Coronavirus Report (1 of 3)
It has only been 8 weeks since the world was upended. Astonishing how quickly everything could change. I want to share some thoughts for our friends and family, and to all those who love Kijabe and are concerned about the wellbeing of the hospital and people in surrounding communities. I’m writing from my perspective as husband to Arianna, a pediatric emergency medicine doctor, Serge missionary, and as director of Friends of Kijabe. There are as many opinions as stars in the sky and the following opinions are my own.
Phase 1: Preparation
Today Kenya is at 582 COVID-19 cases, 190 recovered, and 28 deaths. We are testing in Kijabe regularly and don’t yet have any positive cases.
We don’t know why the virus has not spread rapidly in Kenya as in America. Weather, the equator, rural lands, TB vaccination – there are many theories, and none sound completely perfect. A flu virus hit Kijabe in Jan-Feb and most families were sick. I had a runny nose and sore throat. Could this have been coronavirus? We won’t know until we have antibody testing, and that’s not on the horizon yet.
In Kijabe, any patient with cough and fever is treated as a suspected case in a separate 80 bed COVID hospital (formerly the Bethany Kids children’s center). Clinicians put on full PPE and assume that the patient is positive until tests come back from Nairobi – usually within 24 hours. For Arianna, this is now routine.
A month ago, we had only a handful of N-95 masks and little else on hand. Outbreak committee meetings were tense – a side-effect of addressing a pandemic with severe resource limitations.
The global supply chain froze as international flights were cancelled. What we now know is that supplies were coming into the country, but vendors were selling at inflated rates on the grey market, telling the hospital they were not available. In fact, vendors had supplies in hand, selling them at 2-4x the normal price.
A team from Moffat/Care of Creation/RVA, including Madeline and Annabelle, started producing face shields and sewing cloth masks and gowns.
After clearing many obstacles, things today are looking much better. Volunteers have produced 2000 shields, 1500 cloth masks, and 200 gowns. We have been able to purchase 1300 N95 masks, 500 goggles, 500 coveralls, and 50 pairs of gumboots (after leaving a COVID room, the clinician steps in a bath of bleach water to avoid tracking contaminants). The French Embassy donated a portable x-ray for the COVID ward, a new ventilator is on the way (thanks Jason!), replacement incubator parts are coming from North Carolina (maternity and NICU are functioning like normal, but we have 4 donated incubators in need of repair).
Another major concern is the oxygen supply. You have seen news reports about ventilator shortages in America, but oxygen is plentiful. The first and most effective treatment for COVID is supplemental oxygen, and its availability is far from guaranteed in East Africa. The Bethany Kids building was constructed with a small oxygen plant underneath, strong enough to care for 10-15 critically ill babies, not 80 adults. The main hospital has been at capacity for years, and to shunt the supply could be catastrophic. We have known building a new oxygen plant and piping would cost $1 million and take months – ot the best option in a crisis. But good can come out of a crisis. While looking for other options, the hospital found a liquid oxygen supply tank could meet our needs as well. This would be much cheaper than building a plant – $117,000 for tank installation and it would be refillable as needed via a truck from Nairobi. One liter of liquid oxygen expands to provide 800L of oxygen gas – so the 10,000L tank will provide 8 million liters of oxygen for each refill. Amazing!
Our non-profit, Friends of Kijabe, set an initial goal of raising $100,000 which we met in days. We’ve purchased PPE and equipment and are standing by to put a deposit on the oxygen system. Donations have come from the US, Canada, UK, Australia, and most notably, the underground church in mainland China. Our hospital clinicians have spent hours reading and writing protocols and working through the night to get ready. Physicians’ children have created Facebook fundraisers to buy equipment to protect their physician parents, spouses have sewn masks for their loved ones in the hospital, and my daughters have glued masks for their mom.
The outpouring of support is nothing short of stunning.
I wish this meant we could take a pat on the back and have a long rest. But this is all just preparation, the true fight is still ahead.
(Part 1 of 3)