maryannewaweru

A Kenyan Journalist Writing About Health

Archive for the category “Children”

Slum Film Festival to Launch G-Involve Film Project

The Slum Film Festival will on Tuesday 13 June 2017 launch the G-Involve Film Project, from 6:00 pm at Alliance Francaise, Nairobi. The film project G-Involve seeks to encourage young people to GET UP and GET INVOLVED in the governance of their communities.  It places a great premium on election of leaders with integrity, it aims to build a culture of active citizenship and responsibility, create constitutional awareness among the youth, and promote positive and meaningful engagement between citizens and their leaders.

During the launch, films will be critiqued and there will also be explorations about the power of film as a tool for social change.

Film Synopsis: The struggle is very real when Pendo,  a young lady living in the slums realizes that she must motivate her peers to break the pervasive yoke of ignorance in order to fight a war for change in the governance of their community.  Their disillusionment about constitutional rights leaves them out of reach from the only weapon that can yield victory.  Can Pendo walk the extra mile and lead her peers to triumph? Watch trailer below.

Senator Harold Kipchumba: “Polio Shattered my Dream to be a Soldier”

By Maryanne Waweru-Wanyama

Anti-polio campaign ambassador Harold Kipchumba, who was paralysed when he was four, appeals to parents to ensure their children get all required immunisation

Growing up as a young boy in the small village of Kaptiony in Baringo County, 52-year-old Harold Kipchumba vividly remembers some of his childhood escapades.

“I would run wildly with other boys picking wild fruits, playing hide and seek games and chasing after birds while herding cattle.”

This however changed one day when at four years old; Kipchumba began feeling unwell.

“I felt pain in my body, I felt tired and I felt weak. Unable to get out and play with my friends, I remained indoors with my mother,” he remembers.

But his mother thought he was just being lazy.

“She scolded me, saying I was being sluggish because I wanted to avoid doing house chores such as fetching water and firewood. She thought I only wanted to eat and sleep.”

Harold Kipchumba

Photo: Harold Kipchumba during the interview 

Within a week, Kipchumba found himself completely unable to move his body from the waist down, especially his legs. It was only then that his parents took the matter seriously.

“They thought someone had poisoned me and pestered me about whose home I had visited and what I had eaten there. They asked who I had met along the way, and if the person had looked at me with bad eyes — thinking that a jealous neighbour had bewitched me. They also asked if I had eaten any wild fruits that may have been poisonous, or if I had touched any wild leaves that could have caused an allergic reaction on my legs,” he recalls.

His parents then sought the expertise of local herbalists to help cure their son.

“The medicine men made me swallow bitter concoctions. They would painfully massage my legs with traditional herbs and oils as they tried to straighten them. But none of their cures worked.”

Finally, after two months and with his legs still immobile, Kipchumba’s parents decided to take him to hospital.

And therein lay another challenge.

The nearest health centre was 40 km away from Kaptiony village. With no public transport in the area, the family had to wait for days for a Good Samaritan to offer them transport.

Eventually, Kipchumba and his parents reached the hospital. But there was no good news for them.

“The doctor said I had polio, which was irreversible. They told my parents that the condition could have been prevented if they had been keen on ensuring I had received all the polio vaccines in my early childhood.”

Kipchumba’s mother did not take the news of her son’s paralysis well, and spent years seeking a cure for him.

“She took me to countless traditional medicine men across the country — from Ukambani, to Kisii, to Kisumu. But none of them ever healed me. It was an exhausting experience for her, as she would get weary carrying me on her back as I was unable to walk or stand. I was big and heavy, but her determination is what kept her going,” he recalls.

Back in the village, Kipchumba would admire his age mates who had already started school.

“I was not in school because the interview for class one required one to touch their left ear with the right hand. I was short and plump with a big head and a very heavy upper body, so I repeatedly failed this test because I could not get my hand over my head. I watched all my age mates go to school while I stayed at home simply because I could not pass this interview,” he recalls.

Frustrated, Kipchumba’s mother decided to return him to hospital. And then she did the unexpected.

“My mother dropped me at the hospital and left, never to return for me. After a while, some Catholic nuns noticed me and took me with them to Nyabondo Home for the Crippled in Kisumu. There, I underwent rehabilitation for my legs, and I was also able to get an education.”

