In seven hours, we can fly from London Heathrow to Boston, complete a workday excluding lunch break, or get a full night rest. Or, we could spend an entire evening in the car driving over thousands of potholes and sharp rocks, getting stuck in mud fuming with toxic poignancy, and arrive home with a pounding headache more frustrated than a one legged cat in a sandbox. This is development work at its finest.
In the past week alone, we have spent over 20 hours riding in a rundown van to get places that would take three hours (max) on the highways of Montana. One 25 mile drive lasted over five hours. If roads were actually built or maintained by the money allocated to them, transportation access in Kenya could virtually eliminate cholera, typhoid, polio, tuberculosis, death from child birth, and hundreds more basic and preventable health issues. It is a frustrating reality for Westerners like us, but it is completely normal and tolerated here. What’s wrong with this picture?
A new project that we are exploring as we begin our journey to medicine revolves around healthcare access in rural areas. Magadi is a sub-county in Kajiado County in the southern part of Kenya. It is one of the most arid parts of the country and sparsely populated in contrast to other parts of Kajiado. There are 42 tribes in Kenya, and perhaps the most popular and well known in the western world is the Maasai. This tribe makes up most of the population in Magadi, and they are known for their nomadic culture, livestock, statuesque figures and colorful garb. Though many of the tribal traditions are preserved in this region, it is also one of the poorest in the country due to lack of economy and education. The need for basic and preventative healthcare was strikingly obvious in our two visits to Maasai bomas (small villages) just off the main road.
Walking into the first village, four women met us skeptically at the entrance of the gate, woven with a vast array of thorny branches artfully arranged in a circle surrounding the boma. Jeremiah, the chief community health worker of Magadi, told them we were doctors exploring medical issues in the area. Though ‘doctors’ was a bit of a stretch, we went with the idea and sat with the women in their manyatta (mud hut).
Looking around we noticed that the open fires inside had no ventilation outlet, and Jeremiah mentioned that education on respiratory problems is slowly changing the cultural traditions and architecture of Maasai manyattas. We were in a village just off the road where cars and medical workers are relatively accessible, and yet the improvements were still slow to take hold. We wondered what the manyatta structures look like a three-hour walk away where education is a rarity. Tuberculosis, glaucoma, and pneumonia are extremely common in these communities due to housing arrangements and living in such close proximity to livestock. Luckily, this boma was near a dispensary where treatment could be accessed; however, luck often runs out for other bomas, and blindness and death occur because of preventable and treatable conditions. Even in this boma, the village leader was suffering from the result of head trauma after he was attacked by thieves two months prior. Without the funds or transportation to seek higher medical care in Nairobi four hours away, his chance of recovery and his family’s ability to succeed without a leader were slim.
Just down the road is another boma where Paul and his family reside. Paul wears many hats in his community – father, pastor of the local church, and caregiver to his 30-year-old son Emmanuel. As a child, Emmanuel began to show early signs of a disease that has been widely eradicated throughout most of the world. His body was withering, his muscles weak, and the medical advice he received offered a misdiagnosis for what was actually a severe case of Polio. By the time he was school-aged, he struggled to participate in education, and teachers discouraged him from continuing – he was too crippled, too weak, and too hard to teach.
At the age of 30, Emmanuel sits in a makeshift wheelchair built from a plastic lawn chair that is both his prison and his lifeline, with nothing but the road to watch and his family to care for him day in and day out. When Jamie knelt down to shake his hand, it was strikingly obvious how small and fragile Emmanuel is. Though weak in body, he is strong in spirit. We told him when we left that we would take his story with us as we prepared to take on the responsibility of using our professions to help people avoid unnecessary suffering. Polio is preventable, pneumonia is treatable, and there are vaccines for TB. If medicine and education could reliably reach these communities, Emmanuel’s life would have a very different outlook.
Kenya is in a unique position to capitalize on the opportunity to make large strides toward stronger communities with better health. Nairobi is an international trade center with a thriving economy and modern resources. There are aspects of the culture that are progressive – cell phones and Facebook reach even the most remote parts of the country. However, the basics like infrastructure and paved roads are making it extremely difficult to make progress toward healthcare access for all citizens. Basic sanitation guidelines like hand washing are hard to implement in schools; clean water is still lacking for thousands of people; and the towns neighboring Nairobi continue to dispose of waste on the streets, indiscriminately burning trash to rid the city of piles of build up. The desire to attain the flashy qualities of the western world while paying little attention to basic civil responsibilities is severely impacting health and other basic human rights. After 20 hours in the car, we were discouraged by the amount of need that could be addressed if there was just one road good enough to reach the suffering Emmanuels. Kenya absolutely has the resources to do it – sadly the political good will is lacking.
We believe healthcare is a fundamental human right. There is need all over the world. Perhaps the greatest lesson we have learned through international development work is that the many blessings we have received also carry the privilege of responsibility to promote and serve the rights of others.
By Sarah Rolfing, Team Agape Kenya
Sarah is pursuing her second degree in nursing at the University of Pennsylvania and will graduate in 2018. Health care access is her project of interest with Team Agape Kenya.