January 31, 2008

MSF provides surgical care as violence intensifies in the west

On January 25, an MSF mobile team had been out for ten minutes when they had to return to base, due to fighting and rioting in the streets. Later that day, the team was able to get to the hospital and found that 116 people needed surgical care.

As violent clashes flared in parts of Kenya over the weekend of January 26 and 27, Doctors Without Borders/Médecins Sans Frontières (MSF) teams were on hand to provide much needed support in Nakuru and Naivasha district hospitals. In Nakuru, MSF teams helped treat 157 wounded patients over two days. In Naivasha, 30 people were cared for.

MSF teams began working in and around Nakuru, a city located in the Rift Valley, in early December, during the run up to the elections when people began to be displaced. Soon after the election, when violent protests gripped many parts of the country, MSF supported the district hospital. At that time, high numbers of wounded people, and the fact that many of the Ministry of Health staff were not able to get to the hospital, meant that the extra support was needed. However, as soon as the situation stabilised, MSF focused on trying to assist people in rural areas around the city, where hundreds of displaced people were living with little or no aid.

By January 19, tensions were mounting once again around Nakuru. The following week, MSF’s mobile teams were only able to go out two times instead of the usual four. On January 25, the mobile team had been out for only ten minutes when they had to return to base, as people were fighting and rioting in the streets.

Later that day, the team was able to get to the hospital to see how they could help, and found that 116 people needed surgical care. The team responded immediately, performing triage and minor surgery. The following day, another 41 patients were waiting for surgical care, but only one surgeon out of four had managed to get to the hospital and there were very few nurses. Supplies, particularly those for surgery, were running low. As many of the roads around the city were blocked a helicopter loaded with surgical materials, such as gauze, drugs, infusions, instruments, and dressings was sent from Nairobi.

At the same time, Naivasha, a town about one hour’s drive from Nairobi, was experiencing violent clashes with 30 people reported killed. On January 28, an MSF team travelled to Naivasha hospital from Nairobi. On arrival, they found 30 wounded patients, the majority of whom had suffered beatings and machete wounds, as well as some gunshot wounds.

As in Nakuru, the violence had prevented many Ministry of Health staff from reaching the hospital. An MSF anaesthetist, nurse, and doctor were called in from Nairobi and arrived a few hours later. They saw six seriously injured patients; two with head injuries were immediately taken to Nairobi by ambulance. The other four patients were stabilized and referred to a Nairobi hospital the following day. The team then proceeded to treat the remaining patients.

Since then, the emergency team has been monitoring the situation in the hospital, as well as in displaced people’s camps around the city. “In Naivasha, we saw two camps: one in a prison with around 3,000 people living there, and another one in a police station with roughly 1,500 people,” says Marcela Allheimen, MSF emergency coordinator. “But more displaced people are arriving, often escorted by the police.” Now, the team will focus on assisting these people, many of whom have no access to medical care.

As violence and insecurity persist in Kenya, MSF teams continue to respond to the emergency needs that arise. As well treating wounded people in the Nairobi slums, Naivasha, Nakuru, and Eldoret, MSF is also providing assistance to some of the thousands of people who have been displaced by the violence in western Kenya and Rift Valley Province. Long-running HIV/AIDS and TB projects are running as normal in Nairobi, Busia, and Homa Bay. However MSF is concerned about the number of patients who have not been able to access care due to the ongoing insecurity.

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