THE PULSE - ISSUE 34 (1)

THE PULSE
Issue 34

DEPRESSION What's Inside?

By:  Mrs. Margaret Sirima - Principal College LIVING WITH POLY-
of Heath Sciences CYSTIC OVARIAN
SYNDROME
Depression, classified as Major depressive
disorder (MDD) by the American psychiatric Ms. Betty shares her journey 
association, is a common but serious illness that
is characterized by an abnormally low mood. The CUSTOMER SERVICE WEEK
disease affects the way a person feels, thinks,
behaves and inevitably decreases an individual’s Behind the smile
ability to function at school, work and home. It
impacts on ones’ sense of self-worth, INFECTION CONTROL
interpersonal relation and social life. WEEK

Hand hygiene safety for all

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The prevalence of MDD has increased There are more women affected than men and at its
significantly. According to WHO, there are worst, depression may lead to suicide.
about 300 million people of all ages who
suffer from MDD. The prevalence of MDD Diagnostic criteria for depression
in children is estimated at 2.5% and
adolescents at 8.3%. However, 30% of Depression should be suspected if the
adolescents have subclinical depressive person presents 5 or more of the symptoms
symptoms. Kenya ranks 5th in the listed below. The symptoms need to have
prevalence of depression with 1.9 million been present for at least two weeks and one
people estimated to have depression. of the five symptoms must be either a
depressed mood or decreased interest in
Globally, the burden of this disorder on previously pleasurable activities. One should
human capital and global development is look out for the following;
significant. There are more women affected
than men and at its worst, depression may Depressed mood most of the day or all
lead to suicide. Suicide is the leading cause day. One may also feel empty or is
of death of persons aged 15-29 years. This tearful. Teenagers tend to present
could be because the diagnosis is often irritability, anger and hostility
missed out in persons of this population.   
Culturally, this age group is not expected to Marked decrease in previously
suffer depression and therefore it decreases pleasurable activities
the suspicion index in the family, at school     
and the community. Change in eating patterns or weight
changes of more than 5% of the body
Despite availability of pharmacological and weight in one month.
psychological interventions, only about 10%    
receive treatment. Some barriers to Change in sleep patterns (insomnia or
treatment include; hypersomnia).

Stigma and discrimination    
Ignorance of the clinical features of
depression      
Inaccurate assessment
Lack of trained healthcare providers      
Mental health system barriers  
Lack of resources
Missed diagnosis

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Slowing down of thought and a reduction Risk factors that play a role in the
of physical activity also referred to as pathogenesis of MDD include biological
psychomotor retardation. (genetics, physical changes in the brain,
     brain chemistry, hormones), psychological
Significant fatigue or loss of energy and social factors (chronic illness, social
     isolation, abuse and neglect, adverse life
Diminished ability to think or events, among others). Identification of risk
concentrate or indecisiveness. For factors and early diagnosis and treatment is
children, adolescents and young adults, important. It is essential that we are all able
this may present with poor school to identify the changes in behaviour either
performance.   self or others and advocate for early
   interventions. Sometimes people turn to
Feelings of hopelessness or worthlessness substances such as alcohol to self-medicate
or excessive inappropriate guilt due to the negative feelings, therefore one
should not ignore or cover up for friends,
Recurrent thoughts of death, or recurrent family and colleagues.
suicidal ideations with or without a plan
or a suicide attempt. Conclusion

One should look out for recurrent thoughts of death, or Depression is real, it is important that we
recurrent suicidal ideations with or without a plan or a talk about it and desist from stigmatizing
suicide attempt. those among us. Any behaviour change
noted should not be ignored or wished away.
It is best to advocate for assessment from a
qualified mental healthcare provider. The
patient and family may also be in denial and
therefore we must be compassionate and
patient but do not relent on the need to seek
for help. It is also important to empathize
and offer all support to the family with a
depressed member. Together we can make
significant changes in people’s lives.

Losing your life is not the worst thing that can happen. The worst is to lose your
reason for living!

