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Milca social work report

Social work (Kibabii University)

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INDUSTRIAL ATTACHMENT REPORT

NAME OF INSTITUTION : THE KISUMU NATOINAL

POLYTHECHNIC

ASSIGNMENT : INDUSTRIAL REPORT

NAME OF STUDENT: MILCA MUTALI WAKASA

ADM NO: TKNP/A/9982

SUPERVISOR: MOSES WEFWAFWA

PERIOD OF ATTACHMENT: 9/01/2023 TO 9/03/2023

SUBMITTED TO: THE KENYA NATIONAL EXAMINATION

COUNCIL IN PARTIAL FULFILMENT FOR THE

REQUIREMENT FOR A WARD OF DIPLOMA IN SOCIAL

WORK AND COMMUNITY DEVELOPMENT

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DECLARATION
I hereby declare that this is my original work. This report on the industrial attachment at
BUNGOMA COUNTY REFERRAL HOSPITAL, my report is presented to Kisumu National
Polytechnic, Department of Communication Development as a partial fulfillment of the
requirement for the award of Diploma in Social Work.

STUDENT NAME: MILCA MUTALI WAKASA

ADM NO: TKNP/A/9982

SIGN: ……………………………. DATE: ……………………………..

SUPERVISOR’S NAME: …………………………….

SIGN : …………………………….. DATE ……………………………

DEDICATION

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I dedicate this work to my parents for their continual support in my academic work to my
lectures and the working personnel of BUNGOMA COUNTY REFERRAL HOSPITAL for
making my attachment successful through their assistance in theory and practical guidance in
pertaining the course I am taking. They have improved my knowledge.

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ACKNOWLEDGEMENT
This internship programme could not have materialized without acknowledging the divine
protection and guidance of the Almighty God.
My gratitude goes to the Director (BUNGOMA COUNTY REFERRAL HOSPITAL), for his
unyielding support and advice during the period of my internship.
My final appreciation also goes to all officers and interns who in various forms assisted me
directly and indirectly towards a cherished practical experience of work ethics and the
application of learned academic knowledge into reality.

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REPORT OVERVIEW
One of the requirements of the students undertaking a Diploma course in Social Work is to
undergo industrial attachment to put into practice what has been covered in class and also expose
them to the practical part and advance their skills.

The main objective of writing this report is to articulate the skills and experience, challenges and
ideas presented to the firm and gained in the industrial attachment exercise I underwent in
BUNGOMA COUNTY REFERRAL HOSPITAL in my department.

This report is therefore to achieve the primary objective of the student to successfully undergo
the course as per the laid down curriculum and also to express the areas of concern where the
training college needs to improve and the institution offering the attachment not forgetting the
need to express appreciation to have been offered the opportunity to carry out the industrial
attachment exercise in the institution

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Table of Contents
DECLARATION.........................................................................................................................2
DEDICATION.............................................................................................................................3
ACKNOWLEDGEMENT...........................................................................................................4
REPORT OVERVIEW................................................................................................................5
CHAPTER ONE..........................................................................................................................7
INTRODUCTION.......................................................................................................................7
BUNGOMA COUNTY REFERRAL HOSPITAL STRUCTURE..............................................8
CHAPTER 2................................................................................................................................9
PATIENT SUPPORT CENTRE...................................................................................................9
CHAPTER THREE...................................................................................................................11
MATERNAL CARE..................................................................................................................11
MERTERNAL CHILD HEALTH.............................................................................................12
IMMUNIZATION (CHILD WELFARE)..................................................................................12
CHAPTER FOUR.....................................................................................................................13
OUTPATIENT DEPARTMENT AND INPATIENT..................................................................13
CHAPTER 5..............................................................................................................................14
ROUTINE..................................................................................................................................14
FIELD WORK...........................................................................................................................14
EVALUATION..........................................................................................................................16
CONCLUSION..........................................................................................................................16
RECOMMENDATIONS...........................................................................................................17
REFERENCES..........................................................................................................................17

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CHAPTER ONE
INTRODUCTION
BUNGOMA COUNTY REFERRAL HOSPITAL is a health facility in Kenya situated around
Bungoma County. Bungoma County Referral Hospital is a government healthcare facility located
in Bungoma town along Kanduyi - Mumias road.

