REPORT ON AN INDUSTRIAL FIELD TRIP TO NYANZA AND

WESTERN REGIONS OF KENYA FROM 6

TH
TO 9
TH
OF
OCTOBER 2014
BY GITONGA MELAVIN MUTHAMAKI Q126/3261/2012
A FIELD ATTACHMENT REPORT SUBMITTED TO
KENYATTA UNIVERSITY SCHOOL OF PUBLIC HEALTH IN
PARTIAL FULFILLMENT OF THE AWARD OF A
BACHELORS DEGREE SCIENCE IN POPULATION HEALTH
September 2014



















ACKNOWLEDGEMENT

Sincere thanks goes to Kenyatta University, School of Public Health for organizing this
educative trip. I would also like to thank our lecturers: Mrs. Redempta and Mr. Peter who
accompanied us during this trip. Special thanks goes to Mr. George who guided us round at
KIWASCO, Mr. George who guided who gave us a tour of Spectre International Ltd. and Mr.
Tom Okal who gave us a warm welcome at CIPCDR Alupe. I would also like to thank God who
was with us throughout this trip.
ABSTRACT

This report outlines skills and experiences learnt during the field trip.

INTRODUCTION
The industrial trip lasted three and a half days during which time we visited KIWASCO (Kisumu
Water and Sewerage Company Limited), The Centre for Infectious and Parasitic Diseases
Control Research (CIPDCR) in ALUPE and Spectre International Ltd. During the trip we learnt
how various aspects of the industries and environment co-relate and interact with public health.
KIWASCO (Kisumu Water and Sewerage Company Limited)
Brief history
KIWASCO is found in Kisumu city and is the major supplier of water to the city. Kisumu Water
and Sewerage Company (KIWASCO) was founded in 2001 and registered under CAP 46 of the
Laws of Kenya as a subsidiary company of the Municipal Council of Kisumu. The Company
began operations on 1st July 2003. KIWASCO was established through the reforms that took
place in the water sector nationally and based on the decision to privatize essential services. The
Company was established through the transformation of what used to be the water and sewerage
department of the Municipal Council of Kisumu. The core objective of KIWASCO is to make
the water and sewerage services provision a commercial activity that generates sufficient revenue
to sustain operations. the water treatment plant first became operational in 1954. It was
subsequently expanded in the years 1970, 1984 and more recently in 2011 to meet the needs of
the ever growing population of Kisumu.
Mission
To improve the quality of life
Vision
"To be the most admired services provider"
Values
Integrity: We strive to be honest, fair, and ethical in our dealings.
Customer Intimacy: We respect and respond courteously to our customers.
Professionalism: We adhere to strict professional standards in our duties.
Innovation: We seek to improve the customer's experience and excel in service delivery.
Work hard and have fun: We are passionate about our work, and enjoy serving the community.

WATER TREATMENT
Water purification is the removal of contaminants from untreated water to produce drinking
water that is pure enough for the most critical of its intended uses, usually for human
consumption. The water should be pure and also win the consumers confidence. Water
treatment at KIWASCO involved:-
Pre-chlorination - for algae control and arresting any biological growth
Aeration - along with pre-chlorination for removal of dissolved iron and manganese
Coagulation - for flocculation
Coagulant aids, also known as polyelectrolytes - to improve coagulation and for thicker
floc formation
Sedimentation - for solids separation, that is, removal of suspended solids trapped in the
floc
Filtration - removing particles from water

Sewage Treatment
Sewage treatment is the process that removes the majority of the contaminants from wastewater
or sewage and produces both a liquid effluent suitable for disposal to the natural
environment and sludge. Sewage treatment is carried out in three steps:-
Primary treatment
Sewage flows through large tanks called primary sedimentation tanks. The tanks are used to
settle sludge while grease and oils rise to the surface and are skimmed off. Primary settling tanks
are usually equipped with mechanically driven scrapers that continually drive the collected
sludge towards a hopper in the base of the tank where it is pumped to sludge treatment facilities.
Grease and oil from the floating material can sometimes be recovered for saponification.
Secondary treatment
Secondary treatment is designed to degrade the biological content of the sewage which ais
derived from human waste, food waste, soaps and detergent. Here there is the use of aerobic
biological processes. To be effective, the biological treatment requires both oxygen and food to
live. The bacteria and protozoa consume biodegradable soluble organic contaminants e.g. sugars,
fats, organic short-chain carbon molecules. Secondary treatment systems were well arranged
systematically.
Tertiary treatment
Tertiary treatment provides a final stage to further improve the effluent quality before water is
discharged to Lake Victoria. More than one tertiary treatment process is used at the treatment
plant. Disinfection is practiced mostly as the final process. It is also called "effluent polishing."


