One Year Down the Line

May 21st, 2014    Analysis

Prepared by Dr. KÓuma Thomas

One year has passed since I joined HealthRight International Kenya. I had worked amongst refugees and the local populace, in remote and difficult places and even in very stable and predictable areas. After staying with HealthRight for one year, it is time to reflect on the triumphs, challenges and expectations for the future. I take this opportunity to take you through a 365 day cycle at HealthRight International.

In April 2013, we receive a visit from Katherine Jansen from Project C.U.R.E. Katherine is thorough and very punctual. We make a visit to two of the 9 project sites together. She engages facility staffs in the health centre to get the baseline assessment of delivery equipment. Nurses and Clinical officers in charge of the two facilities freely share with us the gaps they are having in Maternal and Newborn care. Some equipment are old, others are rusty. In some cold places like Kapyego, there are no newborn warmers. I think that Kangaroo Mother Care can help in such places but, this place is too cold! Katherine thanks the health staffs for their co-operation and participation and we return to Iten. Kerio Valley’s scenery is too enchanting from Iten. Katherine remarks that Kenya is such a beautiful country. I concur with her. We discuss the next day’s plan and I hand her over to Hellen M&E officer for HealthRight.

July 2013 beckons, I book an appointment with our site managers and members of Sobon Community based organization. We are to have an introductory meeting to ensure that all requirements are met before work begins. I board a vehicle together with Papa our driver and Leah our senior finance and administration manager. We go through a tortuous route. The landscape is superb. Green plantations of maize and Irish potatoes, a lash cover of tea and hills surrounded by sometimes friendly, sometimes threatening clouds. After one hour, we meet a lorry going to collect Irish potatoes from farms stuck in a muddy stretch of the road. The lorry covers most of the road and only human traffic and motorcycles can manoeuvre through. We look at our clocks and we realise that we are getting late.

We make a telephone call to Silas one of our site managers to inform him that we are stuck and are considering taking an alternative route. Before looking for an alternative route, Papa gets out of the vehicle, tries to help the truck driver by digging out some of the mud covering the truck’s path and putting murram on muddy sections to help the vehicle tyres have a grip on the murky terrain. The truck driver tries to manoeuvre his way out but, the road proves impassable.

Picture 1. A challenging road network but, work has to go on

We take a detour through the beautiful Lelan hills. After an additional hour, we reach Cheptongei Health Centre.  It is almost lunch time, but the overenthusiastic team of Sobon and HealthRight staffs prompt us to go ahead with our planned meeting. Silas and Abraham initiate the discussions. Leah takes the team through the administrative requirements and the organizational capacity assessment chart. Questions are asked and prompt answers given. Sobon members are happy, site managers satisfied and our team’s mission for that day accomplished. We touch base with the field team for a few minutes and then board the vehicle back to Kitale.

After a few weeks I make a visit to West Pokot and find very active Community Health Workers under the superb watch of MOH staffs, Hawa and Agwala. Hawa and Agwala prove to be very reliable staffs who require very minimal supervision. We make a short visit to Lelan and meet members of the CHW group working as links to Kabichbich Health Centre Maternal waiting home. I get a briefing on the Maternal waiting home. It was constructed by HealthRight International to make the delivery experience of pregnant women from remote places of West Pokot safe and non-life threatening. The MWH has clean beds, a television set to keep the mothers informed and very supportive nurses. Hawa, Agwala and I meet the CHWs and then chart a way forward on how to make the MWH sustain its support to pregnant women. HealthRight commits to support seed funds for an income generating activity. The group members select poultry keeping. Back to Kitale.

In January 2014, we receive our Africa Program director Jen. Jen is so much familiar with Kenya, she almost feels at home. She has an easier way of creating rapport with all staffs. We soon make a joint visit to West Pokot and Elgeyo Marakwet. We visit Psigirio Community Unit to follow up on their income generating activity. Hawa introduces us to the team. The 3 CHWs that we met are elated. After a 6 month wait, the hens have started laying eggs. A sign of good tidings and a great welcome for Jen. The CHWs show us some of the eggs and they estimate that they will be making a profit of Ksh. 9000 per month if all things go well. They share some of the challenges they are facing with us. Chicken feeds have become more expensive since the government started levying a 16% Value Added Tax (VAT) on them. We encourage them not to lose hope………..the hens have started laying the golden eggs!

Next, we meet Sub County Health Committee members in Cheptebo. HealthRight and Ministry of Health staffs introduce themselves. Kamau our Operations Research manager makes a presentation on the baseline survey findings. Questions are raised on some of the indicators and Kamau handles the session professionally. Indicators on respectful maternal care raise a lot of interest. There are some denials here and there about the existence of abuse but, we inform them that the baseline survey was carried out at the community level. What Kamau had presented was just how the community perceived the maternal and newborn services offered in health facilities. Those who claimed they had been slapped, shouted at or left alone when in labour just shared what they experienced. There is a general agreement that the baseline survey findings are key in helping Ministry of Health and HealthRight in improving quality of services offered to pregnant women and their newborn children in Marakwet east and west districts. Jen then touches base with the Sub County Health Management teams for both districts and a clear plan of action is developed for our future work.

One month later, medical supplies and equipment that Project C.U.R.E. had donated arrive. Anthony our logistician and I engage the County team to help us expedite the transportation from the port of Mombasa. Honourable Biwott , Dr. Osore and Dr. Shinga are very eager to receive the supplies and are of great help. The container of medical supplies finally arrives in Chebiemit  and the good news soon spreads like a wild bush fire.

Invitations are sent out to USAID our main donor, County government officials and local politicians and community members to come witness the distribution of equipments to health facilities. Dr. Marion Kurgat, Medical Director for Marakwet East, spearheads this event.  D-day finally arrives. The County governor’s convoy is soon met by a group singing songs promoting maternal and newborn health. The County Minister of Health and the Governor alight from their vehicle to join the jubilant group. The meeting begins, equipment formally handed over to PMNH+ health facilities and speeches are made. All are in agreement that the health of the mother, newborns and the community at large is of great importance. I look at my calendar……..one year is such a short time in HealthRight.

Picture 3. Elgeyo Marakwet County Governor and County Executive for Health receiving a rousing welcome from Community members, Ministry of Health and HealthRight staffs.