Nov 15, 2017

BREAKING THE HYKE

Fatuma providing sensitisation at Isiolo MCH
Fatuma providing sensitisation at Isiolo MCH

“Yei, I got it, I got it!!” sighed Halima* with joy at receiving a 3 years contraception protection method of family planning (FP), and having called Fatuma*- CHAT’s partner and a Family Planning Community Own Resource Person (FPCORP) to report on the good news.

“My husband has finally accepted and I have visited Eremeti dispensary for my implant” Said Halima with uncontrollable tears of joy.

Halima’s husband, Muhusin*, is a Madrisa teacher (one who teaches on Muslim doctrine), but with Fatuma’s household health education that includes a strong referral system, Muhusin had become an ‘enlightened’ man and allowed his wife to visit the Eremeti health facility to access family planning services.

This Muslim community has very rigid religious belief.  Women in this particular setting have very little or no say - their husbands making most of the decisions on their behalf.

It has been a challenging journey requiring enormous amounts sensitization sessions & patience breaking into these strong religious communities - but CHAT in collaboration with members of the community and the Kenya Government - ministry of health (MOH)  identified Fatuma, a wife to the Mullah ( senior religious leader in a Mosque) to facilitate the gentle penetration to these relatively deeply religious communities.

CHAT’s support to  Fatuma’s important work, has been well received - echoed by the Kenyan government, the MOH , where Muslim women’s accessibility to fp services have increased tremendously from approximately 5%  in 2014, to approximately 25% by October 2017.

Before Muslim women would not even walk to the health facility to seek for any health-related services without their husband’s consent -  let alone seek FP services - which is still a controversial issue within the Muslim faith.

However, Fatuma by using CHAT’s innovative a door to door mobilization method of sensitization using a back packing strategy, most of these stringent cultural and religious barriers are slowly fading, paving a way for women to freely walk to the health facilities and seek for health care services – and most with a major focus on seeking for  FP services!

This was pointed out during a field visit by CHAT’s Project officer to facilities around Isiolo Town - by the GoK Medical Officer who commented that - “This county is very much impressed by the work done by Fatuma, the FPCORP that you are supporting - her mobilizing, counseling and referring within this very stigmatized group (Muslim women) about FP services” said Dr. Kiluva, the Medical Superintended Officer.  “Were it not for the effort of Fatuma, the hospital would be reporting very poorly in these family planning/ Reproductive health key indicators,” he added.

“Fatuma’s contribution is highly felt in both Maternal Child Health and FP departments, where she is referring an average of 30 - 45 FP clients for long term contraception methods, and 15- 20  for short term contraception methods,  on a monthly bases respectfully,”  noted Miss Halake –  Isiolo County Gok MoH Nursing Officer  & Reproductive Health Coordinator.

In the quarter under review, thanks to your donations- that contributed to helping CHAT reach 19,141 individuals with family planning/ ecological awareness information out of which 6,638 clients were able to access different FP contraception methods of their choice & 1,228 patients treated for different conditions.

“Woman has always been the chief sufferer under this merciless machinery of the statutory law. Humbly she has borne the weight of man-made laws, surrendering to their tyranny even her right over her own body.... Against the State, against religion, against the silence of the medical profession, against the whole machinery of dead institutions of the past, the woman of today arises.... If she must break the law to establish her right to voluntary motherhood, then the law shall be broken. ~Margaret Sanger, "Shall We Break This Law?" in The Birth Control Review, February 1917  [Referring to the Comstock Act. —tε¡·g]

Halima (FP beneficiary), beating against all odds
Halima (FP beneficiary), beating against all odds
Aug 18, 2017

"CULTURE SHOCK" DAKTARI MONITORING CHAT

Dr. Oliver assisting CHAT with service provision
Dr. Oliver assisting CHAT with service provision

After 5 weeks I found myself sat in the beautiful surroundings of the charity’s base outside Nanyuki town, faced with the formidable challenge of compiling all my experiences and emotions into a semi-lucid dialogue. From London and having just graduated as a medical doctor I opted to volunteer with Communities Health Africa Trust (CHAT). One job was to monitor CHAT’s activities.

My first time to understand the extent of need in the undeserved communities that CHAT visits was in my first 14 days accompanying the motor mobile clinic team. We reached 7 communities dotted over great distances within Samburu County in northern Kenya.

On reaching a very dry remote community “Ol Donyo Nasipa”, I felt a palpable sense of satisfaction as we started unloading medicine to begin the day's work. Even before setting the tables, clients & patients had surrounded the whole team ready to receive services, with rogue children running around aimlessly, excited by the commotion. We worked the full extent of the daylight. FPCORPs mobilizing and educating communities about integrated Family Planning (FP) with ecological awareness, the driver assisting in weighing children with a comedic scale device that wouldn't look out of place in a British fish market, the nurse immunizing children both small and large & the clinical officer providing basic treatment to patients as well as working together with the nurse in provision of FP contraception methods.

