Community Health Workers drive sanitation changes amongst the Maasai

This post was written by Chris McKeon, Writer and Production Assistant at Arete Stories.

The Maasai of Laikipia region in northern Kenya face a number of health issues. With a history of nomadism they had never felt the need for toilets as the bush always sufficed. However, with the decline in size of the territory along with the erection of more permanent structures, safe disposal of fecal matter has arisen as a major concern.

Preventable diseases such as diarrhoea are widespread, and pose a significant threat to the health of the Maasai – especially that of infants and children under the age of five.

The problem stems from a lack of basic hygiene. “The Maasai aren’t used to using pit latrines,” says Daniel Kipishe, a Community Health Worker in the Morupusi area. “They just go in the bush.”

A traditional Maasai home in Morupusi Group Ranch of Laikipia County, Kenya. Image: Matthew Willman / AOA

A traditional Maasai home in Morupusi Group Ranch of Laikipia County, Kenya.
Image: Matthew Willman / AOA

Each year, around the world, more than 1.5 million people die from water, sanitation and hygiene-related diseases, according to WHO. Millions more suffer from preventable diseases such as diarrhoea and intestinal worms.

For the Maasai, the lack of adequate sanitation may be hindering progress in other areas of community development, including maternal and child health.

Simple health advice is the solution to stopping the spread of disease. Anglican Overseas Aid (AOA), along with the Mothers’ Union of the Anglican Church of Kenya, has trained 25 Community Health Workers in Morupusi to help overcome this problem. Their role is to provide basic health advice in the villages and report on the area’s health needs to the Kenyan Government. Although the health workers were selected from the population, initially the Maasai were wary of engaging with them.

“People did not understand us when we started,” explains Samwell Mugo, another Morupusi health worker. “They thought we were a nuisance, asking all these questions, and they thought we would use the answers to benefit ourselves.”

But recently people have begun trusting the health workers because they find their advice useful. “People respect us more, and are more interested in what we have to say,” says Daniel. “We have a higher status in the community now.”

The health workers in Morupusi are using this newfound trust to launch a campaign to improve sanitation in the area. It is already having an effect. Elizabeth Kaparo, a health worker and Treasurer of the Morupusi Dispensary Committee, explains, “People have started constructing pit latrines and digging dustbins at their homes and we have been teaching them about nutrition and how to wash their hands.” The health workers have also been showing people how to build “leak tanks” – suspended bottles of water with a small hole near the bottom which provides a flow of water for handwashing.

Community Health Workers (CHWs) sit for a meeting in Morupusi. CHWs work in the local community to provide access to basic healthcare. The CHWs in Morupusi have also begun a sanitation campaign. Image: Chris McKeon / AOA

Community Health Workers (CHWs) gather for a meeting in Morupusi Group Ranch. As well as improving their community’s access to basic healthcare, the CHWs in Morupusi have also started a sanitation and hygiene education campaign.
Image: Chris McKeon / AOA

Some suggestions have been better received than others. Handwashing and dustbins have been popular, but the Maasai have been slower to dig pit latrines. “Changing habits is hard,” says Daniel, “And they might not change until there are some bad consequences, like a typhoid outbreak.” But slowly things are changing, and the arid landscape around Morupusi is increasingly dotted with small, white toilet huts.

This campaign is a result of AOA’s strength-based approach in the region. The community-based health workers have identified a problem and developed a solution on their own. Now the health workers want to expand their role even further. “We would like to be equipped with medicines when we go round the community, so we can help people at home,” says Samwell. “And we would like bicycles so we can get around more quickly.”

With their useful advice and drive to improve healthcare, the Community Health Workers are a welcome addition to Morupusi. The Group Ranch Committee Secretary, Francis Museka, is particularly pleased with their campaign. “They have brought the spirit of volunteering to the area,” he says.

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