Reaching the unreachable, our journey into Ringiti Island

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A rapidly growing population, high population density, failing food production, and low resilience to climate change characterize Homa Bay County.

Located along the shores of Lake Victoria in western Kenya, Homa Bay County is home to 955,060 people and has a fertility rate of 5.2 children per woman compared to the national average of 3.9 children per woman.

The county has several Bays and islands even though the two popular Islands are   Mfangano and Rusinga.

While working with the ministry of health officials in outreach activities, we identified a small but populous island with high HIV prevalence and low uptake of contraceptives.

Ringiti Island has a population of 6000 and an estimated HIV prevalence of between 35 to 55% among adults. Majority of people here find it difficult to access health services because of the infrequent public transport and boat trips that take several hours and sometimes require an overnight’s stay.

We planned for a joint outreach with the Ministry of Health using the nearest government health facility called Wakulla Health Centre within the Island as the link facility. We were to offer integrated reproductive health service while the ministry of health staff offer curative services.

“There is only one boat that goes to Ringiti Island and it leaves Mbita at 7.30am, and will take you 3 hours”, a local fore warned us when we enquired about the transport to the proposed outreach site.

Luckily, on the D-day, May 17 2015, the Ministry of Health offered us an engine boat owned by the health center. We left the shores of Mbita town at 7.00 am.

We arrived at Ringiti at around 10.00am and found a group of anxious people waiting for us.

“The doctors are here at last,” they sighed.We set up our service station in a hall provided by the beach leader trying to replicate a hospital setting. We start off with health education prior providing services

The numbers trickled in and at some point we felt overwhelmed as we had to leave the island before the lake gets ‘bad’. For safety reasons, no boat braves the waters beyond 2 p.m. for fear of the afternoon and evening turbulence.

We were at cross roads. “Do we leave all these clients who badly needed our services? Or do we hope that the lake will be calm today and stay longer? We decided to stay until 4pm.

“Please come back again another day,” they told us as we put up our things together in preparation to leave the island.

The journey back to the mainland through Mfangano Island was horrifying. The waves were bad and we all offered silent prayers every time a huge wave tossed the boat sideways out of its forward course.

For a few moments we took solace on the self-proclaimed experience of the coxswain but all confidence was thrown away at the sight of any rising wave- some getting as high as one meter up.

We arrived at the hotel at 8pm.The day was long; the journey was dreadful but worth the hassle. We slept feeling achieved having fulfilled the KMET goal of reaching the unreachable and underserved with quality services.

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     Reported by Sarah Mercy                                                             

A mother’s determination to get the IUCD

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Twenty seven year old Irene Atieno had been in constant conflict with her husband regarding the use of a contraceptive method after having their first child who is now two years. She desired to space her pregnancies but the partner argued that family planning would affect her health.

She suggested the use of condoms as an alternative but this too failed since the man had not fully bought into the idea of contraception.
Irene who is also blind decided to go for Depo injections despite her partner’s dissenting opinion. She was persuaded that her choice was right since neither of them was employed nor had a steady income to care for their children and personal needs.

She had attended a crocheting course at Aluor School of the Blind and had a crocheting machine that she would occasionally use to crotchet sweaters for neighbors’ schoolchildren. Each sweater fetches 450 to 600 Kenya Shillings.
Irene divulges that at some point they had a misunderstanding and had to live separate with her husband. She defaulted on the depo jabs and got pregnant as soon as they reconciled the marriage.
The reunion was not long lived and later on she returned to her rural home in Asembo Constituency with two children. The last-born is now six months old.
She swore never to take chances with birth control and once at home, Irene visited Mama Ann Odede Clinic, one of the Huduma Poa Health Network Facilities.

Irene insisted on getting an IUCD reporting that she had once used implants and had hormonal effects on her. In addition, she was aware she had defaulted on Depo before and did not wish to take the risk again. Unfortunately, the Sub County was experiencing IUCD stock outs. She says she was advised to come a few days later after the facility had restocked.
Luckily, she learnt that the said health facility would be holding a joint community outreach with KMET and the Ministry of Health in their village.