~Jo Nesbo~

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Hospital), reproductive disorders such as
LIVING WITH Polycystic Ovarian Syndrome (PCOS) occurs
POLYCYSTIC from the onset of puberty; patients
OVARIAN experience irregular periods from the start.
SYNDROME He defines PCOS as a disorder that causes
the ovaries to develop numerous follicles
By:  Beth Njoroge - M&CS (collections of fluid that surround the eggs)
without releasing them. It’s characterized by
Ms. Betty Onyando had a normal childhood  irregular periods(too few times, too far in-
like many of us. She was a jovial child who
truly enjoyed playing with friends in school Since I was in High School my menses have never been
and at home. At that time, there were no regular, and I never saw it as something alarming
gadgets like smart phones and tablets. There because I would just miss a month or two
weren’t many toys to play with and watching
TV was only allowed in the evenings in many between and too heavy); excess androgen
Kenyan households. Nonetheless, she levels(excess hair on the face and body,
remembers her childhood as simple with darkening of the skin, severe acne and male
memories she’ll carry forever. patternbaldness); and polycystic ovaries
(enlarged ovaries with many follicles).
As girls grow up and reach puberty, they Moreover, it affects over 10% of women of
start learning more about their bodies. reproductive age with insulinresistance, high
While younger girls are taught about what to levels of insulin, obesity and genetics being
expect when they reach puberty, it never the most commonrisk factors.
really sinks in until they are experiencing In 2014, Betty’s menses became extremely
these changes. For Betty, it wasn’t any
different. She had learnt a thing or two
during her tertiary life and knew that things
are not always in black and white. “Since I
was in High School my menses have never
been regular, and I never saw it as something
alarming because I would just miss a month
or two”, she remembers. It did not occur to
her that she could be dealing with an
underlying issue.

According to Dr. Paul Koigi
(Obstetrician/Gynecologist at The Nairobi

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irregular. She would go 6 months or more think of better days”, she expressed.
without getting her periods. Moreover, she
gained 20kgs. “This scared me”, she explains, Despite the challenge of living with PCOS,
“I had to see a gynecologist who did some her academic aspirations are still alive. As a
hormonal tests”. She was then diagnosed child, she was an average student but always
with hormonal imbalance and put on a pill aspired to be better. She attributes her desire
to regulate them and induce menses. This for academic achievement and excellence to
mode of treatment was effective but short- her parents who have been in academia for
lived. As soon as she discontinued the pill many years. They have been her role models
after 6 months, her periods became irregular throughout the years and have always been
again. there to encourage her to do and be her level
best. She looks forward to being identified as
In 2015, she weighed 10kgs more. In a span Dr. Betty Onyando in the future as she just
of 1 year, she had put on 30kgs. It felt as a enrolled for her PhD.
great time to seek a second opinion. Given
her underlying symptoms; irregular periods, In conclusion, Betty expresses that humans
hormonal imbalance and tremendous weight are all going through struggles. They may
gain, she was diagnosed with PCOS. not be similar in nature but the effect these
struggles have on us affect how we lead our
This was the beginning of major changes in lives. One philosophy she believes in is
her life mentally and socially. In 2018, a empowering and supporting each other with
study on Anxiety, Depression, and Quality of the different kind of struggles. Betty does her
Life in Women with Polycystic Ovarian best to create awareness on PCOS and
Syndrome was conducted in India. It mental health on her social media platforms
revealed that the prevalence of anxiety and to educate young people. She knows that real
depression among women living with PCOS power comes when you decide to empower
of ages 18-45 is 38.6% and 25.7% others.
respectively. PCOS and mental health are
intertwined because of the symptoms that Betty does her best to create awareness on PCOS and
present. As a result, for Ms. Betty, PCOS mental health on her social media platforms to
came with anxiety and depression. She educate young people
explains that being in and out of depression
over the years, there are many times she
could wake up feeling that it was all too
much for her to handle. In addition, she
became withdrawn socially. Fortunately,
self-awareness has played a big role in
ensuring that she’s able to bounce back. “I
just look at where I have come from and 

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CUSTOMER The team at MCF ward receive a cake  during customer
SERVICE WEEK 2019 service week

By: Christine Matogo - M&CS The team at Northwing ward receive a cake  during
customer service week
Customer Service Week is celebrated
annually on the first week of October. This is The team at St. Andrew's ward receive a cake  during
a very special week for organizations customer service week
passionate about delivering service
excellence and exceeding expectations for
every customer, every time.

This year, the celebrations were observed
from 7th to 11th October 2019 with the
National theme being 'Behind the Smile'. It is
in response to the needs of customers as
expressed throughout the year; that they are
desirous of customer experience excellence
that is beyond just the superficial smiles
provided; and that behind the Smile there is
a sustainable effort to handle customers with
the care they deserve throughout. –ICX
Kenya.

The week-long celebrations provided a
platform for the hospital to appreciate both
the internal and external customers.

Do things for people, not because of who they
are or what they do in return, but because of

who you are!

