Kilifi Kids

It was 8.30am when I arrived at the Ganze Health Facility and as I walked through the Facility, I noticed a great number of women who were either pregnant, holding infants or struggling to keep their young children still. The small room was packed to the brim and most women hurdled due to lack of seats. The Mother to Child Health (MCH) room was very noisy, as children were crying; some running and others were crawling on the floor. Regardless of this situation, I was welcomed with great excitement once I introduced myself.

The mothers were really co-operative and exhibited a lot of interest and genuine curiosity as we shared a lot concerning the importance of ante-natal and immunization. “What would I do if I missed my appointment to the clinic’’ asked Mama Kanze. Thanks to the introduction of CHWs, one of their roles is to remind members of their communities about their appointment dates. We immediately lost ourselves in the discussion of CHWs and their important role in our community and appreciated some interesting facts about the use of technology in rural health care.

At  9.30am the nurses on duty reported and due to time constraints in relation to the large turn out at the clinic, they immediately took to preparation of vaccines by transferring them from the fridge to the smaller coolers. Thereafter they started their daily schedule on immunizations and antenatal attendance. As time went by more mothers came in and were eventually attended to.

I also had the opportunity to talk to one of the nurses in the facility. It was very enlightening to find out that ‘‘Over 100 pregnant mothers and the children who came in for immunization came in for their clinics after the CHWs had visited their homes and they reported back by text-messages.” The SMS Network brought so much relief and efficiency as fewer appointments were missed. Texting also saved the nurses and staff travel time, by eliminating the need to hand deliver reports to the District Hospital. The nurse was happy to announce that the number of attendance of children on immunization increased from 25% to 80% across the District and the maternal mortality rate has decreased in the communities.

With these remarkable results of the project, it proves that mHealth, in all its simplicity, works miracles in improving health care. Medic Mobile prides in use of basic technology to improve healthcare. At 12.30pm all children and the pregnant mothers had been attended to and had left.

Our first perspective training in Mtwapa is showing very promising interim baselines survey data as I noticed a rise in turn out of male CHWs.

 
The male CHWs showed a lot of interest during the training and really contributed a lot in terms of co-operation and genuine curiosity during facilitation. The facilitators were impressed with the depth of magnitude and interest that the male CHWs questions had.
Since it was all about antenatal and immunization, It came as a surprise that the male CHWs were more involved when compared to the female CHWs. I remember one male CHW asking, “How would I know a woman is pregnant?” Katana, a fellow male CHW was quick to answer that, “Since CHWs reside within the assigned households, they are encouraged to have friendly relations with their neighbors. With this rapport, a woman will feel open enough to provide the information needed for registration purposes. Once we know her L. M. P and age, we can determine her E.D.D”. Katana impressed the whole crowd and provided not only inspiration but also knowledgeable facts that helped both genders of CHWs.

 
At the end of this weeklong training, the CHWs can easily explain importance of both ANC and immunization. They are equipped with necessary knowledge in the health field and handed materials to assist in the cause. An invaluable material that is distributed is a Nokia Phone (courtesy of Medic Mobile). With this, they can easily work within the projects while relaying information easily to administrators.

 
It is a priceless moment when ululation and laughter is heard during the end of the training. All the faces of the CHWs confirm a newfound hope and enthusiasm on all the things that they have learnt and the fact that they become essential in their contribution towards a better society

The team at Medic Mobile is sitting under a tree at a family shamba (farm), listening to the story of how families in Kilifi struggle to access healthcare.  Recently, Fatima, who is 24, recognized that her 3 year old son, Mohammed, was not recovering from pneumonia.  He had returned from a visit to the Ganze clinic the week before with medicine for pneumonia, but he had not responded to the treatment.  Within a few hours, his condition continued to go downhill, and Fatima decided to take him back to the clinic.

At the clinic, the nurses immediately referred him to the central hospital, given his critical condition.  There are no emergency vehicles at the clinic and so Fatima needed to find the funds to pay for a trip into town.  Her family own about 20 acres of land, and are small-scale farmers.  They have very limited access to funds, and did not have the $10 on hand to pay for transport.  Fatima only option was to seek assistance from anyone willing to help. Her closest option was her nearest neighbour. Luckily, he agreed to lend them the transport fees, at an interest rate of 10% per week.  For a family that only earns $10 per month, this interest rate was too high, but the choice for Fatima was simple – the life of her child or refusing the loan.  She chose the life of Mohammed, and he is now thriving and growing well.  He had contracted a severe case of malaria, and arrived to the hospital just in time.

