Kenya: Lwala Healthcare Project

Construction of the main hospital connecting wing is nearing completion

Clinical services will begin shifting to this wing at the end of July. The existing hospital renovation will take place during August and September, at the same time the new staff housing moves toward completion. An official opening and ribbon-cutting ceremony is scheduled to take place on November 2. Because of a slight delay in project activities, LCA’s Operations Team and LCA management are actively working with the contractor to move the progress forward in order to catch up to the original timeline. Major achievements in the reporting period include the following:

• The interior and exterior walls were plastered and painted, floors were tiled, fixtures and furniture were installed, and electricity was wired throughout the building.
• Construction of the walls for the staff housing has been completed, and the land around the buildings was leveled.
• An equipment vendor was competitively selected, and an initial equipment order was placed in June. Additional equipment will be ordered in July and August.

Defaulter Tracing at Lwala Community Alliance

Assessing patient data collected over recent years, LCA clinical staff noted a steady increase in defaulter rates during the rainy season. Inclement weather and poor road quality during this period made it exceedingly difficult for beneficiaries to attend their scheduled clinical appointments and treatments. As a result, many clients were not accessing the medical, psychosocial, and nutritional services provided by LCA, and poor adherence to medication during this time contributed to most treatment failures recorded.

In an effort to reverse this trend, this season the LCA defaulter tracing team and entire patient support center (PSC) devised a long-term method of dealing with the problem at the local level. To encourage treatment adherence, the team shifted their approach, instead deciding to meet clients at their own homes for home assessment, psychosocial support, adherence counseling, and medical and nutritional services. Despite challenges including harsh weather and poor roads, the PSC staff remained flexible and determined to serve their clients in the most effective way possible. Even simple solutions like rain boots and rain jackets helped in ensuring the staff can get where they need to go.

Ultimately, this initiative has been an integral part in lowering defaulter rates among LCA beneficiaries. Through their own persistence and neighborliness, the PSC staff has conveyed to their clients the importance of good drug adherence and attendance at the clinic as scheduled. These changes in patient care have led to improved outcomes and have helped maintain standards of health during the rainy season in Lwala. The Njura Women’s Support Group is a group of 40 widows living with HIV/AIDS in North Kamagambo who meet every Friday afternoon. The group was started in 2013 by a few widows who felt neglected, abandoned, separated, and stigmatized by the community because of their HIV status. The widows were seeking medication from different health facilities in order to avoid being known as HIV+.

Emily

Emily is 22 years old and a member of the Salama Pamoja mentoring program. She lives with her husband, who is both a peasant farmer and a community health worker in the village of Kadianga. She also has two young children, ages 5 and 2.

Emily’s father died when she was very young, forcing her single mother to raise all six sons and eight daughters by herself. Growing up in a family of 14 children, Emily is no stranger to poverty and the burden it has on people. In fact, she is the only member in her family to finish high school. In the face of such difficulty, she still managed to get a passing grade while holding several odd jobs to pay off her school fees. However, despite finishing high school, she could not continue her education since she had no sustainable financial support. As a result, Emily married at the young age of 17.

Earlier this year, Emily joined Salama Pamoja’s out-of-school girls mentoring program. With the guidance of trained mentors, she learned about family planning and the importance of child spacing. After learning about maternal and child health, Emily decided to have only three children, whom she can properly care for and nurture. She also learned how to be a better parent. Like many other mothers in Kenya, Emily would often leave her 5-year-old child to watch the younger sibling while she attended to housework. However, since the program, she has learned the importance of proper parenting and supervision.

Through the support of her mentors, Emily has also grown in confidence and self-esteem. She learned to voice her thoughts more effectively to her family. Before, she was too timid to speak to her husband, but now she is able to sit down with her husband to discuss different issues including family planning. She and her husband are communicating more effectively and making decisions together, strengthening their relationship.

With newfound self-esteem, Emily made a decision in April to further her education by going to college to study early child development (ECD). In college, she found a new dream of becoming an educator and is now working part-time as an ECD teacher at Kadianga Primary School to earn money to continue to pay for college. She also wants to learn how to make soap so she can continue to finance her own education and have financial stability. Emily found her independence as a woman as she strives to better her and her family’s future. Through Salama Pamoja, Emily has learned not only to respect herself but also gained the respect of her family and her community.