~Harold S. Kushner~

The team at St. George's ward receive a cake  during
customer service week

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MORAL INJURY Prof. L. Atwoli presenting on substance abuse among
SYMPOSIUM healthcare providers

By:  Maryanne Wahito - M&CS Audience enjoying ice-breaking session during the
symposium
According to Dr. Jonathan Shay, “Moral
injury is damage to one’s conscience when Dr. Aysha Edwards propelling the program as a master
perpetuating, witnessing, or failing to of ceremony during the symposium
prevent acts that transgress one’s own moral
beliefs, values, or ethical codes of conduct.” Dr. Y. Morra presenting - Work Life Balance
It has three required components: & Synergy: Looking Towards Tomorrow

Betrayal of what’s right by;
someone who holds legitimate authority
in a;
High-Stakes situation.

Its manifestations include self-harm, poor
self-care, substance abuse, recklessness, self-
defeating behaviors, hopelessness, self-
loathing, and decreased empathy which has
been noticed to be on the increase amongst
healthcare providers globally.
 
In line with World Mental Health Day on
10th October 2019, this event focused on
mentAal'thhaenak lytohu' fcoakrehbyetahletphactiaernet practitioners.
 

Trauma creates change you DON'T choose,
Healing is about creating change you DO

choose

~Michelle Rosenthall~

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INFECTION and the community whom all have a
responsibility of ensuring patients' and ones
CONTROL WEEK safety.

By:  Joyce Wamiru - Infection Control This year the week was celebrated at the
main hospital and the outpatient centers.
The Infection Control Week is celebrated Our theme was 'Hand hygiene safety for all'.
every 3rd week of October. Millions of The main message to all the staff, patient,
infection prevention and control visitors and community is that with the most
professionals across the world participate in inexpensive practice of hand hygiene the
activities commemorating International chain of infection transmission is broken.
Infection Prevention Week. The annual The activities begun on 14th October 2019.
event was initiated by President Ronald On this day, an activation was conducted to
Reagan in 1986. sensitize them on the importance of hand
hygiene. All participants were given a
International Infection Prevention Week pamphlet on hand hygiene and taken
(IIPW) focuses attention on the importance through the steps of proper hand hygiene.
of infection prevention in saving lives and
healthcare cost while improving the patient The infection control liaison nurses visited
safety and outcome. Over the years, this different departments with the aim of
week of recognition has vastly expanded to creating awareness on infection control
every corner of the globe, including measures. The departments visited included
Australia, the United Kingdom, the Middle catering department, finance, laundry,
East, and Southeast Asia and Africa. The human resources just to name a few.
event is spearheaded by the Association for Concurrently, we conducted an interview at
Professionals in Infection Control and Capital FM with the discussion
Epidemiology (APIC) in the USA. encompassing on the importance of hand
hygiene.
A 'thank you' cake by the patient
The climax was on Thursday where there
The Nairobi hospital has been were 2 activities; one was a lecture on
commemorating Infection Control week for standard precaution. The staff were
the last 12 years. Every year, a theme is encouraged to get back to basics in
carefully selected depending on the gap prevention of infection with emphasis on;
identified with the aim to increase awareness
and compliance. The week is planned and Hand hygiene
supported by the hospital administration Personal protective equipment (PPE)
with the commitment of improving patient
safety and outcome. The activities that are
planned encompass the patient, staff, visitors

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Hand hygiene Hand hygiene the when and how
Personal protective equipment (PPE) Respiratory hygiene and cough etiquette 
Respiratory hygiene and cough etiquette Personal hygiene after toilet use for both
Environmental cleaning the girls and boys
Proper waste disposal
Cleaning and disinfection of Patient care The activities would not have been achieved
equipment without the participation of all.  Let’s
remember that hand hygiene is safety for all
The second activity of the day was at Riara
group of schools with an emphasis on;

SN Joyce Wamiru demonstrating how to do a proper hand Tom Simba (Head M&CS) learning how to do a proper hand
wash to a client wash from Nurse Peninah

A 'thank you' cake by the patient

Nurse Peninah leading the hand hygiene talk at Riara school L-R; Nurse Mwangi, Nurse Wachira &SSN Wamiru on
personal hygiene after toilet use for both the girls and boys

