This is the second post by Jessica Blankenship, Ph.D., Helen Keller International’s Regional Micronutrient Advisor, as she chronicles HKI’s ongoing work in Kenya.
In the US, access to basic health care is seldom a concern in our daily lives. While equity of health care is under debate, there is no disagreement that children in the US do not often die from diarrhea, measles, malaria and pneumonia. In sub-Saharan Africa, however, these diseases cause 50% of under five child deaths or 4.5 deaths every minute of every day.
I am traveling with the Kenya Red Cross to an outreach center they run in North Turkana. This area of Kenya is famous for its inaccessibility. It is a four-hour off road drive from Lodwar, the capital of Turkana, to the Health Center in Lokitaung. It takes another two hours over rough rocky terrain to reach the outreach center which is close to the South Sudan border. Communities in this region simply do not have access to health care. The nearest health center is 70km (43.4 miles) away and the local dispensary is empty, filled only when an outreach is conducted in the region.
The Red Cross started their outreach to this village just three weeks ago in a response to the drought which has caused the death of livestock, reduced ability of the community to purchase food, and increased the risk of disease due to poor sanitation. We arrive at the community center, a small cluster of three single room buildings, which form the dispensary, primary school, and community meeting room. There are already 150 young children waiting for their daily serving of CSB porridge, provided by the Red Cross and served every day in an effort to ensure that these vulnerable young children receive a nutritious daily meal to supplement their diets. Within a few minutes of our arrival, there are hundreds of men and women within the village center, holding the hands of young children and carrying babies strapped to their backs.
The Red Cross provides four major services during the outreach visits. In the center of the village, all pregnant women and children under five years will have their mid upper arm measured to determine if they have acute malnutrition. Those that do are ushered to the distribution site, where they are registered to receive a weekly ration of either CSB porridge and oil if they have moderate acute malnutrition or, if they have severe acute malnutrition, plumpy’nut, a highly nutritious dense peanut paste. From the distribution site, the children and women can join the line for the small clinic set up at the empty dispensary building where they will receive basic health services and can speak with a doctor about any health concerns. The most frequent complaints in this community are diarrhea, respiratory infection and eye infections. These complaints are mostly caused by poor hygiene and sanitation; in this village, like most of North Kenya, soap is uncommon and water is considered too precious to spend on washing.
In the empty one-room schoolhouse, a nurse provides basic antenatal care services (ANC) to pregnant women. Most women who come to the ANC are around 26 years of age but may be on their 7th or 8th pregnancy. Other than the current outreach, these women have no options for medical care when they are ready to give birth. With the closest medical center a five day walk away, almost all women give birth at home with the assistance of an untrained midwife. Complications, when they occur, are disastrous for both the mother and baby.
While the outreach provides necessary services, it is not a long term strategy for the surrounding communities. It is unrealistic to have a doctor or even a nurse in each community to provide these services; there is, however, a strong will in Kenya to train people within the community on very basic health services. These community health workers would be based in the same communities they live in and have access to basic drugs and materials to provide life-saving interventions in a timely manner. Walking through the village, past the long line snaking past the dispensary and the hundreds of children happily slurping their hot porridge in the sand, it isn’t difficult to imagine the positive impact access to health care would have for this community.