Kabula Clinic Project

            On August 12, 2003, the Bill Selke Memorial Clinic opened in Kabula, Kenya. This opening was the culmination of two years of work by Humanitarian Medical Outreach, the local non-governmental organization Inter-Community Development Involvement (ICODEI), and other partner organizations. The project idea was conceived in response to complaints from local community leaders about a lack of basic health care that was affordable, accessible and high in quality. The Bill Selke Memorial Clinic is all these things.  

            The clinic facility consists of three examination rooms, a laboratory, a counseling room, an administrative office, a storage room and a reception area. The examination rooms and laboratory all have running water that is piped in from an elevated rain collection unit outside, providing much cleaner water than is typically available to residents of this area. There is one flushable toilet inside the facility and two traditional drop-shoot latrines outside. The clinic is equipped with electricity, which is also unusual for structures in the area and allows for storage of drugs as well as use of certain advanced equipment.

            The clinic is staffed full-time by a clinical officer, nurse, nurse’s aid, and laboratory technician. They are able to provide diagnostic and treatment services for most diseases common to the area, including malaria, typhoid, and brucellosis—three endemic diseases that share very similar symptoms but require different treatments. In cases where one of these diseases is suspected, one small fee is assessed to cover a physical examination and laboratory tests for all three diseases. In this way, a conclusive diagnosis can be made and appropriate treatment given. The fee is less than that which a patient would pay for a single test at most facilities in the district. Prior to construction of this facility, proper diagnosis was prohibitively expensive and most local residents would self-treat any case of fever as malaria using self-prescribed medications—a strategy that could prove both ineffective and dangerous. In addition to diagnosing and treating these and other illnesses, clinical staff members also commonly perform pregnancy testing and treat minor traumas.

            The clinic’s full-time staff members are frequently joined by volunteers from abroad, including medical students and doctors, as well as support personnel from ICODEI. Volunteers who lack medical expertise help with administrative aspects of the clinic, including patient processing and record-keeping. Medical students and doctors help triage and examine patients, and occasionally organize large-scale free clinic days. During the first six free clinic days, approximately 1700 patients were seen. An ICODEI staff person organizes HIV testing through the clinic and also provides pre- and post-test counseling to patients.

            The clinic in Kabula, Kenya, is entirely self-sustaining. The small fees assessed from patients are far more affordable than at other, more distant facilities, yet they are enough to pay staff salaries and replenish supplies. The clinic employs local personnel and is a model for community-focused healthcare delivery.