Médecins Sans Frontières has been present in Homa Bay since 1996 and works in conjunction with the Ministry of Health at the 250 bed District Hospital, servicing a catchment area of 700,000 people and bed occupancy often over 100%. Since a few years, our goal is to ensure access, continuity and quality of care, focussing mainly on HIV and TB care. Successful HIV therapy requires 95% adherence to the drug regimen with a minimum combination of three antiretroviral drugs (ARVs) and drugs to prevent opportunistic infections are taken at 12 hourly intervals without interruption, to prevent virus replication. Access and a progressive integration of services are our main focus, as are the challenges these present.
The ‘Pharma Team’, as we three are known as, Josiah Otieno, Everlyne and I, are responsible for all the ordering and distribution of drugs and medication. This includes ARVs, drugs against OIs (immuno-suppressed patients are susceptible to serious often fatal Opportunistic Infections), TB and MDR (multi-drug resistant) TB drugs, as well as nutrition supplements (for example, HIV patients have a high incidence of secondary malnutrition) and many medical and laboratory items. These are arranged in four converted shipping containers and an old thatched roofed hut called a ‘tukul’. We also supply drugs and equipment to two other HIV clinics in the region, a family planning and mother and child health clinic, a TB Clinic, four wards, the HIV/TB culture labs and three rural health centres.
