Reduce Suffering in Kenya Via Health Care Services

 
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Pauline Treating A Patient
Pauline Treating A Patient

The day starts before the birds do, there is still mist outside, the grass is cold and wet with dew, it’s time to start packing and set off for the next community. All that is heard is the zipping up of tents and bags. A metal pot is nestled on a small gas stove, a hot cup of sweet tea is all that is needed to keep the “wolves away” in the early morning. Once finished, Nurse Pauline with Peter, CHAT’s driver, pile into the yellow land rover and make their way to their next community, this could be as close as 50km or as far as 150 km or more usually following off road tracks and trails.

It’s a long drive, the team is always relieved to arrive at the next community. The fun doesn’t stop yet! First in order is to find a good place to set up the simple clinic for the day. This can be from setting up the treatment tables under a big shady tree (shade-less depending on the weather) to finding empty classrooms or kiosks big enough to fit in everything including Pauline herself and a patient. They begin unpacking the medicine and set up the two rickety metal tables, Peter sets up the tent nearby for private services.

Not only is Peter CHAT’s driver, he is an excellent mobiliser. Pauline won’t be seeing him for a while, which is just fine as Susan, Community Own Resource Person (CORPs) had “backpacked” from her home community to mobilize here for a few days, she had come up with a number of people who needed our services; from family planning, HIV/AIDS counseling and testing (HCT), TB information to basic curatives. Susan works alongside CHAT with a performance based MOU after CHAT facilitated her training.

Evelyn came to Pauline with her 18 year old daughter, Mary. Mary got pregnant while she was in school. She has a child who is only three months old. Mary had an accident some time ago which has left her with a problem with her leg making it difficult  to do normal day to day tasks, her mother has to help her with her child and many other house hold duties daily.

Evelyn explained that she wants Mary to go back to school, the child will be cared for but they are both afraid Mary will not manage with another child on board. Nurse Pauline having listened, took the time to explain each FP method. After some time Mary decided that she wanted the 3 year implant; after receiving the implant she was excited about going back to school - she had a smile from ear to ear.

Evelyn asked Pauline for her mobile phone number so she could keep in touch with her, she hopes that Pauline will return to visit them. Mary was also given Susan’s, CHAT’s FPCORP’s number. Small displays of thanks and appreciation really make it worthwhile, even the day seems less hot! 

Tummies are rumbling, when is it lunch time? The team doesn’t stop for lunch, there are patients waiting to be treated. They will wait until the evening when they have time to prepare a meal.

Before night falls they set up camp for the night. Bags come out and the same zipping noise is heard. Peter shares with Pauline that they provided services to 78 impoverished people yesterday – 96% wanted family planning ecological awareness services – 55 chose the 3 year implant method of contraception method!

Another day well spent, thank you for all your kind donations that make these ventures possible!

Dear Donors.

 

Happy 2015 to all of you! Below are a few excerpts from our Director's year-end notes. We have received some good news, had some harrowing rock climbing accounts in the field, entered into some new territories, and will hopefully be sending the beloved camels out on a trek very soon! Please take a read below to get a taste of what life on the ground in Kenya has been like over the past few months:

 

ACCESS TO COMMODITIES:

We were given the most amazing surprise in November when, after months of trying to get at some longer term family planning (fp) commodities sitting in the government stores, the Kenyan government released approximately 15 million KSH worth (!!!) of the longer term fp implant method commodities to CHAT for us to distribute. This will be able to help 18,000 women to protect themselves for 3 years against unwanted pregnancies. This is great news in light of the below facts:

  • Studies have shown that Kenya has one of the highest unskilled abortion rate in the world!? And though we don’t know the rate for infanticide, from our experience we know this must be very high too!
  • Currently, approximately 225 million women in developing countries want to avoid pregnancies, but are not using modern contraceptives.
  • Poor maternal health and HIV/AIDS are the two most common causes of death for women of reproductive age- and a key factor is lack of use of appropriate contraception!!

 

ACCOUNTS FROM THE FIELD:

Recently, the CHAT team traversed breathtakingly beautiful scenery while providing fp services to underserved, poor communities in Nyandarua (central Kenya - a 1st time visit to this part of Kenya for CHAT).