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CANCER in counselling and relevant information. It is
SURVIVORS 9TH run by the warriors with support from
ANNIVERSARY nursing team, dieticians and other medical
professionals.
By:  Glorias Wangechi - M&CS
Importance of joining the Support Group
The cancer support group is normally
celebrated in October. This year, we Feeling less lonely, isolated or judged
celebrated the 9th Anniversary. The event Gaining a sense of employment and
started at 2.00pm with many guest already at control
the venue. Opening remarks was done by Improving your coping skills and sense of
Champlain Rev. Dr. Obwaka. adjusting
Talking openly and honestly about your
The celebration was out of this world. There feelings      
was solemn moment of attributes and candle
lighting in memory of the fallen cancer Reducing stress, depressing, anxiety, or
warriors. Later a cake was cut to grace the fatigue      
occasion. Everyone was encouraged to join Developing a clearer understanding of
the support group. The Nairobi hospital what to expect with your situation
cancer support group provides holistic care Getting practical advice or information
about treatment options       
Comparing notes about resources, such
as doctors and alternative options.

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CHARITY HEART Brenda at St. Mary's ward post open heart surgery
FUND BENEFICIARY
L-R; Joseph Wabomba (brother), Brenda and Janetrix
By:  Peninah Kioko - M&CS Wabomba (sister).
Brenda and ChN. Akaliche
2017 was a Challenging year for Brenda L-R; Sr. Mukanda, Brenda and Staff Nurse Ngundi
Nakhungu, a form one student at Friends
School Naitiri Girls in Bungoma.  At age 14,
she started experiencing shortness of breath,
excessive sweating and could not engage in
school activities as she was getting too tired
and could hardly walk.

By June same year, she started experiencing
sharp pains on the left side of her chest and
could not sleep at night. She was on and off
different hospitals and was diagnosed with a
heart condition at Moi Referral Hospital
Eldoret. In July, she was referred to Kenyatta
Hospital for further treatment and diagnosis
because of the nature of her condition.

The parents, Patrick Siundu Wabomba and
Electa Wachilonga from Namutokholo
village, Kabuyefwe Location being peasant
farmers could not afford the treatment.
 
Dr. Gachara referred them to the Nairobi
Hospital to seek financial assistance. Her
request was received by the hospital social
worker Roselyne Odiembo who
recommended her as a candidate for the
Charity Golf kitty. The surgery was
successfully done in October 6th 2019, and
she was discharged on 14th October 2019.

We wish Brenda quick recovery.

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SOUTHFIELD MALL OUTPATIENT
CENTRE TURNS 1

In pictures

A cake to signify Southfield OPC 1st anniversary Attendees join in praise and worship during the ceremony.

Attendees listen to the speeches during the ceremony R-L; Catherine Makau (Unit Manager Southfield OPC),
DOS Carolyne Mulanda and part of the attendees lead the
cake cutting ceremony

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THE NAIROBI HOSPITAL STARS

AUDIT STARS, QUARTER 3 2019 L - R; Faith Rotich & Jane Mutuku from Diatetics receiving
their appreciation gift from DOS Carolyne Mulanda
By: DNS Benta Omonge 

The just concluded Q3 Clinical Audits saw
some record breaking achievements of 96%
from the team from Galleria OPC
represented here by Manager Polly
Mubangi, followed by Capital Centre with
90%. Seen in the picture is Manager  Maggy
Muoki. Jane Mutuku and Faith Rotich
represented the Nutrition department and
scored a record 94% and finally, the most
improved department with an outstanding
improvement score of 30% went to the team
on Maia Carberry Floor. DOS Carolyne
Mulanda graciously  presided over this
joyous occasion which took place at the
Anderson Medical Centre on the 22nd.
October 2019.

Maggy Muoki (Unit Manager Capital OPC) receiving an
appreciation from DOS Carolyne Mulanda

Polly Mubangi (Unit Manager Capital OPC) receiving L-R; ADNS Ayodi, ChN Miano and DOS Carolyne
an appreciation from DOS Carolyne Mulanda Mulanda

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THE NAIROBI HOSPITAL STARS

In pictures

Renal Unit team appreciated by a happy client

St. Francis team appreciated by a happy client Oncology team appreciated by a happy client

Nancy (Oncology) receives flowers as a sign of appreciation for her
assistance during the patient's journey

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POSITIVE FEEDBACK

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September 2019 trivia question October 2019 trivia question

Which 2 organs can be donated from a What's your fondest Christmas memory as
living donor? a child?
    
Share your answer with
Kidney [email protected]
Liver The 3 most captivating responses will be
awarded
September 2019 trivia question Good luck!
winner

Irene Muchina
Finance Department