However, the young boy always remained hopeful that his mother would return for him someday.

“As I watched my friends get visited by their family on visiting days and be picked by their parents on closing day, I always stared at the gate, looking out for my mother. But she never came.”

That notwithstanding, Kipchumba was a bright pupil, and scored well enough to earn him a spot in Lenana School, a national school in Nairobi. While there, the school helped trace his family. It had been more than 13 years since he had seen his mother. He remembers the reunion.

“I cannot forget that moment. I was overjoyed. On seeing me, my mother shed tears, apologising profusely — saying she had never meant to leave me at the hospital, but had done so out of helplessness and frustration. Begging for my forgiveness, mother told me she had spent years regretting her decision to abandon me. I was too happy to see her and easily forgave her. I was also reunited with my siblings, including those who had been born after I had left,” he says.

After competing secondary school, Kipchumba was admitted to Kenyatta College (now university) for a degree course, but turned it down for an offer at Kimmage Development Centre in Ireland where he pursued development studies. He however says that one of his greatest dreams while growing up was to be a military man.

“When I showed up for the recruitment exercise in 1986 at the age of 24 years, the officers were shocked at my presence. They asked me why I was there, yet they had made it very clear that they wanted youths who were physically fit.

“I argued with them, saying I was physically fit, only that I was in crutches. Besides, I told them that I was capable enough to serve in the military in the administration, logistics or planning departments. But they turned me away.”

Dejected, the young Kipchumba returned home.

“If my mother had ensured I had received those two polio drops, then my dream to serve in Kenya’s Defence Forces would have been valid, just like Lupita’s.”

Principal Secretary for Health Prof Fred Sigor, Baringo County Governor Benjamin Cheboi and anti-polio campaign ambassador Harold Kipchumba during the world Health Day celebration in Marigat in April

Kipchumba during the World Health Day celebrations

Kipchumba, who holds a Masters degree in Local Governance and Leadership, is today a development consultant. Married with three children, he finds time off his busy schedule to participate in polio campaigns. He works together with the Ministry of Health to champion the cause of polio across the country.

Polio is an infectious disease that attacks the nervous system and can lead to paralysis, disability or even death. The polio virus enters the body through the mouth in water or food that has been contaminated with faecal material from an infected person.

The disease mainly affects children under five years old who are not fully vaccinated. Children in Kenya are vaccinated against polio in routine immunisations through the Kenya Expanded Programme of Vaccination (Kepi). They are required to receive at least four doses of the oral polio vaccine in the first year of life. Polio symptoms include fever, fatigue, headache, vomiting, stiffness in the neck and pain in the limbs. For every 200 people infected with polio, one of them ends up with irreversible paralysis (usually in the legs). Among those paralysed, 5 – 10 per cent die when their breathing muscles become immobilised by the virus.

While many countries across the world have managed to completely eradicate polio, others still continue to grapple with this preventable disease. Kenya is one of them, and has an interesting history to it.

For 22 years from 1984 to 2006, Kenya was polio-free. However, this changed with the influx of foreign nationals into the country, mainly those from neighbouring countries. In 2006, two polio cases were reported in the country, which were importations from Somalia. In 2009, there were 19 detected cases of the virus in Turkana, which were importations from South Sudan. Another case was detected in Rongo, Nyanza province in 2011, and which was linked to the 2010 outbreak in Uganda — which was in turn linked to the 2009 outbreak in Kenya. As of December 2013, there were 14 confirmed cases in the country.

In light of this, the Ministry of Heath has been working with partners such as Unicef, World Health Organisation, and polio ambassadors such as Kipchumba in conducting mass immunisation campaigns to ensure all children are vaccinated against polio. Polio has no cure, and can only be prevented through immunisation.

According to Dr Ian Njeru, the head of the Division of Disease Surveillance and Response, these campaigns will continue taking place until all children are reached.

“All children in the country must be immunised, because for as long as there is a detected polio case, then all children across the country are at risk,” he says.

The polio virus knows no borders and carriers frequently move from place to place. Meaning the virus can appear anywhere in the country. Despite heightened awareness campaigns, the ministry is still not achieving its target of having more than 90 per cent of children immunised.