The Centre for Infectious and Parasitic Diseases Control Research (CIPDCR), ALUPE.
The Centre for Infectious and Parasitic Diseases Control Research (CIPDCR) is one of the 12
centers of the Kenya Medical Research Institute (KEMRI). CIPDCR is located 8km north of
Busia town along the Busia-Malaba road in western Kenya. It is right on the Uganda border with
Kenya in Alupe near River Okame.
It was established in 1947 as the Alupe leprosarium hospital when the government of Kenya set
up a hospital for this purpose in Alupe. The mandates of the Alupe leprosarium included:
a.) Management of leprosy as a referral centre for this disease in East Africa
b.) Research on leprosy and other skin diseases
In 2000, the centre's name changed to Centre for Infectious and Parasitic Diseases Control
Research (CIPDCR). Its mandate was expanded to include:
a.) HIV/AIDS, STD'S research
b.) Tuberculosis research
c.) Leprosy research
d.) Emerging and Remerging Diseases research
e.) Malaria research
f.) Geo-helminthes research
g.) Fungal infections research

The centre runs an outpatient clinic through which daily clinical services are offered using
evidence-based prevention and treatment.
Major Achievements of Alupe
1. The prevalence of Leprosy has gone down to near complete elimination stage at
0.2-0.5/1000.
2. Single dose treatment of Fungal skin infection and Diseases-tinea capitis
3. Prevention of Mother to Child Transmission of HIV.
4. Offering counseling to HIV/AIDS patients.
5. Early Infant Diagnosis of HIV/AIDS making it possible to test exposed infants
and those infected to access ART treatment fast.
CIPDCR infrastructure

The centre has the core equipment required for diagnostic services. For research, the center has
assembled a turnkey laboratory for Early Infant Diagnosis of HIV. For immunology research,
CIPDCR has renovated laboratories and acquired the latest equipment for CD4 enumeration and
manual gating. For arbovirus work there is a serology and molecular laboratory.
CIPDCR has some ongoing research projects such as Surveillance of Cholera in Busia District
Hospital in western Kenya
The centre collaborates with major research & training institutions. As a centre of infectious and
parasitic disease control research it also acts as a national referral hospital for patients with
sleeping sickness in Kenya. It has 5 laboratories namely:
Trypanosomiasis laboratory
Microbiology lab
Parasitology lab
Biochemistry lab
Early infant diagnostic lab

Major Research implementations
HIV Research.
KEMRI in collaboration with other stakeholders and partners are working to identify the HIV-
infected children early, prior to the development of clinical disease, to ensure quick intervention
and treatment. The health interventions can be put in place through growth monitoring,
developmental monitoring, counseling and education on infant feeding, opportunistic infections
prophylaxis and determination of infection status. The Early Infant Diagnosis (EID) program
was born from the realization that children below 18 months may not benefit from HIV testing in
Kenya and yet they are at risk of getting the virus through their mothers. Although HIV positive
mothers can pass the HIV virus to their unborn children, it is not always a guarantee that they
will have infected children but they may have the HIV antibodies. Hence this test accurately tests
for the virus not the antibodies and thus more accurate for all children born from HIV positive
mothers in the whole country.
Arboviruses Research.
Emergence of arboviruses goes undetected most times by the fact that they show similar
symptoms with other Tropical fever. Novel diagnosis of this Life threatening infections is
important to save life. Currently a seroprevalence study of Dengue-2, Chikungunya, Yellow
Fever, Onyong nyong, West Nile Virus and Rift valley fever is being undertaken by various
scientists based in Alupe-CIPDCR.

GENERAL MICROBIOLOGY RESEARCH
Fungi infection is one of the research programs that is carried at the Centre for Infectious and
Parasitic Diseases Control Research (CIPDCR). Although the fungi infection is one of the
neglected diseases globally, it is very common in general population and the extent of the
increase in Africa is unclear. The manifestations can be very extensive and have unusual
morphologies. KEMRI in collaboration with eminent researchers from Nagasaki and Chiba
Universities in Japan are working the modalities of improving the existing system of conducting
basic, epidemiological and clinical research in fungi infection, with results feeding directly into
local and international health policies.



Spectre International Ltd.
Spectre International Ltd. commissioned its Ethanol distillery in 2005 this after an extensive
rehabilitation programme initiated in 2003. Our operations are based at Kisumu in Kenya, along
the shores of Lake Victoria approximately 10kms from Kisumu along the Kisumu-Busia
highway.
Vision
To be the manufacturer of choice of the highest quality extra neutral alcohols and spirits in
Africa
Spectre International Ltd. Is involved in manufacture of Extra Neutral Spirit, Neutral Spirits,
Industrial Methylated Spirits and Colored Methylated Spirits produced from sugar cane molasses
to be used in the beverage, pharmaceutical and personal care industries. In addition to the spirits,
they also produce CO2 gas, Dry Ice, Active Dry Yeast (ADY) and Wet yeast for baking and
other fermentation uses.
As part of giving back to the community Spectre International Ltd. has been involved in projects
such as Community Water Points, Community Sports Activities Program, and provision of
security for the local community among others.
Occupational hazard measures taken by Spectre International Limited
a.) There was a red pipe running along all the companies pipes for averting fires.
b.) Guard rails to prevent the truck and workers from falling over the edges
c.) Helmets to prevent head injuries from falls and collapsing objects
d.) Training of workers in measures that prevent injuries
e.) Safety signs to remind workers on precautions
f.) Fire extinguishers
g.) Occupation health safety officer who supervises the industry for risks and ensure the
workers are following the precautions
h.) During water treatment workers put on chemical respirators


CONCLUSION
The trip was a great learning experience. I was able to understand how population health is
applied in the industries.