We later met Irene at Opiata Beach during the outreach some 15 kilometers from her home. This is where she finally got the non-hormonal method.

“I don’t want to be going back to the hospital after every three months, it is too hectic and easy to forget,” she says of the Injections.
We got in touch with her two months later via phone and Irene assured us that she is doing well save for a little cramping before her menstrual periods. She is optimistic that she will not be getting another child anytime soon until she is ready for one.
“I’ve not had any problem with this coil, and I know I will give birth only when I want now,” adds the special needs mother.
Reported by Pamela Nyagol-Quality Assurance Officer

ACK Khasoko Health Centre: First IUCD inserted and recorded was because of KMET

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In the year 2014, the Ministry of Health directed us to ACK Khasoko Mission Health Centre when KMET was on a mission to recruit more facilities into the Huduma Poa Social Franchise from Bumula Sub County.

The sub county has a population of 129,011 and is the second most populous sub county in Bungoma County. A county that records a total fertility rate of 5.0 compared to the national rate of 3.9.

Huduma Poa has worked with the facility for 11 months now in core intervention areas of integrated family planning and integrated management of childhood illnesses (IMCI). The nature of partnership includes staff training, provision of technical support in quality management and offering support supervision.

In addition, KMET supports four community health volunteers attached to the facility to refer clients from the community for health services.

In May 2015, the KMET Huduma Poa program staff and the Executive Director visited the facility to ensure there is uninterrupted service delivery and offer feedback on the progress made in the areas of child health (pneumonia, malaria and diarrheal diseases), family planning and cervical cancer screening.

The health facility had inserted 19 IUCDs, 312 implants and screened 220 clients for cervical cancer in a period of nine months. Joseph Odhiambo, the clinical officer in charge confirmed that indeed long acting and reversible contraceptive methods were not their priority before the partnership.

The only method of contraception being offered then was the injection and male condom.

“I have been here for four years and the short relationship between you KMET and this facility has been a big achievement. One because the first IUCD to be inserted was done when we started the partnership being the first time an IUCD appeared in the records of the facility,” reported Joseph.

Joseph explained that the only period they ever recorded an Implant insertion before, was when a nonprofit organization would occasionally use their room to offer the services using their own personnel and not the hospital’s.

Being the only provider trained on cervical cancer screening and insertion of IUCDs in the facility, Joseph has mentored two other colleagues who were recently recruited with the support of the KMET Quality assurance officer.

He attributes the number of cervical cancer screening and family planning clients to efforts of the community health volunteers.

The four community health volunteers were trained and given job aids on family planning, HIV counseling and cervical cancer for purposes of referrals.

During a roundtable feedback session the CHWs underscored the importance of the training saying that, they have been equipped with facts, which make their work easier.

“KMET has really considered the work of CHVs and trained us; we are not scared when we talk to the community and this has made the four of us unique from the other CHV’s who are not in Huduma Poa,” reported Judith one of the community health volunteers.

She reported a shift in attitude of clients from Depo injections to more long-term methods citing instances when they have had outreaches where clients turn up in large numbers and night falls when more clients are still coming in.

They however challenge KMET to think of a package that can bring men on board in family planning, suggesting options like prostate cancer screening.

The biggest challenge the facility experiences is that there is no health practitioner trained in cryotherapy in the sub county hence they refer clients to the county referral facility which is far away and hampers effective follow-up.