“Some of the barriers include religious sects that do not believe in vaccination or modern medicine. The poor infrastructure and dire security situation in some regions has also made it hard for us to reach all children,” he says.

According to Dr Njeru, children who have received previous polio vaccines should still be immunised in every campaign.

“It is safe to administer multiple doses of the polio vaccine to children. The extra doses give valuable additional immunity against polio,” he says.

Article courtesy: The Star

Does Being Short Disqualify a Pregnant Woman from Natural Birth?

By Maryanne Waweru-Wanyama

When Valerie Kasaya was in her eighth month of pregnancy, she one day noticed an unusual discharge. Having had a smooth pregnancy all along, the discharge deeply worried her.

A resident of Kawangware slums in Nairobi, 20-year-old Valerie decided to go for a checkup at a public health facility in Westlands, a distance of about 14km away. That is where she had been attending her antenatal clinics.

At the clinic, Valerie was informed that her cervix had started opening, that she could give birth anytime. The nurses further told her to begin preparing for a caesarean section as it would be impossible for her to deliver naturally.

“Nurses told me that because I was short, this meant that my pelvic bones were small, indicating that a natural birth would not be possible,” she recalls.

Valerie is just about five feet tall. The attending nurse then referred her to Kenyatta National Hospital (KNH) since the clinic did not have the facilities required for the surgery.

“Even though I was disappointed to learn that I would not deliver normally, I trusted the medic’s verdict because they are the experts,” she says. But back home, Valerie’s mother would hear none of it.

“My mother insisted that I could still give birth naturally. She said she had seen shorter women than me deliver naturally. She asked me to seek a second opinion, and accompanied me to a nearby clinic.”

Valerie Kasaya with her baby

Photo: Valerie Kasaya with her baby.

At FreMo clinic, a small privately-run health centre that serves the low-income population of Kawangware, Valerie and her mother were excited to learn that physical stature alone is not enough to determine if a woman will give birth normally or not.

“The midwife at FreMo said they would let me try natural birth first and if it failed, then they would refer me to KNH for a caesarean section,” recalls Valerie. She was then sent home and asked to return when labour started.

A few days later, labour started, and she immediately walked to the clinic — a distance of about two kilometres. During labour and while waiting for her cervix to fully dilate, the attending midwife helped Valerie engage in some exercises.

“She made me swing my hips, squat, and also instructed me on how to breathe. She said all this would help the baby descend, as well as ease my labour.”

Four hours after the onset of labour, Valerie delivered a healthy baby boy weighing 3.1kg. During delivery, it was just her and the midwife and she had a smooth delivery with no complications. She did not even have an episiotomy (surgical incision on the posterior vaginal wall during labour).

“I was surprised because I had successfully delivered my son naturally, yet other nurses had told me that I was a direct caesarean candidate because of my small stature,” she says.

Both mother and baby continue to enjoy robust health with no complications. Her son is now seven months old. Magdalene Katuku, the midwife who helped Valerie birth her baby, says that it is possible for short women to deliver naturally.

“Natural birth is determined by a number of factors, and it is wrong for one to make assumptions based on height alone. Having a small stature does not disqualify one from a natural birth. It all depends on the size of the baby, and the size of the pelvis. A big woman can have a small pelvis, which may not allow the baby to pass through, as her baby might be big. In the same breath, a small woman can have an adequate pelvis that may allow her baby to pass through,” she says.

At FreMo clinic, Magdalene says the emphasis is on natural delivery. Last year alone, of the 211 deliveries, 207 were natural births, with four being referred for caesarean section to KNH when there were obvious indications that a normal delivery would not be possible.

Magdalene says that their successful rate for natural births is by design, not coincidence. “Throughout the pregnancy, we help the women engage in certain activities that help keep her fit and which boost her chances for a natural birth,” she says.

Pregnant women who attend clinics at FreMo learn about chest stretches, which reduce pregnancy aches and pains and improve blood circulation. They also learn about exercises that reduce back pain — a common concern in pregnancy.