It is stories like these that directly inspire our goals for emergency transfer work.  We recognize that it may take some time for Kenya as a country to build up an efficient and sustainable emergency response system, but it is critical for rural clinics to create innovative solutions to emergency transfers.  It is our vision that an SMS-based transfer system would be created that would make it possible for patients to arrive in time for care, recognize warning signs more quickly for referral, and that a financial system would be designed to help mothers like Fatima receive support when they most need it.

Some years ago the term mHealth sounded “ambitious, hilarious, unbelievable,and mostly non-African” Mobile phones or just technology in rural healthcare? It seemed a big joke and three years down the line we have a testimony that it really works.

“In the entire chain of healthcare, the front-line healthcare workers play the game”, These are words close to what Josh Nesbit, CEO Medic Mobile, continually mentions in his posts. Notably, he reckons that Medic Mobile as a technology organization with most of its inclination towards rural healthcare, “knows technology as a tool, not a solution, focuses on communication gaps, not just data collection, works in challenging settings, and focuses on improving health in under-served communities and gets excited about ubiquitous technology, because accessibility matters”. This is what drives us into improving our strategic partnership with Medic Mobile our technical partners in our mHealth project in Coastal Kenya.

Within the years we have reached out to a cohort of CHWs in groups of 45, 100 and now 50 all receiving our technology piece that includes a mobile phone, solar charger and relevant training towards improved uptake for Antenatal Care and Immunization for children.

“The technology piece – CHWs with their mobile phones and solar chargers

Seemed too basic at start but with professional planning through the Human Centered Designs we get to understand how the chain flows and our tools and approach is then guided by well documented data flows visualizing each step.

We thus authoritatively confirm that mHealth works and conclusive indicators from our initial work show that In Ganze, Kilifi of Coastal Kenya, after a one-year pilot, institutional delivery rates increased from a baseline of 20 deliveries per month to 48 deliveries per month (no maternal deaths). Immunization rates for referred children increased from 18 to 30 children per month. “This is awesome”, reckons the District Medical Officer of Health as impact is clearly seen to penetrate the efforts of the Community Health Workers-CHWs.

Rotarian Alex Maina hands over mobile phone and solar charger to a CHW-with them are Lydia, MOH staff and others

The A -B-C of mHealth is thus as simple as ABC and it works.

It is a dusty, dry day in Kilifi as a mother walks to the clinic for delivery. Martha* is brave, making this journey despite knowing that the clinics are on strike. For the last 6 weeks in Kilifi, and across Kenya, the government clinic nurses have been on strike, requesting the chance to be recognized as a worker’s union. As a result of the strike, nursing staff at the clinics were reduced to only the bare minimum, and all facility activities were fully stopped.

Martha, who makes this brave journey is only 29 years old and has previously lost 3 babies in delivery. Knowing the value of clinic-based deliveries, aided in her decision to walk the 2 miles to the clinic. Previously, she had given birth with the help of a family member, who was unable to help when the birth became complicated. She was visited by a Community Health Worker who is part of the Kilifi Kids program, and it is this CHW who told her of the value of clinic-based deliveries. These deliveries are supported by a nurse who has successfully delivered hundreds of children, and these children are able to receive expert care and even referral to an advanced hospital if they need extra care.

As she arrived at the clinic, she was greeted by the only nurse who is on site during the strike, a young woman named Paris. Even though Paris is supposed to be turning away patients, she is moved with compassion when she sees the mother arrive. She rushes her into the maternity room, and prepares for delivery. After a few moments, we hear the sound of fresh cries of the new-born baby, and a new little baby boy is born.

Martha is overjoyed as she sees her son for the first time, and sings the praises of Paris for her health and support. This is the goal we work towards at Kilifi Kids – Seeing mothers and new-born babies born in clean, safe facilities under the care of a well-trained nurse. We are excited to share that the nurses’ strike is now over, and we anticipate many stories like this one will be told very soon!

My name is Rita Ombaka. I’m the new volunteer Community Director for the Kilifi Kids blog. If this is the first blog post you are reading, I’d like to welcome you, and thank you for joining us to learn more about life in Kilifi, Kenya and the work that Kilifi Kids is doing there and around the world. And for those of you, who are returning visitors, please accept my personal thanks for your invaluable continued support!