This hospital in Bungoma County offers 24-hour emergency medical care services open for 24
hours

VISION

To be an efficient and cost effective medical care centre for a healthy community

MISSION OF THE HOSPITAL

To promote and participate in the provision of integrated and high quality, curative, promotive
and rehabilitative services to the community

GOAL

To contribute towards and reduction of healthy inequalities and to improve the healthy impact
and outcome in indicators

OUR CORE VALUES

 Professionalism

 Timeliness

 Quality

 Integrity

 Team Work

 Honesty And

 Innovativeness

BUNGOMA COUNTY REFERRAL HOSPITAL STRUCTURE

BOARD OF DIRECTORS.

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MEDICAL OFFICER

ADMINSTRATIVE
 Transport MEDICAL SUPPORTIVE STAFF
 Surgery
 X-ray
 Cleaning  TB
 Physiotherapy
 Domestic  Dental
 Laboratory
 Security  Occupational
 Pharmacy.
 Agriculture  General medicine
 Personnel  Therapy
 Finance
 Records
 Maintenance

CHAPTER 2

PATIENT SUPPORT CENTRE

In this department, clients who have been tested positive are being monitored and showed the

importance of taking drugs so as to prolong their lives not forgetting that AIDS has no cure at

all .in this area the following takes place .pretest counseling , posttest counseling and

adherence . Under the adherence counseling the patients who were currently on CTX are

introduced to ART as a result of reduction on their CD4+ counts. It is also in the department

whereby infected clients who would want to bare children are advised on what to do being that

during the process both the partners might be at risk of viral load and this because they have

different type of viruses and therefore the health care providers will give them the right time to

have a child as well as preventing viral load. it is also preventing the child from getting infected

as long as there will be save delivery especially in the hospital it is also in this department where

by PLWHAS identify themselves those coming from the same locality and form support groups

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that enables them to stand strong during emotional time and help lift their spirits. This group

also help them in providing basic need such as food among others, it help them to encouraged

and get support from on e another.

The department is well equipped with the machines in the laboratory. These them during the

monitory of the clients in checking the CD4+counts and during HIV/AIDS testing. There are two

types of algorithm used in the laboratory that is; determine and the first response. In this case

therefore determine uses the chase buffer as the reagent while first response case uses wash

solution as its reagent and it is used as a confirmatory test for approval as it was very sensitive

and confirms the determinant test result being positive. The results are achieved within an

interval of 10 to 15 minutes of the test.

All the clients tested HIV/TB positive are also cared for in this department where their name are

enrolled in the laboratory tools such as HTC laboratory MOH register 362, HTC service

summery, dairy activity MOH register 642 laboratory top-up form and laboratory stock cards.

The patients are also opened for files that help in keeping the records of the clients up to date and

for easy follow-up months, they are done yet leaving vitamin A supplement that’s given after

every 6months. We did our best to make the clients understand and a good number we found

during our defaulter tracing period responded positively and the program was meeting the target.

There are various types of ARUS that issued in the department. And the following are some of

the drugs given to the clients;

1. Stavudine [D4T]

2. Nevirapine [NVP]

3. Lamivudine [3Tc]

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4. Zidovudine [Azt]

5. Tenofovir Disaproxil Fumarate[TDF]

6. Efevarenz[EFV]

These drugs also have combinations and are given depending on the viral load and the CD4+
counts of the client and under instruction the directives are given on how the drugs are to be
taken in regard to the time the patient choose for him /herself to be suitable for drug taking. This
helps boost immunity of the body and prevents the multiplication of viruses reacts with the
patient, he/she is given another set of drugs among the first time of regimen.

CHAPTER THREE

MATERNAL CARE

Within the hospital there was antenatal care services offered to the expectant mothers in which

they are monitored and be offered for all the health care services they need so as facilitate safe

delivery. All expectant mother are required to attend clinic for screening of diseases that are

communicable and can easily be transmitted to the infant during and after pregnancy. All of them

are a must to be tested on their HIV/AIDS status so as to help protect mother to the child

transmission of the virus. If in case the mother to the child transmission of the virus, if in case

the mother is found positive she will be put on the prophylaxes to help protect the child from

getting infected. They are also given nevirapine syrup for the child that they start giving

immediately at birth not only that, they are being done for anc profile so as to do away with the

stis if the might have. During their visit, they are given the folis that help in raising the blood

volume in their bodies and so that they don’t suffer anemia and also help in providing appetite.

They are also taught on how best they can take care of the babies and themselves as well as the

importance of having delivering at the hospital but not at home.they are alsogiven tetanus taroid

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to help prevent neonatal tetanus and this is given to them in their first pregnancies in which the

first pregnancy a mother was given 1st and 2 nd t.t. respectively. Ouring this period, they are also

given health education on HIV/AIDs. Nutrition family planning and personal hygine during

pregnancy and breastfeeding. On nutrition it was tried to make them understand health eating

style and having a balanced diet and drinking well prepared.