In addition, the midwives teach the women how to do special press-ups, which help prevent aches and pains due to the growing belly. “We encourage the pregnant woman to walk throughout her pregnancy. Walking is a good cardiovascular exercise, and helps keeps her fit. She should however be cautious not to walk to the point of exhaustion or breathlessness,” says Magdalene.

FreMo clinic also offers free childbirth classes for women in their last trimester. Here, they are given information about the birth process, where they are taken through the stages of a natural delivery.

“We encourage them to come with their spouses for moral support. It helps the couple prepare themselves psychologically for labour, and build their confidence about the birth process. During childbirth classes, we answer all their questions as they share their fears and expectations. We reassure them, helping them build confidence in the body’s ability to birth a baby,” she says. Their partners also learn how they can support the woman during labour, such as helping her with breathing exercises and massaging her back.

During labour, the pregnant women are encouraged to squat, as this not only speeds up labour but also fastens the opening up of the pelvis, providing room for the baby to descend. They are not encouraged to lie on their back, as this slows down baby’s descent therefore prolonging labour.

“We are also never in a hurry when the woman is labouring. We are patient with her, and attend to her throughout the birth process, the ultimate goal being a healthy baby. Due to the close monitoring, we are able to assess and anticipate any complications that would necessitate an immediate referral and transfer to KNH, which we facilitate as we offer them transportation. All the above are what we believe has led to our high success of normal deliveries,” she says.

 

An expert’s view

Is it possible to tell if a woman will not be able to have a natural delivery judging solely by her height? According to Dr Stephen Mutiso, an obstetrician / gynaecologist at Kenyatta National Hospital, a diagnosis of cephalo-pelvic disproportion (CPD) is often the key determinant in such cases. Cephalo refers to the size of the baby’s head, and pelvic means the size of the birth passage.

A diagnosis of CPD means that either the baby’s head is too big for the woman’s pelvis, or the pelvis is too small for a normal sized baby. In women diagnosed with CPD, normal delivery is difficult and at times impossible.

“Small women tend to have a small pelvis, and are likely to have difficulties during delivery. Any woman with a small pelvis and whose baby indicates being slightly bigger compared to her pelvis is not advised to try normal delivery,” he says.

However, Dr Mutiso clarifies that there are short women who have small babies and go on to have successful normal deliveries, hence the need for proper assessment by the health professional during antenatal care or when labour begins.

“This assessment will help determine if the pelvis is adequate enough to allow baby to pass through. If the baby’s size is small to average, then labour should be considered,” he says. Dr Mutiso warns of attempts to push a baby that cannot pass through a small pelvis.

“This could lead to prolonged labour and cause obstruction, which in turn may result in complications such as fistula, rupture of the uterus, serious infection, excessive bleeding after birth and foetal distress. In some instances both mother and baby may die.”

Dr Mutiso says that in the event vaginal delivery goes on to take place, the mother can sustain serious perineal tears or cause damage to her reproductive organs. Further, caesarean deliveries done when one has been trying to push are more difficult and associated with increased complications.

“In as much as most pregnant women plan to delivery naturally, it is necessary for them to understand that complications may arise during labour, and which may necessitate a caesarean section. These complications include failure for labour to progress despite good contractions, foetal distress and excessive bleeding.”

Article courtesy: The Star

I Was Healed of Fistula Which Had for Years Embarrassed And Caused Me Agony

When nine-month pregnant Yvonne Njoki’s water broke at 7pm one Monday evening in June 2009, she was delighted as this only meant that she would soon hold her newborn in her arms. Then aged 26 years, she knew all would go well as she it had been a relatively smooth pregnancy.

Yvonne had religiously attended her ante-natal clinics at a private hospital in Gilgil, Nakuru County. So when her waters broke, she made her way to the same hospital where upon examination, she was told she had only dilated 2 centimeters.

With labor progressing slowly, the nurses attending to her decided to fasten it by inserting a tablet in her vagina to help quicken her baby’s arrival. The medicines used for artificial induction usually help soften the cervix, help it to open up, cause the uterus to contract, or stimulate contractions.

Twelve hours later and with no progress in her labor, Yvonne was inserted another vaginal tablet.  Another twelve hours later and still no sign of baby, she was inserted yet another tablet.