We used our motor mobile and backpack strategies to reach these ‘forgotten’ communities who live on the steep slopes and valleys west of the Aberdare forests. Here, in the sheer heights of South Kinankob, CHAT’s backpacking nurse, Pauline, suffered severe ‘sense of humor failure’ whilst clambering, puffing & gasping her way up agonizing seemingly 90% incline slopes to reach her fp clients! With her was Volunteer, Jorien, from Holland, and she was also being assisted by enthusiastic howls of laughter and general glee from Peter pushing ‘Her Hardship’ from behind (Peter is CHAT’s intrepid jack of all trades’ (driver/mobiliser/clerk).

Meanwhile, Mrs. Pauline Lokipi strode ahead providing her door-to-door fp/ecological sensitization services to hundreds of clients who then patiently awaited our other Nurse Pauline, “Her Hardship,” to catch up and insert mostly the longer-term contraception to those clients that chose this method.

Rose, CHAT’s project officer, and I missed out on this ‘hilarious excursion’ (depending on, of course, whose points of view you listen to!!) as we motored beyond to meet villagers around Kieni Forest. Rose did what she does best talking and sharing much needed fp & ecological awareness information with men of all ages – enormous amounts of noise accompany these meetings with much hilarity and clapping from the audience- & Rose!

CHAT’s door to door fp mobilization will continue for another 2 months in Nyadarua, being provided by local family planning community own resource persons (FPCORPs) & local nurses whom CHAT & the Ministry of Health identified. We will have been able to afford to avail free implants to at least 2,800 women in this County by the end of February. Over 900 women have chosen the implant method as of mid December already.

Our backpack strategy also continues in the slums of Nanyuki, Maralal & Isiolo, the poor communities surrounding the flower farms on the slopes of Mt Kenya, in and around the Karissia Mountains in Samburu, and numerous mobile communities throughout Laikipia, Samburu, Isiolo & parts Meru and Nyeri.

 

DID YOU KNOW:

  • Kenya’s population growth still remains one of the highest in the world and, currently, approximately 45% of the population lives below the poverty line (US $1 per day). (I personally think this is a MUCH higher percentage - In some communities where CHAT provides services, up to +90% are living below the poverty line).
  • In the last 2 – 3 years, over 85% of CHAT fp clients chose the longer term contraception protection (3 – 5 yrs), often accompanied by husbands, sons, brothers and boy friends who escorted the women to the services.

 

CAMEL MOBILE PLANS:

We had plans to send a camel mobile out for a month starting mid November, to an area ‘forgotten and remote’- along the county boundaries of West Laikipia with Baringo County; peopled by traditional Pokot and Tugen cultures. But, we were asked by the community and government leaders to delay this, due to insecurity in the region (security forces moved in to search for carjackers). This is now scheduled to go out mid January for a month.

 

OTHER PLANS:

From January to March CHAT will be up in Laisamis District in northern Kenya providing integrated health services targeting poor communities and the trucking route which is delivering to the construction of what, in 3 years time, will be the worlds largest wind farm – above the shores of southeast Lake Turkana.

 

We look forward to keeping you abreast of the goings on over the next few months. In the meantime, a very happy and healthy start to 2015 to all of you, from all of us, at CHAT.

 

Asante Sana!

 

CHAT

Wheels that won
Wheels that won't quit.

Dear Donors,

Jambo from Nanyuki- the CHAT headquarters in Kenya. Life has been ticking along, and the wheels of the yellow mobile clinic continue to roll along the plains of Laikipia and Samburu, stopping to set up clinic under the shade of an acacia tree each day. Please see the attached chart, summarizing targets reached over the last three months, made possible by the support of Global Giving donors and other contributors.

Though funds have been steady enough to send out our 4X4 mobile clinic, our camel clinic has been unable to make its month long journey for the last 6 months. Costs associated with sending out the camels and crew are higher than those associated with the 4x4 vehicle. Because of this, we are endeavoring to offer more creative funding options. A company sponsorship is a wonderful and exciting opportunity to give back and involve your business and team in an exciting and unforgettable adventure, and maybe even send one or two representatives on an exciting trip of a lifetime, to document the journey.

