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.
Reported by Sarah Mercy