Reduce Suffering in Kenya Via Health Care Services

CHATs motor mobile clinic visited Bokish community in Mukogondo, North Laikipia, Kenya to offer medical services, because the nearest facility is over 30 Kms away - up and through the  Mukogondo hilly forest, which has some of the worst driving terrain in Laikipia County - (one can only drive down the cliff with an off road car – a Land Rover or Land Cruiser - but not any other car). The indigenous forest harbors hunters and gatherers, with a few pastoralists that migrated from other areas. It is so dry at this time of the year; and overstocking compounded by over population and poverty is the cause of overwhelming degradation of the environment.

“During CHATs outreach visit to this desperate traditional, conservative community, the majority of the community visited the clinic to receive different health services -  and I being a Pastor and mobiliser, realized that it was my duty to ‘bring light’ to this marginalised community” CHATs CORP partner, Parare, narrates. It’s during a ‘Lemojong’- a Maa  traditional singing and dancing event held at night by the young beaded girls, that Parare  met Nabolo*- a beauteous beaded girl.

“I can see that you are a Pastor & health mobiliser. I have been listening to your ‘preachings’ but realized that the youth in this community have been brainwashed by tradition;  in fact you won’t believe that most of these young innocent-looking girls (barely 15 years old), have two or more boyfriends and have broken their virginity in the name of attending such events,” Parare recalls Nabolo’s comments. After an in-depth discussion between the two, Parare realized that these innocent young ladies just practiced what they traditionally knew; Nabolo could not give any risks associated with their actions – she was just doing what she learnt from her peers.

“I have noticed that the information about integrating Population, Health & Environment (PHE) as a component within the FP is not for my ears alone as most of us, including the community, must work together to organize a big meeting at the village square during one of the ‘Chekuti or Gumbaro skul’- a kind of schooling for beaded girls, morans (young warriors) & elderly, who have never attended elementary school,” Nabolo explained.

“CHAT management organized for the motor mobile clinic as an opportunity to provide choices to this vulnerable community choosing between ‘ill’ culture and, to my surprise on that particular day, the mobile clinic turned the whole event into celebrations aand many community members visited the clinic to receive fp health services instead of their usual classes,” Nabolo narrates.

“I noted that majority of these young girls and morans had STIs, with a few bold young beaded girls confirming that they have had several unsafe abortions traditional using herbs they prepare locally,” CHATs Nurse Ntinyari explains. “I wish I had met this team on time as at my age, I have already had an abortion as I was not sure of the moran responsible for my ordeal, but at least you have been here and I gained much from all of you, and I will ensure that the many generations yet to come will never undergo the same experience as mine. Three years implant is my ‘life saver’ now and will always work closely with you, Pastor,in spreading the news,” an amazed Nabolo laments. 

“I can attest that I being a Pastor and a CORP will not only provide health information, but also spiritual nourishment to this community as family planning goes hand in hand with religion as birth control is an important moral choice - motherhood is a choice not a requirement,” CORP & Pastor Parare then waved farewell to the community

With your support (cost shared) in the quarter under review, CHAT has in  been able to reach a total of 19,734 individuals with Family Planning encompassing ecological awareness information of which, a total of 71 ANC mothers were attended, 85 children immunised, 1,047 patients treated for different conditions and a total of 8,685 women chose and took different family planning methods.

“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]