We thank you for your continued support and will be in touch again in a few months time.

Asante Sana.

The team at CHAT.

 

 

 

 

 

Rita (an Alias) of Northern Kenya
Rita (an Alias) of Northern Kenya

"Access to family planning could reduce maternal deaths by 25 to 40 percent and child deaths by as much as 20 percent." World Bank, 2009

Rita (an Alias) of Nothern Kenya

For public platforms use Rita (an Alias) of Northern Kenya

Rita is only 14 years old. She came to our clinic late at night to get the 5-year contraception implant inserted into her arm. Not surprisingly, Rita's mother brought her to our clinic in secret.  Neither wanted Rita's father to know that she was getting birth control. While with us, Rita shared that she wanted the implant because in the last six months she has had two abortions. Both abortions were conducted in the bush, in secret, by an unlicensed/untrained community member. She did not want to talk about the process that she endured, only to say that it was "horrible" and that she didn’t want to do it again.  She viewed CHAT's mobile health clinic as her only hope to avoid another pregnancy.

By way of background, Rita is sexually active with one boyfriend. Unfortunatley, it is still part of the Samburu tradition that if a young warrior gives a girl red beads, he is considered her "boyfriend, and as such, entitled to engage in sexual relations with her whenever he pleases. This sexual activity is conducted with the parents’ consent. However, it is very common for the warriors to have more than one "girlfriend".  What is difficult for Rita is that in the Samburu culture, it is considered taboo for a warrior to marry his "girlfriend."  Tradition will only allow her warrior boyfriend to use her sexually until he is ready to marry.  Once ready, the warrior will then go in search for a woman suitable to be his wife.  

Needless to say, this cultural phenomenon poses a huge problem for young Samburu girls.  Through exposure to unsafe sex with men who have many sexual partners, girls like Rita are forced to put themselves at risk of contracting devastating sexually transmitted infections/diseases--up to and including HIV/AIDS.  But perhaps even more worryingly, if a girl in this tradition accidentally gets pregnant, and has a child out of wedlock, she will not be able to marry at all in her lifetime.  Sadly, this cultural reality results  in a very high rate of abortions in young Samburu girls--most of whom are carried out in secret and performed under brutal conditions by an unlicensed/untrained community member.

Your generous donation can help reduce these unwanted pregnancies by providing much needed Family Planning options to many more women in Kenya!  Please donate today to help these women make a better life for themselves! 

Samburu Women and Children Ceremonial Dance
Samburu Women and Children Ceremonial Dance

Dear Donors,

We hope everyone’s 2014 is getting off to a healthy, and productive start. New years are often filled with a sense of possibility, as dreams or aspirations seem to take on a more tangible form.  Our aspirations of providing accessible and affordable care to the indigenous tribes of Kenya remain, continuing to grow with the demand each year. And in our pursuit, it is always important to be thankful and recognize our partners who help to keep us going.

At the end of January, Impatient Optimists, part of the Bill and Melinda Gates Foundation, posted an article on family planning and maternal health- how interconnected the two are and thus the importance of their integration.  Though the focus group of the article is perhaps not the typical CHAT audience, who are of a lower socio-economic status than those the article relates to, the lessons learned from in depth data analyses that were preformed, are similar lessons CHAT has learned along the way.

One ‘lesson’ that came to mind when writing this report, is the absolute importance of consistency in care delivery, availability, and affordability of contraceptives. What is the best to achieve these two necessities? As the article concludes, it is through private and public partnerships that the needs are most effectively met. 

For the past 10 years, CHAT and the Kenyan Ministry of Health have been partners in the goals of contraceptive availability, affordability and education. Together, we have been doing our best to ensure that the communities get what they need. But when the government falls short, and it certainly does at times, it is the private donors, such as you all who are reading this, who afford us the ability to keep our promise to these communities.

So, as we begin another year with you as one of our valued partners, we wanted to say a quick and simple, thank you. Your generosity helps to create a healthier world more than you may realize.  

Let’s make 2014 a good one…!

  

Asante Sana,

 

The Team at CHAT

Links:

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CHAT Volunteers

Volunteers
Nanyuki, Kenya

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Map of Reduce Suffering in Kenya Via Health Care Services