It was with this kind-hearted and truly unflappable nurse that the most obvious need for CHAT was found, as she spent the entirety of her day literally encircled by mothers who were awaiting impatiently for their child's turn; adding a soundtrack to the scene was a chorus of betrayed children screaming their disapproval at the countless needles the nurse was working her way through - surprisingly there were some as old as 4 years who had not yet received any vaccinations, a grave-risk to their young lives.

Meanwhile the FPCORPs, using Samburu’s local dialect provided information about FP contraception methods to families that had even up to 12 children. For those ready to receive free FP contraception methods of their choice were provided there and then.

For many, these services are normally 2 days walk or an unaffordable motorbike ride away, conditions I can imagine you would not welcome when sick. This of course is only the journey there, next is the question of where they can stay if not an inpatient,  and how will they afford the small costs of interventions and consultation as well as who will look after any children or cattle which they care for, in their absence. Barriers such as these are toppled with the hard work of CHAT and as I sat on a bumpy ride back to our camp I felt I had a good appreciation of just how vital this charity is.

I realized that CHAT uses the Population Health & Environment (PHE) approach and since family planning is a strategy of balancing population growth with economic development for sustainable use of natural resources, the PHE approach leads to an increased FP access and reproductive health services in the underserved & remote communities, as it integrates the environment into reproductive health and FP programs -prompting not only greater participation of women and adolescent girls, but also encourage men and adolescent boys to get involved, hence leading to a more effective and sustainable solution to the population and environmental issues.

”Population growth is straining the earth’s resources to the breaking point and educating girls is the single most important factor in stabilizing that, plus helping women gain political and economic power and safeguarding their reproductive rights” Al Gore.

CHAT reached 15,938 individuals with fp/ecological awareness information, of which a total of 1,609 patients were treated for different conditions; 7,448 women chose different FP contraception methods in 10 counties where CHAT operates in the last 6 months.

CHAT is simply an amazing inspirational charity created by Kenyans for Kenyans.”

Dr. Oliver practising what he likes best
Dr. Oliver practising what he likes best
Aug 18, 2017

TURNING POINT

Gatwiri receiving services via door to door nurse
Gatwiri receiving services via door to door nurse

At the foot of Mt Kenya, Gatwiri,* is a 14 year old girl living in a Nanyuki town slum called Likii, since 2012

“I came to work for my aunt as a maid, earning a meager salary of Kes 1000/- a month (USD $ 10). It was rigorous and back-breaking work.

When my aunt approached me to accompany her to Nanyuki, I naively imagined that life would be rosy; but was soon puzzled as to why my ‘dear auntie’ began treating me the way she did after I complained to her about the enormous workload. My aunt, annoyed, then beat me unconscious, locking me in a room for two days without food/water.

I managed to run away to a friend who ‘worked’ in Nanyuki’s 'red light’ street.

Another chapter opened - I am now a prostitute!” Gatwiri smiled to an astonished CHAT nurse.

Gatwiri’s friend introduced her to a new life of “money without sweat”’ as she put it - a life where she makes money effortlessly, sometimes as much, or even more than what she was earning per month - in just one night!

“What with the big spending foreign soldiers and our own army soldiers, who number in thousands - and not forgetting that Nanyuki is a popular tourist destination - all good for ‘businesses! And provides me with a much needed refuge away from that cruel harridan of an aunt!”

“I have perfected the art of prostitution. Sex work’ is my permanent source of income - affording my own rent in the neighboring Majengo slum.

I was a timid innocent girl, but currently I am now a hardened night lady who not only will sell sex, but also indulge in drug abuse - and I have also terminated several pregnancies,” Gatwiri comments.

“This way of life brings with it challenges such as being used without payment for my services by ‘macho men’ - being raped and dumped, often mostly late at night; being assaulted, or arrested for loitering by security personnel whose main motive is often to extort money from me, or give them free sex – sometimes in gangs!  Nonetheless, there seems to be no turning back as much as I want to. I don’t have another way of making money – and anyway, I feel like society would not accept me back to allow me to lead a normal life,” she says.

“I can attest that Gatwiri detests being what she is today. She never dreamed she would end up like this – selling sex;  but she does manage to feed, clothe herself and pay for her one shack ” CHAT's mobiliser, Rosie, confirms.

“I learnt about CHAT services from a friend” says Gatwiri, “Out of curiosity, I visited Rosie, when she counseled me about the different FP options I realized a sense of freedom!

Rosie discussed risk factors associated with my lifestyle – STIs and HIV/AIDS. I thank God that I had not contracted HIV /AIDS (as far as I know) which my peers and I in this business regard so casually - that AIDS is “just another accident” but is actually serious concern causing fear and dread,” Gatwiri laments.

And hey, this might surprise you but I am getting married and will invite CHAT team for my wedding - I feel I am  here today because  they opened my eyes so much -I really appreciate the knowledge and sensitivity they shared with me,” Gatwiri smiles as she leaves the clinic.

CHAT reached 15,938 individuals with fp/ecological awareness information, of which a total of 1,609 patients were treated for different conditions; 7,448 women chose different FP contraception methods in 10 counties where CHAT operates in the last three(3) months.

Did you know Kenya has the highest unskilled abortion rate (46%) worldwide.

 
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