MERTERNAL CHILD HEALTH

IMMUNIZATION (CHILD WELFARE)

This involves immunization of the children from the age of 0-5 years. It is important being that it

keeps the child safe from preventable diseases such as polio, Tuberculosis, Measles among

others. The supplies of the vaccines are done on a monthly basis to enhance continuous

immunization program by the ministry of health. In addition to that, the vaccines in which the

refrigerator is being monitored and chattered every morning. Client’s particulars are done for

entry into the MOH immunization register for easy tracking of defaulters as well as the TCA

dates so as to keep the mother reminded on their visits and those who have completed the full

immunization. For the supplies to be properly done and stored, the health care providers do keep

the records on the stock ledger books for each vaccine. This is done to help in monitoring and

evaluation on the required supply for each month depending on the target population of the

region. It cannot say that there are no challenges experienced in this program, there are especially

defaulters that come to clients who believe that after receiving the measles injection at a month,

they are done yet leaving the vitamin A supplement that’s given after every 6 months. They did

our best to make the clients understand and a good nu number which will found during our

defaulters tracing period responded positively and the program was meeting the target.

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CHAPTER FOUR

OUTPATIENT DEPARTMENT AND INPATIENT

They visited the two departments and tried to go through and see how the clients, are being

monitored and they learnt a lot that is; tools part cleaning the wounds. As well as offering first

aid. To patients with injuries like those who had accidents.

Most of the patients in the inpatient departments are cared for even though proper treatment is

not available and for that matter as a community health worker, It becomes a challenge and they

had to look for other way to make things work. Regardless of how unfriendly the nurses were,

they took part in ensuring the cleanliness of the wards through the use of the sub-ordinate staff

members through health education, they could help the patient every morning on benefits of their

health and therefore they had to take it more serious through living a healthy productive life so

as to avoid re-occurrences the diseases they taught were suffering from ,for example ,they taught

them on; HIV/AIDs prevention measures ,malaria control and prevention ,Amoebiasis ,typhoid

fever, schistomiasis gia.

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CHAPTER 5

ROUTINE

FIELD WORK

This involved community diagnosis whereby they were working with the community healthy

extension workers (CHEWS) who help us in knowing the community and the health related

issues e.g. households with which they were doing routine check and delivering report to the

PHO Busing the community diagnosis indicators register for the house hold number one (1) and

each CHEW was given a target of one hundred households that they look after in the field they

could be able to make health education in form of mobilization in the following areas

Importance of immunization, hygiene and sanitation in schools:

In homes and markets places they also took part in the polio campaign even in churches ,they

also conducted inspections with the PHO staffs whereby they took part in premises ,they can’t

say that there were no chances though they encountered some of exam[le during door to door

health education on the importance of immunization .they found some families in a village called

karate who does not believing in taking god’s protection. the gave them clear information on this

issues concerning health especially on immunization

The main objectives

• To improve the trace defaulters

• To improve on nutrition counseling’s

• To encourage them to use the drugs to reduce the viral load

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• To improve counseling and guiding of HIV testing and counseling’s on client

• To un underhand what is done in the community village

• To reduce the number of HIV infections to at least 50%

Challenges

 Its insufficient health work

 A lot of congestion

 No proper customer care

 Most machines not operating

 Lab and pharmacy is conjested

 No fire fighting and equipment

 Electricity outage

 No proper sanitation of hygiene

 Language barrier

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EVALUATION

After the three months practicum part of my study. They had learnt a lot forcefully being that

they were not allowed to access most of the importance areas of the study especially in the

laboratory and the dental department as well as management. They found it very difficult to

access those places in order to acquire the important information they needed.

CONCLUSION

The hospital according to my view was objective despite normal daily challenges of unexpected,

deaths and severe cases of some deadly diseases. Some of the various weakness they came across

during the practicum. The ward are very pathetic and with this regard, there was need for

changes and government should come in fully to support the lives of the citizens.

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RECOMMENDATIONS

The hospital especially the wards are supposed to be adjusted with the necessary requirements.

E.g. the mosquito nets should be provided in order to avoid health complication among the e.g.

the mosquito nets should be given more time to take part in ensuring the attainment of the

objectives more professional are to be added to make and offer quality services to the clients in

order to avoid both infant mortality as well as preventable deaths so as to maintain the population

to provide labor, good leadership of future to maintain the growth of the county’s economy for

the life.

REFERENCES

I did my consultation in the following professional and individuals

- Nurses

- Doctor

- Public health officers

- Patients

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