during the annual OSEA conference held in Kampala, Uganda.

 

  1. 2. Provide sustainable quality eye care services to underserved population through outreach services and training in various counties in Kenya.

 

Community outreach programmes have always been an indispensable element of the Department of Ophthalmology. The consistent goal of the team is to provide the highest quality eye care to as many people as possible and perform as many surgeries as possible.

 

In spite of the challenges the programme faces, a total of eighteen (18) free surgical eye camps were undertaken between February and November under the joint sponsorship of our partners.

  • During each visit a team of consultants and doctors totaling to 8 were involved in the outreach activities. Throughout the period, surgical, diagnostic and eye care counseling were provided to the patients.  A total of 3375patients (Adults and children) were screened in rural areas of Litein, Mwingi and Garissa and Kitui and Kenyatta National Hospital.

 

3. Develop academic staff and students through participation in CME/CPD activities

 (national/regional/international)

 Academic staff and students in the department participated in more than 15 various local/ international conferences, workshops and training programmes where they also presented papers.  Some of these  included:

  • The Ophthalmology Society of Eastern Africa (OSEA) Conference held in Kampala, Uganda in October whereby 6 postgraduate students presented papers during the conference.
  • Dr. Sheila Marco attended and presented a paper during the 25th International congress of German Ophthalmic Surgeons held on June 14th -16th at Nurnberg, Germany.
  • Prof. Dunera Ilako, Dr. Millicent Kariuki and Dr. Sheila Marco attended Research Training by EACO on May 30th -31st 2012 in Dar es Salaam, Tanzania.
  • Dr. Kahaki Kimani attended Clinical rotation training at the L.V.Prasad Eye Institute, India from June 18th – July 2012.
  • Dr. Kahaki Kimani was a participant /facilitator of a training for a research team in Ocular Morbidity Study at IIorin, Kwara State, Nigeria from 10th – 17th  2012

 

 

 4.Participate in VISION 2020 activities and enhance networking.

The department implemented the following to contribute to the flagship of VISION 2020

  • To enhance visibility and advocacy, Dr. Sheila Marco published an article in the Daily Nation on GLAUCOMA in May 2012.
  • The Department is engaged in policy dialogue with national ministries and regional authorities to promote inclusive education.
  • Through the partnership with our Partners, postgraduate  students were able to complete their elective terms in various regions as well as participate in outreach activities
  • Through the partnership with our Partners, postgraduate students were able to complete their elective terms in various hospitals as well as participate in outreach activities in 3 satellite hospitals within the region thus enhancing networking.
  • The department carried out several consultancies with various organizations/institutes.                                           

 

  • The department has continued to participate in the national/regional global prevention of blindness activities by maintaining links with the International Council of Ophthalmologists (ICO), Middle East African Council of Ophthalmologists (MEACO), the German Opthalmological Society (DOG), American Academy (AAO), Ophthalmological Society of Nigeria (OSN), and Ophthalmological Society of Ethiopia (OSE) and  participating in joint planning and project implementation with stakeholders e.g. EACO, MOH on childhood blindness among others.

 

 

 

 

3. Progress against activities

 

aEnrolling 10 postgraduate students from various countries in sub Saharan Africa.

Accordingly the development of human resources has been a priority for the department of Ophthalmology over the past years. The department during this period operated within its planned activities of enrolling postgraduate students .In the academic year 2012/2013 which commenced in September 2012, a total of 10 Postgraduate students were enrolled; (4 from various parts of the country and 6 foreigners drawn from South Sudan, Cameroon, Mozambique, Ghana and Burundi.

 

  1. Enrichment of Optometry clinical experiences through elective term rotations in various eye hospitals for 17 postgraduate students.

The department cooperated closely with training partners during elective term rotations and enhanced international exposure and co-operation whereby students on elective term were attached in various countries for clinical exposure.  During this period 18 postgraduate students attended and successfully completed their elective term in various hospitals in Kenya, Botswana, Ethiopia, Peru, Ghana and India.

