Patients in a queue waiting to be seen by the doctor at Likii Dispensary

They prepared this report for our board to assist them in overseeing project activities and draw attention to some of the challenges facing healthcare professionals in the area.

Please download the PDF file below:

PEDPACT_REPORT_APR_2011_red

(Patients names have been removed form this document to protect their privacy)

An innovative foot pump for watering the vegetable garden

The second thing that caught our eye was a small group of boys peddling on some kind of pump and watering the small green shoots of kale struggling in the hot sun. This pump is one purchased by Kijani using funding from Collier Trust.

Kijani’s volunteer Barney Muckle, a retired agricultural engineer, discovered this little known device in his work and, after assessing the situation at the school, surmised that it would be perfect.

An earth dam lined with heavy duty plastic

The new guttering on the roofs of the school classrooms provided more water than could be stored in the two storage tanks. Barney then had the idea of digging a small dam on the lower end of a ever-so-slight slope on the grounds and lining it with a heavy duty plastic.

This ‘dam’ could now store gallons upon gallons of water. While the rest of the area dried up and all neighbouring crops died, the school had plenty of water.

The trick is to get the water from the dam to the crops. Hence the pump – the foot pump easily generated enough of a water flow to allow the children to water their cabbages and kale. This cabbage and kale was for some children their only source of vitamins and minerals during this drought.

Hell's Gate irrigation channel

Hell’s Gate had an ongoing water problem. The park gets water from the local water body, but the service was unreliable and becoming more and more expensive. Also, in that area, there is no natural water beyond Lake Naivasha and the soil is too permeable to make good dams, even in times of sufficient rains. Without a steady supply of water to keep the animals within the park they wander (as the park is unfenced and backs onto a huge ranch) into cultivated areas where they are often killed or are ‘harvested’ for the illegal ‘bush meat’ trade. Thus having accessible water for the grazing animals in the park increases the number of animals safe from harm from humans and decreases human/animal conflicts.

The twin rock spires of Hell's Gate

After the first performance, Hell’s Gate’s Management Committee used the money they received from Kijani to purchase a new water bowser, which they named Carmen (after the opera), and a second-hand tractor to pull ‘Carmen’. Using money raised from the operas Don Giovanni and Porgy and Bess, the Park installed piping for a water system. A neighbouring flower farm has generously allowed the park to access water from their borehole. Today, Hell’s Gate has a reliable source of free water to fill up the watering holes frequented by grazing wildlife in the area.

The Winyitie Widow’s group is self-managing, but has the ongoing support of Fidelis, a volunteer Social Worker. With Fidelis’ guidance, and funding from Kijani and the Collier Trust, the group is now a model of how simple income generating activities can help a group pay for health care costs and food. The group has several successful projects where they make needed products like soap making or charcoal briquette, or grow tree seedlings and sell them at a small profit. “The group is very good about saving the money so they always have enough to pay for medicine and transport to the doctors if one of the children is sick with an opportunistic infection such as T.B., lymphadenopathy, scabies, or oral thrush,” says Fidelis. She beams with pride when she tells of Sharon, an orphan with HIV who was very sick, but today “this 4½ yr old is now healthy, can easily play and squat with ease.”

Regretfully, the income generating projects don’t provide enough income to pay for the school fees for the orphans old enough to attend secondary school. “Times are hard in that there’s no food in the farms and manual work in the farms is also not readily available due to drought. The little the members get goes into feeding the orphans.” Kijani Kenya Trust, with funding from Collier Trust, pays the school fees for 13 secondary school orphans, one of whom received straight ‘A’s.

Cecilia

Cecilia’s grandmother brought her to one of the outreach clinics held by Community Health Africa, a medical charity that provides basic health care and family planning services to communities in hard-to-reach areas of Laikipia District. At this particular clinic, Kijani and Gertrude’s were present to support the services of Community Health Africa and to conduct research and a needs assessment for PEDPACT.

The doctors from Gertrude’s, at first glance, didn’t think Cecilia was going to live much longer. Her grandmother didn’t know her age, but guessed she was about 8 years old. Cecilia looked more like a four year old – she was tiny. She was incredibly weak, frail; her only movement and sign of life was her violent coughs.

Cecilia was diagnosed with HIV at the age of two. Her mother had recently died of the virus and was now cared for by her grandmother, who is very elderly and unable to provide Ceciia the care she needed. The doctors gave Cecilia a broad spectrum anti-biotic and nutritional supplements then set to work finding her a place in a suitable children’s home – if she survived the night, she’d have to be moved to a home with specialist care.

