Dr Eunice Ndirangu of AKU SONAM East Africa (left), Duncan Okoth who graduated and Elizabeth English, a trainer from Australian Association of Stomal Therapy Nurses (AASTN) [Photo/MoH Press team]
Patients with stoma, fistula and chronic wounds will get a huge relief following the graduation of 14 nurses trained in stoma wound and continence management at the Aga Khan University School of Nursing and Midwifery (SONAM) in Nairobi.
The programme is the first of its kind in East Africa and this is the third group of nurses trained under the Kenya Stoma Wound and Continence Nursing Education Programme.
The nurses, 13 from different parts of the country and one from Botswana were trained under the Kenya Stoma Wound and Continence Nursing Education Programme, a partnership between Kenya and Australia. The programme was conducted by tutors from the Australian Association of Stomal Therapy Nurses (AASTN).
The number of patients with stoma, fistula and chronic wounds is on the rise in tandem with increase in Non- Communicable Diseases (NCD). Most of the patients with gastric cancers end up with bowel stomas- a surgically created opening in the abdomen that allows waste to leave the body. Cardiovascular diseases and traumatic injuries have led to increase in chronic arterial and venous lower limbs wounds and acute wound respectively. Nursing care for such patients has remained a major challenge due to few health personnel with such specialty and high cost of quality disposal bags and dressing materials.
In the absence of adequate knowledge and care, patients with stoma may have odour and skin problems, management issues and stigmatisation and most likely, undergo unnecessary suffering. Patients with acute and chronic wounds may undergo unnecessary complications leading to amputations or even death due to infections.
Speaking at the graduation ceremony, SONAM Dean, Professor Sharon Brownie, said the nurses will help ease the pain of many people trying to cope with the social, psychological and basic management issues associated with stoma.
“A nurse with knowledge about this condition can provide the skills and knowledge to allow these people to live with dignity, and continue confidently with activities of daily living” said Professor Brownie.
In a country like Kenya where majority of people live on less than a dollar per day, the cost of stoma bags, which are mostly imported and sold in select pharmacies at cost as much as Sh1,400 and Sh100 per bag for reusable and disposable ones respectively is unaffordable to many poor patients.
The reusable bags are disposed after using them twice or thrice. In addition, users have to buy a base that ranges from Sh700 which is attached to the pouch and used up to four times or less if it soils.
Professor Brownie whose message was delivered by SONAM Kenya Academic Head, Dr Eunice Ndirangu said a total of 53 nurses have graduated from the programme since 2013 with those from remote regions being sponsored by SONAM. 49 of the nurses have been from Kenya and four from other parts of Africa.
“Stoma wound and continence care expertise is lacking in Kenya, and the graduates would positively impact the lives of patients across the country. From the first two programmes, 17 Kenyans have completed an advanced programme to prepare them to be future Kenyan tutors, to ensure sustainability of the programme,” she said.
The training programme is in line with the Sustainable Development Goals (SDGs – 3 and 4), which seek to ensure health and well-being for all (SDG 3) at every stage of life and quality education (SDG 4), respectively.
It also supports Kenya’s economic blue-print, Vision 2030, which emphasizes on investing in people to improve the quality of life for all Kenyans by targeting a cross-section of human and social welfare projects and programmes, in areas like education and training, health and environment.
The programme is structured to include 50% clinical and 50% theoretical learning, and the nurses mainly undertake their clinicals at the Aga Khan University Hospital (AKUH), Kenyatta National Hospital (KNH), Kijabe Mission Hospital, the Spinal Injuries Hospital and St Mary’s Mission Hospital. A total of 17 volunteer Australian nurses participated in training the local nurses.
Mr. Fred Omiah, who represented the Ministry of Health, noted that one of the key achievements of the programme is the establishment of dedicated nursing positions for stoma wound and continence care at AKUH Nairobi and KNH. The nurses heading these units were trained at SONAM during the first and second programmes.
“The Stoma Wound and Continence Nursing Association of Kenya has been established to support the sustainability of stoma management. An international delegate to the World Council of Enterostomal Therapists [WCET] has also been appointed to ensure Kenya is well represented on the world stage,” said Omiah.
Ostomy support groups led by stoma graduates are already functional at both AKUH Nairobi and KNH. These groups promote patient networking opportunities and donation distribution.
Graduates are also setting up help centres in their regions so that ostomates do not have to travel long distances for assistance or supplies. There are now stoma wound and continence nurses in AKUH Nairobi, KNH, MP Shah, Machakos, Kijabe, Homa Bay, Malindi, Nyeri, Meru, Kisumu, Eldoret, Samburu, Bomet, Kilifi, Kakamega, Siaya, Kwale, Kisii and Wajir.
The Enterostomal Therapy Educational Project started in 2013 with faculty expertise support from Australia, as part of the Kenya-Australia WCET-AASTN Twinning Project.