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by  emmanuel oyier

Partnerships that work: Huduma Poa involves church in reproductive health

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Hundreds of patients thronged St. Mary’s Catholic Church in Soy mining village, Kwanza Sub-County, almost overwhelming Huduma Poa social franchise team and providers seconded by the MoH.
The outreach had been organized by one of the Huduma Poa Social Franchise clinic, Seed of Hope in collaboration with the Ministry of Health and the most popular church in the area.
 In preparation for the outreach, Bernard Baraza, a community health worker (CHW) attached to the franchise clinic and his counterpart liaised with other community health workers around Soymining village to identify the most suitable site for the reproductive health outreach. They identified St. Mary’s Catholic Church and approached the administration.
The chairperson of the church board welcomed the idea saying the church would support any intervention meant to improve the livelihood of the people in the area.
This is also contrary to the common belief that religion is a barrier to family planning. A 2015 study titled: The Influence of Religion and Ethnicity on Family Planning Approval: A Case for Women in Rural Western Kenya concludes that in as much as religion and ethnicity have been found to be of significance in shaping attitudes towards family planning in other settings, the two variables are of no significance among women in Western Kenya.
The CHVs seized the opportunity, distributed posters, and talked to members of the congregation during the Sunday mass. The Soymining outreach and others that the Huduma Poa franchise has held in collaboration with churches and the Ministry of Health is a demonstration of working public, private, partnership in healthcare.
Beatrice Amayo KMET Quality Assurance officer reinforces contraceptive information after CHWs give a health talk at St. Marys Catholic Church Kitale
Margarate Nyongesa a CHV from Soymining says the church is one of the ideal venues to hold outreaches because religious leaders boost the trust of community members because of endorsement even if they do not personally talk about the services.
“We are close to our local pastors because our obligations to reach the people are similar therefore this makes our mobilization work easier,” adds Baraza.
 Community Health Worker encourages women to touch the IUCD at Nyamaraga SDA church in Migori
On this particular outreach, 41 women received long acting and reversible methods of contraception; 48 were screened for cervical cancer; 75 counseled and tested for HIV.
KMET Huduma Poa Program Officers have since adopted written letter templates customized for church audiences as a mobilization tool for CHWs in addition to posters, and door-to-door mobilization.
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We empower and educate the vocational way

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Education of girls is essential in the drive by nations to achieve development goals.

Despite this fact, the girl child is often perceived and treated as inferior and has been socialized to put their needs second after everyone’s thus undermining their self-esteem.

Many girls hardly get the relevant type of education that would make them overcome the social, cultural and health challenges.

As a result many girls end up dropping out of school for a number of reasons. To empower such girls so as to attain knowledge and skills that help them make a change in their life, KMET came up with SFC (Sisterhood For Change) program.

The SFC program empowers girls to attain knowledge and skills that will improve their economic independence and soundness.

The goal of SFC is to increase access to livelihood opportunities and sexual reproductive health information/services to adolescent girls and young women from poor backgrounds.  Participants are trained in vocational, reproductive health or life skills besides hairdressing, dress making and food and beverage courses.

For those who wish to enroll and have children; no need to worry because KMET has also established a daycare facility to take care for the little ones as their mothers learn.

SFC works with a range of stakeholders into meeting some of its objectives. These includes the police, Government ministries, local administrators, community leaders, religious leaders, parents whose mandate is to provide ongoing support, guidance, contribute to the growth of the program and feedback to the KMET management on how best to improve quality of services offered at SFC. This forms a committee named the Youth Advisory Committee (YAC).

In addition, KMET offers referral sites on health related matters affecting the adolescent girls at SFC to bring in positive health seeking behavior among the adolescents and young women to reduce the social and structural factors that contribute to HIV vulnerability.

Once the participant is through with Vocational training they are placed in a 3-month internship, where they develop their vocational skills.

Courses Offered.

Food and Beverage  (6months)
Hairdressing Beauty Therapy  (6months)
Dress making  (one year).
The courses run for six months apart from the Tailoring course that runs for one year.

Intake is ongoing. If you wish to enroll please contact:
Jennifer Musuya
Email:j.musuya@kmet.co.ke
Cell: 0719364388
You can also reach us by visiting our website: http://www.kmet.co.ke or follow us on Facebook and twitter.

Through the eyes of a wounded child: 27year old behind bars for defiling a 4 year old

At a tender age of four, Janet* is going through any woman’s worst nightmare.  She is frail but can manage a smile. One week ago, a person well known to her drugged her, defiled her and left her for dead in a maize plantation.