Although I was not born in Kilifi, I grew up there and consider it my home when in Kenya. I am currently a student at Lewis & Clark College in Portland, Oregon and make an effort to visit my family in Kilifi every summer. I have been fortunate enough to have experience in administrative duties from internships in notable Non-profits such as Business for Culture & the Arts in Oregon and the Lincoln Center for performing Arts in New York. I also hold leadership roles in my college as the current Vice President of International Students. Some of my personal accomplishments have been bringing donated stationary from Oregon to primary school students in Kenya. My true passion lies in not only helping mission-driven not-for-profit organizations reach their full potential, with their help of their supporters but also bringing development back home to Kilifi.

I join Kilifi Kids with that goal in mind, hoping to bring you insight into the work that our dedicated staff and volunteers around the world are undertaking to eradicate childhood malnutrition and improve public health. Over the coming weeks and months, you’ll be hearing more from me and a number of new contributors, not only about the work of our organization, but also about major advances in international development, public health, mobile health technology and leadership success throughout the Kilifi community and beyond. A new addition to the blog will be an inside story to what life in Kilifi is like.

Our hope is always that this be an immersive, interactive and participatory process. If there are topics which you’d like to hear more about, people you’d like to hear from, or if you have inquiries or comments, please feel free to air them, either via the comments section of our blog, or by finding us on Twitter at @KilifiKids or Facebook. We’d love to hear from you!

Thank you again for being a part of our community.

Kilifi Girls join the Techie space

Another story comes from our Kilifi, thirty girls all assembled by Moving the Goal Post Kilifi –Kenya, a girl based organization working towards empowering girls from the un-privileged Kilifi community. Girls with divergent views on what computers are and with an expectation to only learn how to type and how a computer is used for communication spent a week studying the computer technology. An introduction of the week’s curriculum by Jonathan Mativo (Project Manager -Kilifi Kids) leaves the girls lost of words with added expectations.

An overall goal to develop a local “TV Station” run by the girls does not seem to sink in well till day one is gone and the girls realize the power of imaging and videos in media work. A slow step by step facilitation leaves the girls with no other option other than to do it themselves as some of them start seeing themselves in a different way.” A TV station is just but a collection of video and image material from a community unit”, exclaims Mativo. With basic imaging and video equipment the girls will easily be in a position to collect lots of videos and images of what is happening in their community and arrange them in a timeline of about 30-45minutes. Every week the girls would then display their material “news” on a daily basis in the market centres.

Jonathan Mativo the trainer engages with the girls in training

This idea seems to augur well as the girls hurriedly group together and ideas start streaming on how to go about it.

This notwithstanding, a day three makes computers a relevant training for the girls as they start engaging the facilitators with more innovative ideas of improving their livelihoods. “I can start my small business for creating documents and saving data for people for future reference e.g. scanning their certificates, title deeds etc”. This idea leaves me with huge hope for the girls.

The digital divide has not taken cognisance of access of ICTs by women and girls as it has for years dwelled more on those that have access and those without, with no particular focus to this gender. A close scrutiny clearly shows that “educating a girl is like educating a whole society” and the same goes without saying that girls have the potential to even be more constructive when it comes to technology issues that require innovation.

ICT for Development Kenya, the facilitating agency runs an Innovation Incubation Center in rural Eastern Kenya that focuses on bringing together communities and individuals who otherwise would not have had an opportunity to have access to a place to develop their ideas. At the Center innovators are grouped by sector and their ideas given the weight they deserve. ICT4D Kenya is not only a computer/ mobile technology based organization but it is an organization that makes use of technology to intervene at different development sectors. “We nuture any type of idea to completion regardless of its nature for as long as it has a positive impact to the generator” says Mativo.

A call to all willing supporters both in-country or in the diaspora is made to re-awaken the giant and pull more girls out of poverty by embracing technology and supporting them to make use of it as an economic activity.

Led by Moses Kiti and the Rotary Club of Kilifi, the latest round of deworming took place on July 12, 2012.  The launch of the program started at Masemo Primary School at 9 a.m. with various stakeholders in attendance, including the Kenyan Ministries of Health and Education, and will continue to 82 other primary schools across the Ganze and Vitengeni provinces in the Kilifi District.  On the following day (July 13), there was a follow-up session for any child who missed the initial drug administration.  It is expected that 29,000 students received a deworming tablet in last week’s campaign.  

A giant thanks to all of those who have supported this work, including our partners, volunteers, and donors.  We are excited to continue this important work, now in our fifth year, and help so many children have healthier and happier lives free of disease!