The following day, Wednesday morning at 7am, the medics used another induction drug, this time putting Yvonne on a drip to hasten the now stalled labor. It had been 36 hours since her waters had broken. This one worked fast for two hours later, she gave birth to a healthy boy. His birth weight was 2.7 kg.

She was attended to by two nurses who helped deliver her baby and who also stitched her episiotomy. An episiotomy is a surgical cut in the area between the vagina and the anus (perineum) made during labor to enlarge the vaginal opening.

Yvonne Njoki.

Yvonne Njoki.

Following the successful delivery, Yvonne, together with her newborn were discharged from hospital the following day. A week later, her stitches had healed quite well and she had no complications.

All went well until one month later when Yvonne began noticing some traces of stool in her vaginal discharge. After searching the internet, she was distraught to learn that she could possibly have fistula. She immediately sought the opinion of a gynaecologist who, after examining her, ruled out the possibility of fistula.

“He told me that as long I was holding my urine and faeces well, then it could not be fistula,” she remembers.

Yvonne returned home relieved, but this relief was short-lived as traces of stool in her discharge continued. Infact, the quantity of stool increased, leading her to invest in black panties to camouflage the discharge. A few weeks later, she was forced to begin putting on panty liners which would help effectively absorb the discharge.

Two years after the birth of her son and many panty liners later, Yvonne’s worry intensified as she had assumed that by then the discharge would have disappeared. She feared that she did indeed have fistula, a condition she considered shameful. She never confided in anyone what she was going through.

“I was too ashamed and embarrassed. How could I be suffering from a condition like this where I leaked faeces? Who would understand?” this pharmaceutical technologist asked herself many times.

As for her sex life, “I was lucky to be in a long distance relationship so my sex life was inactive and I liked it that way,” she remembers.

A few months later, when she couldn’t take it anymore, Yvonne decided to consult another doctor. She saw a gynaecologist who discovered a small hole between her vagina and rectum. He diagnosed the condition as rectovaginal fistula.

It was bitter-sweet news for her.

“I was sad because my worst fears had been confirmed – I had fistula, a highly embarrassing condition. But it was good news because at least my problem had been diagnosed and I could be treated. No more panty liners and stool-laden discharge,” she remembers.

She was then referred to a fistula repair specialist in Nairobi.

“The doctor examined and confirmed that I had fistula, and he further informed me that it had to be repaired as soon as possible because the hole had been getting bigger with time. Which was true because by then the stool in my discharge had continued to increase in quantity. I was doing up to five full panty liners in a day!”

Two and a half years after the birth of her son, Yvonne underwent a successful fistula repair surgery at Kenyatta National Hospital (KNH).

But she wondered what had caused the fistula.

“I had no obstructed labor and my baby was only 2.7 kg’s at birth, so I wondered how I could possibly have developed fistula. But upon further enquiry, I was informed that it could be that my episiotomy was not repaired well. I later found out that the hospital I delivered in had some unqualified staff,” she says.

“My advice to women is that they should not be blown away by the lure of private hospitals and their luxurious facilities. Sometimes they do not have competent medics. Atleast with government facilities you are sure the staff are skilled,” She advises.

Yvonne also advises people to seek second, third or fourth opinions if uncomfortable about a diagnosis.

It has been almost three years since the operation, and she is completely healed.

“I have no more leakages and I now live my life fully. I can now wear white panties and I have never worn a panty liner since the operation,” she says, beaming with joy.

Yvonne's four year-old son.

Yvonne’s four year-old son.

What is Vaginal Fistula?

A vaginal fistula is an opening that allows urine or stool to pass into a woman’s vagina – in what is known as incontinence. Women with fistula suffer from constant leaking of urine and / or feaces. Fistula is mainly caused by a prolonged and or obstructed labor

According to the World Health Organization, between 50,000 to 100,000 women worldwide develop obstetric fistula each year. Most of these cases are in developing countries.

A 2010 study published in the BioMed Central Journal on select hospitals in Kenya found that some of the risk factors for developing obstetric formula included: delays in making decisions to seek delivery services after six hours of labor onset, taking more than two hours to reach a healthy facility, and labor duration of more than 24 hours.