STOP SGBV
One Wednesday evening Janet came back from school and her mother gave her some money to buy sweets. The ninth born out of 10 children went to share the sweets with her daddy. Her dad sent her to close the window and that is when she met James*, a family friend squatting near their window.

She recounts how James lured her to join him for a motorbike ride. Half way through the ride, James offered to buy her a mango. She remembers James sprinkling some powder on the fruit but she did not pay much attention to it, after all James was like a brother to her. She however noticed the mango was more bitter than usual.

She didn’t pay much thought to it and continued eating the mango. She doesn’t remember much after that but she does remember being woken up by mosquitoes. She found herself in a maize plantation in total pain. She let out a scream and that is when a Good Samaritan came to her aid.

The parents noticed that she wasn’t back at around 9pm. They searched for until 3am with no luck. In the morning they reported at the chief’s camp as well as at Janet’s school.

Luckily, the Good Samaritan called the school and they confirmed that she was actually a student there. She was in a bad state and was rushed to Kisumu County Hospital and her parents called. They arrived when she was being rushed to theatre.

Her mother could not understand how James their humble 27-year-old neighbor would commit such an inhumane act on her daughter. “I may never understand why he did it but I am asking God to forgive him” she managed to say after we concluded interviewing her. “….but I want him to pay for his crime to serve as an example to the rest” she added.

James has since been arrested and charged. His case has been mentioned and hearing will resume on 8th September 2015. He couldn’t afford the 500000 cash bail hence he is been held at Kodiaga.

How safe are our girls? How well do you know your neighbors? Can you trust anyone with your girls anymore?
With statistics showing most children are defiled by people they know, we encourage everyone to be more vigilant. Let us protect our children, ending the violence starts with you!

*Names have been altered to protect the privacy of the survivor.

For help call, KMET free on 0800724500 or contact Child line Kenya-11, JOOTRH 0714138868

KMET is also in the process of operationalizing a safe temporary  shelter known as the Freedom House for people who are suffering gender-based violence. Get in touch with us to learn how you can be part of the process.

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Almost everyone’s got one problem, choose yours; missing or decayed teeth

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Did you know that the average adult between the ages of 20 and 64 has three or more decayed or missing teeth? If you are missing one or more teeth, there are plenty of reasons to correct the problem. For one thing, a large space between your teeth may affect how you speak or eat. Even if it’s not noticeable, a missing molar can affect how you chew. Remaining teeth may shift and in some cases, bone loss can occur around a missing tooth.

At  Kmet some of the options we offer to replace a lost tooth or teeth are through dentures: partial acrylic denture and complete denture.

Tooth decay is also one of the major reason one may need a filling. With today’s advances, you don’t have to suffer from missing teeth. At Kmet, we offer three types of filling: temporary, composite and amalgam filling. Temporary filling is best under the following conditions.
· Following a root canal
· To allow a tooth’s nerve to “settle down” if the pulp became irritated
· If emergency dental treatment is needed (such as to address a toothache)
· For fillings that require more than one appointment – for example, before placement of gold fillings and for certain filling procedures (called indirect fillings) that use composite materials
At Kmet, some options we use to replace a lost tooth or teeth are through dentures: partial acrylic denture and complete denture. This is done if you’ve lost all or most of your teeth. A denture is a removable replacement for missing teeth and surrounding tissues. Two types of dentures are available — complete and partial dentures. Complete dentures are used when all the teeth are missing, while partial dentures are used when some natural teeth remains.
Other dental services offered are Acrylic crown, acrylic bridge per unit, surgical dismpaction, root canal treatment, polishing and simple extraction.
For more information,
CONTACT US
Tom Mboya Estate, Along Kondele-Nyawita By-pass,
off Kisumu Kakamega Road
P.O. Box 6805-40103
Kisumu. Kenya
TEl: +254 728219528
We shall never know all the good that a simple smile can do.
Mother Teresa

by beryl onyango