Overcoming the obstacles to basic healthcare access

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

When The Road Less Travelled project began, the newly-built Morupusi dispensary sat alone on an empty hill. Its metal roof shone but the dust that covers the region had already begun to settle on its walls. Mounds of rubble surrounded it, instead of the people who normally wait outside health centres. Inside, there was nobody. Its walls and rooms were bare. There were neither drugs, nor places to store them nor people to administer them. The dispensary looked abandoned, but it wasn’t – it had never been occupied.

It was built with funds from the local Constituency Development Fund to serve the 4000 Maasai pastoralists who live in the Morupusi Group Ranch, in northern Laikipia, Kenya. They were walking 10 kilometres to the nearest hospital at Doldol, where they would wait for hours to be seen; a return journey that would take up to a day.

Before the clinic opened, women from Morupusi would have to walk to Doldol carrying their children on their backs if they needed medicine.  Image: Matthew Willman / Anglican Overseas Aid

Before the clinic opened, women from Morupusi would have to walk to Doldol carrying their children on their backs if they needed medicine.
Image: Matthew Willman / Anglican Overseas Aid

“We wanted a dispensary here because of the distance,” explains Elizabeth Kaparo, a local Community Health Worker and Treasurer of the dispensary committee. “Women have to walk to Doldol carrying their children on their backs if they want medicine. So we applied to the Constituency Development Fund (CDF) for money.”

Attaining funding to build the clinic was only the first step on a long road to improving access to health services for the Morupusi community. Once it was built, because the Ministry of Health had not been notified about the clinic, there was no budget allocated for staff, and no medical supplies. The building stood empty, and the Maasai continued their long walk to Doldol.

When the Community Development Committee reached out to Anglican Overseas Aid and The Road Less Travelled for help, project staff saw immediate potential in the clinic to become a central hub for community health and education. They formed a three-way partnership with the community and the Ministry of Health.

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The changing role of Maasai men in maternal health

James Senjura works closely with the Maasai pastoralist community of Laikipia, Kenya, to improve maternal and child health. He is a Project Officer for Mothers’ Union, Anglican Overseas Aid’s partner in The Road Less Travelled project, and also a father and positive role model for other men in his community. The project works with the community to identify key development challenges, and helps to develop locally-appropriate solutions to deliver basic health care and education where access to formal services is limited. James answers some questions about traditions and gender norms relating to maternal and child health within his culture.

In the Maasai community of Laikipia, how would you describe the traditional role of men in maternal and child health?

Traditionally, men’s role in maternal and child care has been passive. Maternal and child health care was in the hands of traditional birth attendants and old women.

Mostly men provide financial support and organise for transportation, and sometimes in consultation with the traditional birth attendant they decide for further action in case of complications or disease occurring. The father would advise on the estimated date of delivery, so that the woman would be prepared.

Image: Matthew Willman / Anglican Overseas Aid

Traditionally, the role of Maasai men in maternal health and child care has been a passive one. Image: Matthew Willman / Anglican Overseas Aid

It was also the role of man to source food (slaughter animals, draw blood) for the mother during and after pregnancy. When a woman was in the last trimester, the man would ready some rams for slaughter after delivery.

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Providing water in Naibor: building businesses in return

This post was written by Loretta Pilla, an Australian volunteer who is currently working in Kenya as a Program Management Officer with Anglican Overseas Aid’s The Road Less Travelled project.

Jchabure Lengunya is a mother of six children between four and 16 years of age. In addition to her family responsibilities, she is also an active member of the Naibor Water Committee. With Jchabure’s youngest child wrapped tightly around her neck, we sit beneath the shade of an acacia tree 50 metres uphill from the recently built rock water catchment in Naibor group ranch, in Laikipia County of Kenya.

“We are now entering the wet season,” she explains, pointing at the vast red clay landscape stretching to the horizon. It is barely flecked with green foliage, with even less houses in between.

Before the water catchment was built the women of Naibor travelled long distances during the wet season to the Naibor open spring to dig for water, and even further during the dry season to the Nanyuki River.

Image: Loretta Pilla / Anglican Overseas Aid

Women of Naibor in Laikipia, Kenya, wait to collect water from the tank at the base of the rock water catchment built by the community with support from The Road Less Travelled project. Image: Loretta Pilla / Anglican Overseas Aid

Jchabure explains that the water committee is responsible for ensuring the sustainable use of water by community members. This is an important role given the pressures the harsh weather conditions and often extended dry seasons can have on water availability.

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Easing the water burden

This post was written by Greg Armstrong, Research Fellow at the Nossal Institute for Global Health, Anglican Overseas Aid’s partner in The Road Less Travelled project.

We met Natana Nalikite and Kumontaare Mayani by an open spring in Naibor, a Maasai group ranch in Laikipia County, Kenya. A rock water catchment is being built nearby to ease the water burden on the local community. It is a burden that is felt most heavily by women, whose task it is to walk long distances on a daily basis to collect their household’s water. Our recent baseline survey in Naibor found that 77 percent of women walk two or more hours per day to fetch their household’s water supplies.

The women of Naibor walk long distances every day to reach the open spring, where they place their containers in a queue and wait for their turn to collect their household’s water.
Image: Greg Armstrong

Natana is in her 40s, a mother of five and the only wife to her husband. Her youngest child, a six month old girl named Sawaoi, is cradled in a sling that sits around her shoulders. Her surname, Nalikite, means to walk slowly, yet Natana assures us that she has greater strength in her legs than her name suggests.

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Bridging the gap in maternal health care for Kenya’s Maasai

This post was written by Sarah Manyeki, Monitoring & Evaluation Officer, and Millicent Wanjiru, HIV Project Officer, for Mothers’ Union – Anglican Overseas Aid’s Kenyan partner in The Road Less Travelled project.

Traditional birth attendants (TBAs) are a sensitive topic in Kenya. They are proscribed because they were believed to have been contributing to the nation’s high maternal and child mortality rates.

Despite the TBAs being proscribed, they still play a very major role in assisting mothers to deliver in remote nomadic pastoralist communities. According to a Baseline Survey carried out by Mothers’ Union between January and May 2012, 92 percent of women in Laikipia and Samburu Counties give birth at home without the assistance of a skilled health worker.

TBA

In safer hands: could empowering traditional birth attendants be the key to bridging the health care gap for Kenya’s nomadic pastoralist communities?
Image: AVI / Hannah Ford

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