Women with fistula face a myriad of problems. Leaking urine and faeces can in turn lead to other medical problems such as genitals sores or ulcerations, frequent infection, dehydration and kidney disease. A lot of stigma is also associated with women who have fistula. Because of the leaking urine or feaces, they emit a constant unpleasant odour, and it is this that makes people reject, isolate and abandon them. Furthermore, because of difficult sexual relations, some husbands leave their wives. Many such women live a sad life, sometimes leading to depression and in some cases, suicide.

Fistula also has economic repercussions. Many women with this condition often experience a disruption in their normal living. Because of the associated stigma, they soon find themselves cut off from their families and friends, finding it hard to attend family, community, religious or social gatherings. Many eventually find it hard to work and earn money, driving them into poverty.

Obstetric fistula is both preventable and treatable. One way is through strengthening health care systems, which should then be able to provide accessible and quality maternal health care by skilled attendants. Access to emergency obstetrics services to all women around the country should also be a priority.

 

*This is a story that I originally published in the County Newspaper. 

Malaria in Kenya: The Facts

Today is World Malaria Day. Even though Kenya has made great strides over the last 10 years in the fight against the disease, alot more still needs to be done, as malaria is the leading cause of morbidity and mortality in Kenya.

Here is a glance of Malaria situation in Kenya:

  •  25 million out of a population of 34 million Kenyans are at risk of malaria.
  • It accounts for 30-50% of all outpatient attendance and 20% of all admissions to health facilities.
  • An estimated 170 million working days are lost to the disease each year (MOH 2001).
  • Malaria is also estimated to cause 20% of all deaths in children under five (MOH 2006).
  • The most vulnerable group to malaria infections are pregnant women and children under 5 years of age.
  •  Malaria is preventable and curable. (Source: KEMRI).

The government has a 10-year Kenyan National Malaria Strategy (KNMS) 2009-2017. The goal of the National Malaria Strategy is to reduce morbidity and mortality associated with malaria by 30% by 2009 and to maintain it to 2017.

Here are more elaborations on Kenya’s malaria situation. 

MalariainKenyaWEB

Malaria mappingmalaria

Malaria mothersatrisk

Malaria DiagnosingMalaria

Malaria Knowledgegap

Malaria Treatingthefever

source of data graphics and information: InternewsKenya

 

What Happens to a Kenyan Woman’s Family After She Dies While Giving Birth?

Every two hours in Kenya, a woman dies during pregnancy or childbirth. Quite unfortunate.

A new report on maternal health in Kenya has further amplified the devastating impact of a mother’s death on her family and in her community. The study, titled: ‘Price Too High to Bear’, reveals that that the unfortunate deaths of these women (mostly preventable), gravely affect her immediate family, the survival of her newborn, the health and opportunities of her surviving children, as well as the economic productivity of her family and her community.

The report by Family Care International (FCI), the International Center for Research on Women (ICRW), and the KEMRI/CDC Research and Public Health Collaboration in cooperation with Kenya’s Ministry of Health highlights the financial costs of the deaths of mothers in poor remote communities on their households, as well as the impact of these costs on family well-being.

The study was done in three sub-counties in Western Kenya (Rarieda, Gem and Siaya town -all in Siaya County) between 2011 and 2013. These were the following key findings:

The loss of a mother harms her surviving family members, her children’s health, education, and future opportunities.

The report states that of the 59 maternal deaths in the study, 14 women died during the last three months of pregnancy, one died during labour, and 44 died post-delivery. It is also important to note that over 70% of the maternal deaths occurred in the course of a normal delivery, while the remaining ones who died had experienced a caesarean section, use of forceps, or other intervention during delivery.

The link between maternal death and high neonatal mortality was also demonstrated:

Of the 59 women who died, 31 infants survived delivery. Of these, 8 died in the first week of life, with another 8 dying in the next several weeks. This left a total of only 15 surviving babies from 59 pregnancies.

In most of the households, the women who died used to carry out various tasks in their homes. These women used to contribute an average of 61 hours of household work each week, with tasks including; childcare, cooking, laundry, and fetching water and firewood. Following their deaths, the women’s husbands, mothers-in-law, older children, or other surviving family members had to pick up the slack, with 88% of families reporting that this had reduced these members’ ability to contribute earnings to household income.