Two weeks later, Cecilia was taken to Grace Children’s Home in Nairobi which specialises in caring for children living with HIV. The doctors at Gertrude’s were amazed at her improvement – while still very sick, it was obvious that Cecilia is a fighter, and should do well with more love and support.

Cecilia was diagnosed with TB (very common among children who are HIV+) and was given the appropriate medication. Within a few weeks, she was stronger. And within a few months, a stranger to Cecilia would never guess she was HIV positive… she runs, plays and laughs with the other children and has a gorgeous sparkle in her eyes. Cecilia, thanks to the interventions of Community Health Africa, Gertrude’s Children’s Hospital, Grace Children’s Home and Kijani, should have a long and joyous life.

Laikipia East District, with sedentary farming communities and semi-nomadic pastoralists, has both arid and semi-arid zones – the terrain within the district is difficult with poor road networks that are a challenge even during dry weather conditions. As such, communities within the district are isolated and amongst the poorest in Kenya. The poverty level is estimated at 57 percent, compared to the national average of 46 percent.

Identifying adults and children with HIV in Laikipia East is difficult as there still remains a strong stigma towards those living with HIV, resulting in low rates of volunteer testing. Kijani aims to reach the children of these communities through partnering with the District Hospital and local stakeholders plus Kenya’s best and most experienced Children’s hospital –Gertrudes.

Together Kijani and Gertrude’s have created the PEDPACT project which will utilise funds raised by Kijani and the paediatric clinical expertise of Gertrude’s in order to bring expert care and treatment to children living in hard to reach areas of the district.

Fund raising for PEDPACT commenced in the UK following a visit to Kenya by Professor Bullock . First a lunch was held where over £7500 was raised to initiate the outreach clinics from Gertrude’s. Since that time, another lunch and a cricket match have swelled the total raised to over £15,000. Monthly donations are also proving a valuable source of income. (Previous activities, two charity lunches October 2007 and 2008 and a cricket match on June 17th 2009).

The project involves:

• A doctor and paediatrician from Gertrude’s to offer clinics in rural, hard to reach community health facilities in conjunction with the Ministry of Health. Their clinical expertise will supplement the care offered by the District nurses and community health workers in the clinics.
• Developing the Comprehensive Care Centre (CCC) at District Hospital and Cottage Hospital in Nanyuki by developing the infrastructure (including the building of play areas for the children) and purchasing needed lab equipment, (such as a thermocycler).
• Training programmes, continual medical education workshops and a mentorship programme to develop the skills of the health staff based in District Hospital and Ministry of Health clinics and dispensaries.

Margaret knows each mother by name

The quickest way to get to the health clinic at Chumvi from Nanyuki is to cut through a huge private ranch. After the long dusty journey along the dirt track that goes through the middle of the ranch, the outreach team from Nanyuki Cottage Hospital is greeted by a nurse with a large smile on her face, Margaret. Margaret has boundless energy and has already rallied the mothers from the local Maasai community to come to the monthly mother and baby clinic. The mothers, wrapped in layers of colourful cloth and wearing beads around their necks, wrists and ankles, are relaxing in the shade of the acacia trees that surround the clinic. Each mother has a baby tied to her breast or bouncing on her knee.

Margaret mingles with the mothers, asking this one about her baby’s cough, and that one about her headaches. She knows each mother by name, she is also Maasai and lives next door to the clinic so she is available and on call every day and night. “The other night I was called to help deliver a baby who was breached, then I spent the entire next day with another family who’s baby was very sick.” But she didn’t look tired; instead, she was running around making sure everyone was seen by the visiting nurses from the hospital for family planning and immunisations. She also made sure those mothers or babies she suspected were infected were tested for HIV. Even though there is still some stigma against people living with HIV, it is obvious Margaret has the trust of the community – those mothers went for testing and counselling after Margaret’s assurances.

Collier Trust, via Kijani, supports this successful clinic. This clinic has become established enough to attract other partners (such as CARITAS) who use the facility and staff as a base for their support for home based care and awareness raising about HIV/AIDS. The level of awareness about HIV/AIDS is impressive when compared to other similar communities who do not have access to such health care programmes.

Kijani Festival “Carmen” was covered by CNN’s Inside Africa programme

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