 

  1. Graduate 10 postgraduate students as Ophthalmologists

7 ophthalmologists graduated during this period and were posted to various hospitals within Kenya and their home countries. Thus the department has continued to build capacity in other African countries and reducing the human resource gap. Two of the postgraduate students will be re sitting for their examinations in February 2012

                             

  1. Provide Outreach Services and conduct 1000 quality cataract surgeries among other eye surgeries

 

 
   

"The eye is the window of the human body

through which it feels its way and

enjoys the beauty of the world."

 

The purpose of the community outreach is to contribute to Society (by reducing the amount of needless blindness). They include diagnostic, screening and treatment (DST) and health awareness. Outreach activities teach the students/eye doctors several aspects of eye care which include Clinical skills, interpersonal communication skills and leadership skills.

 

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  •  
  • Outreach activities increase productivity, quality of care and cost effectiveness in cataract surgery programmes.
  •  A total of 3289 patients (2741 Adults and 548 children) were screened in rural areas of Litein, Mwingi and Garissa and Kitui and Kenyatta National Hospital. They were able to restore sight to 956   patients through eye surgeries. .  The outreach team was able to attend to a total of 548 paediatric patients with various medical and surgical eye problems including significant numbers of eye Conjunctivitis, refractive errors among other eye diseases.

 

 

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  1.   Factors that have affected/may affect the project

 

                                                                              

                          

 

The department has had challenges in procuring outreach consumables, as well as transportation to the various outreach camps.                                                     

 

5. Strategic progress

Detail of actions taken and any progress made, for example:

    - embedding the project within existing systems and structures

    - strengthening existing systems and organisations

    - securing replication/scale-up of the project by government/others

    - empowering & involving communities

Human Resource Development

 

In line with VISION 2020, the development of sustainable, affordable & equitable comprehensive eye-care systems is an integral part of the national health care systems. Human resource development is an essential component of the VISION 2020 programme and the department has continued to train Ophthalmologist from sub-Saharan Africa.

 

Empowering and involving communities

 

The department liaises with Hospitals and the community members within the 4 outreach catchment areas in mobilizing communities and patients to attend the outreach camps where free eye surgeries are conducted.

 

 

 

 

6. Reflections and key learning points

Looking back over the last year:

   - What has worked well/not so well?

   - What improvements do you think should be made?

   - What would you have done differently, given the chance?

  • Project implementation of this project has proved so far to be effective and efficient from program, budget and administrative points of view. Utilizing existing partnerships and cooperation with government, donors and civil society, and networks has allowed for an integrated approach to addressing project objectives.

 

  • The preliminary findings of the project have shown that a 1 year project is quite short to achieve the project’s objectives and ensure the sustainability of results. There is an obvious need for further interventions and review of the project duration to three (3) years in order to improve the delivery of objectives which the department wished to be incorporated into next year planning.

 

  • The department with Eastern Africa College of Ophthalmologists (EACO) has embarked on implementation of the HR development activities in Kenya. The roll out will go along way in responding to the institution capacity and infrastructure gaps complementing the ongoing initiative with Partners.

 

 

7. Planned activities for next year 2013

 

  1. Conduct 1000 cataract surgeries
  2. Facilitate training of  one academic staff in subspecialty in a field in Ophthalmology
  3. Staff and students to participate in local, regional and international workshops, seminars and conferences.
  4. Staff and students to participate in the annual OSEA conference
  5. Graduate 10 postgraduate students as Ophthalmologists
  6. Enrol 12 postgraduate students from Kenya and other African countries
  7. Undertake 18 outreach camps in 4 marginalised areas of Kenya
  8. Enhance international exposure and cooperation by attaching 10 postgraduate students for elective term rotations
  9. Monitor quarterly progress of implementation
  10. Participate in various national /regional global prevention of blindness activities
  11. Postgraduate students to sit for their University examinations and ICO examinations
  12. Enhance relevant research activities for academic staff and postgraduate students
  13. Commemorate the World Sight day through outreach activities.
  14. Foster partnerships and linkages with other organizations.

 

 

 

 

The Department of Ophthalmology is awed, Inspired

 and grateful for the committed support it

continues to receive from its Partners

Year: 
2012:00