Some of the deceased women were also involved in farming. For these, their deaths in some cases forced the household to allow land to lie fallow, or to cultivate fewer crops. Some families indicated that they had lost crops after the death of the woman, because surviving household members were not able to allocate to farming the time they had when the woman was alive.

A mother carries her son on a farm in rural Kenya.

For the surviving school-going children, they were in some cases withdrawn from or forced to miss school, because economic disruptions made it difficult to afford school fees. The household could no longer afford to pay the school fees, because the mother’s income was not available any more. Even when there was some money, it was used to hire casual farm labour.

Where children continued their schooling, often their grief and new household responsibilities negatively affected their schoolwork. In a number of cases, families reported that children withdrew from school altogether. Others who remained in school often had less time for schoolwork — and less time to actually attend school due to the additional household chores and because they had to take care of their younger siblings.

Social, emotional and other non-­economic consequences

In many parts of Western Kenya –where the study took place, a ‘household’ is made up of all those who eat under the same roof. Before the mother’s death, majority of individuals in the household ate in the woman’s home. But after she died, only about a quarter of individuals from her household continued eating in her house. Of those who changed where they had their meals (most of them children aged below 18 years), they said they did so because of the death of the mother. In most cases, children began taking meals in the home of their grandmother. Other children were removed from household and given out to relatives for foster care.

When a woman dies, her funeral costs are a crippling hardship for her family.

Funerals are a big deal in Africa, and Kenya is no exception. Many communities strive to give their departed relatives a ‘grand, respectable’ send off which could see them spend huge amounts of money. Across all wealth levels of households interviewed, families’ funeral costs exceeded their total annual expenditure on food, housing, and all other household consumption. On average, economically active members took a month off from work during the funeral period. Given the already high costs of the funeral, this lack of economic activity is an additional burden for the household.

A mother selling potatoes by the roadside in rural Kenya.

Those are just some of the key findings of the study. Indeed, it only goes to show that Kenya continues to have a high maternal mortality rate, despite commitment from the government to address the issue. It only means that the country needs to pull up its socks in reducing maternal mortality rates. Meanwhile, 2015 is just around the corner, and I wonder if my country will be able to achieve MDG5, that of reducing maternal mortality.

I can only hope for the best.

A Difficult Pregnancy and Premature Twins Inspired A New Venture

Her twins were due on 20th July 2013, but they came early -on 29 April 2013. It had been a difficult pregnancy right from the beginning, as she experienced heavy bleeding, severe cramps, had an open cervix…until doctors recommended that she undertakes a cervical stitch if she wanted to save her babies. She is Maryanne Kariuki, and it is this experience that led her to begin her own personal initiative, the A & J Initiative. Read more….

Maryanne_Kariuki with her twins Avie and Jamie.

Maryanne_Kariuki with her twins Avie and Jamie.

Amara Initiative: Training on First Aid for Kenyan Parents and Nannies

Amara

Living with Epilepsy in Kenya: A Young Woman Shares Her Story

The estimated number of people living with Epilepsy in Africa is close to 10 million. Of these, 75% are children and adolescents below the age of twenty years. In many African communities, Epilepsy is associated with withcraft, and because of the stigma attached to Epilepsy, many of them never get to see a medical professional about their condition, and therefore continue to suffer the negative consequences of this.

Sally Njenga is a young Kenyan woman who was fortunate enough to seek medical intervention for her Epilepsy, and is today an Epilepsy awareness advocate. She shares her story.

Shiatsu Therapy: The Story of Angeline Akai, A Visually Impaired Lady

On a Saturday morning, Angeline Akai walks to work from her Kibera house to the Salus Oculi offices in Hurlingham, Nairobi. Angela is a shiatsu therapist.

Shiatsu is a unique, non-invasive therapy designed to stimulate the body’s inherent ability to heal itself. Angeline’s work involves the application of pressure on a client’s body using her fingers, thumbs and palms in a continuous rhythmic sequence. This stimulates a natural flow of energy through the body, calming the nervous system, improving circulation and relieving stiff muscles and easing stress. In Shiatsu therapy, no massage oil is applied, and the person remains fully clothed throughout the therapy session.

Angeline has been doing this job on a part-time basis for the last eight years. She is totally blind, and hers is a story of determination.

At the age of three, Angeline got a measles attack but unfortunately, lack of timely medical intervention threw her into the world of darkness. Angeline attended Kilimani Primary School, an integrated school which accommodates children with special needs. She attended the school courtesy of Sightsavers International.

Each day, Angeline had to trek to and from her Kibera home to school, something that was very difficult, more so when crossing the busy roads. Often, she would go hungry all day long owing to her parent’s inability to pay for her lunch. Many times, her family would do with only one meal a day. It was also the norm for the family to spend nights in the cold owing to her father’s inability to pay house rent.

Owing to these challenging circumstances, Angeline was lucky to get a place at Thika School for the Blind in class six, where she was able to comfortably pursue her studies.

“Life was much easier there, though each time I thought of my family and their tribulations back home, I would get very stressed.”
But in spite of these woes, Angeline managed impressive grades in her Kenya Certificate of Primary Education (KCPE). Scoring 510 marks out of 700, she was admitted to Moi Girls’ School Nairobi, a school which also caters for those with special needs.

As her parents were once again unable to pay her fees, Angeline’s stay in school was erratic, as she relied on different well-wishers to settle her arrears. Despite this struggles, she sat for her Kenya Certificate of Secondary Education (KCSE) in 2002 and attained a C plain.

“My dream career was in counseling and I looked forward to joining university. But I knew that was just wishful thinking because my parents couldn’t afford it and from experience, I knew that finding a sponsor was going to be difficult,” she remembers.

To keep herself busy, Angeline, together with other visually impaired people were trained in shiatsu therapy by the Japan International Cooperative Agency (JICA).

Luck smiled on her when in 2004, she got sponsorship to Highridge Teachers College where she later graduated with a P1 teaching certificate. The challenge, however, lay in securing employment.

“When I talked to my fellow graduates who were sighted, they told me they were also facing difficulties in being absorbed into the teaching industry. As a blind teacher, my chances were close to nil.”

To avoid becoming rusty in her teaching skills, Angeline volunteered at her former school – Kilimani Primary. She also continued working as a shiatsu therapist and used her income to support her parents and siblings.  Among her three other siblings, Angeline is the only one who made it beyond class 7.  In those days, before the introduction of free primary education, her parents could not afford the required school fees.
As she continued searching for a job, Angeline secured sponsorship for a certificate counseling course at Kenya Association of Professional Counsellors (KAPC) in 2006.

“Counseling has always been my passion. After taking the course, I confirmed that counseling is where my passion lay. I resolved to take a degree in counseling. Sadly, the sponsorship was only for a certificate. I hope to attain a degree in counseling someday.

In January 2009, I got a job as a rehabilitation assistant at Nairobi Comprehensive Eye Services. My work involved identifying recently blind people in different communities, counseling them, and training them on independent living skills. Many newly blind people live in denial about their visual inability, and many of them still harbor lots of anger and bitterness towards life. My counseling skills came in handy as I spoke to them, and encouraged them to accept their status and move on with their life. Blindness is not the worst thing that can happen in life.”

Unfortunately, the project Angeline was affected by dwindling donor funds due to the economic crunch, forcing it to downsize. Angeline was retrenched just a few months into the job she had come to love.

Martin Kieti, Executive Officer of Kenya Union of the Blind (KUB) says that among the greatest challenges for people with the disability is securing employment.


“It is very difficult for blind persons to find employment in Kenya unless they have qualifications that are above average. Most blind persons train as teachers, with the profession accounting for more than 90% of blind persons who proceed to tertiary institutions

Unfortunately, since the Teachers Service Commission (TSC) stopped the direct employment of teachers from college and introduced the interview system at District Education Boards (DEBs) and Boards of Governors (BOGs), many blind teachers are today going unemployed,” says Kieti.

As she continues to search for a job, Angeline today survives on her earnings from shiatsu therapy. On average, she makes 7,000 shillings a month. Her income is spent on among other needs, rent for her one-room house in Kibera which she shares with her sister – a single mother. She also supports her father, now a widower.

Angeline and other visually impaired people who practice Shiatsu therapy are hosted by Salus Oculi Kenya, an organization which empowers the visually impaired.

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