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Kenya, 14 August 2016: Going the last mile for pastoralist children at the Kenya-Somalia border

© UNICEFKenya/2016/Abagira
Four year old Halima Hussein is a nomadic child who was reached during the 2016 Measles-Rubella Immunization Campaign launched by the Government in May. Marwa and her team found her family travelling along the Kenya-Somalia border.

By Dr. Abdullahi Abagira and Bibi Aisha Mbete

DADAAB, Kenya, 14 August 2016 – Shrubs, thorny bushes, hot sand and the scorching sun characterize Kumahumato, a remote village 30 kilometres north of Dadaab near the Kenya-Somalia border. Healthcare is a human and constitutional right, yet access to quality health services remains a challenge for the pastoral communities of Kumahumato that have suffered from decades of marginalization and insecurity.

Marwa Osman Abdow, 22, is a Community Health Extension Worker (CHEW) who supports the Kumahumato and Libahalo Community Units in the Dadaab Sub-county of Garissa. Born and bred in Garissa Town, Marwa never anticipated that one day she would have to leave the comfort of her parents’ home and move 120 kilometres away to an area of severe hardship in order to serve her community. She embraced the challenging work environment and has found ways of offering basic quality healthcare to pastoralist families.

As a CHEW, Marwa supervises Community Health Volunteers (CHVs), who work within the Dadaab Community Units. She works hand in hand with them to ensure that every household is reached. Marwa does household visits whenever there are cases that require additional attention from a qualified health professional. Fortunately, she is able to treat and manage cases of diarrhoea, malaria and moderate malnutrition. In addition, where possible, Marwa facilitates referrals to the nearest health facilities for the more severe cases.

With support from UKAid and UNICEF, Marwa has done the training for the basic Community Health Extension Workers as well as the technical training modules for the Trainer of Trainees for Community Maternal and Newborn Health.

She says, “It is from these trainings that I was oriented in understanding my role as a CHEW. The trainings have equipped me with the critical knowledge and skills to contribute to the reduction of the high burden of mothers and children dying from preventable causes. Our health centre has also benefited from the new Maternal and Newborn Health equipment supplied last year by UKAID and UNICEF”.

Unskilled deliveries are still a very common occurrence in the area that Marwa covers. To help tackle this problem, Kumahumato Health Centre now uses the Nomadic Strategy in targeting and reaching populations that are constantly on the move.

Marwa says, “With the vastness and insecure situation in this region, we need innovative approaches to reach the most vulnerable because these people have extraordinary needs. The health centres are too far apart and it takes a high level of endurance by the people to access them.”

Marwa adds that, “The situation is even tougher for expectant women and children who rely on someone to take them to a health facility.”

© UNICEFKenya/2016/Abagira
Marwa Abdow is heading out to one of her household visits in Kumahumato, Dadaab. She works as a Community Health Extension Worker, supporting Community Units along the insecure Kenya-Somalia border.

Implementing the Nomadic Strategy comes with its fair share of challenges. Team spirit, determination and flexibility are what drive Marwa and her colleagues during mobile clinics and immunization campaigns.

In order to reach the most vulnerable women and children, they walk for many hours, often without food and water, braving the unbearable heat while risking to be stung by scorpions or bitten by a snake.

Marwa says, “My satisfaction comes from knowing that I too can contribute positively to this community.”

While performing her duties she also finds that she has to multi-task as a translator between the non-local health workers and the illiterate nomadic women and children.

Marwa adds, “I ensure that with the few mothers and children that I am able to reach out to, I find friendly ways of sharing the valuable maternal and child health knowledge and skills acquired from the UKAid-UNICEF training.”

In May 2016, Marwa and her team were part of the nationwide Measles-Rubella Immunization campaign. Through their hard work and determination they were able to significantly extend immunization coverage in the region compared to past initiatives.

© UNICEF Kenya

It was during the campaign that they met Halima Hussein, a 4-year-old girl who had never been vaccinated since birth. Her family was found traversing the vast arid stretch along the Somali border searching for pasture and water. Little Halima was quickly given the standard schedule of vaccinations, including those against measles and polio. She was also given Vitamin A supplementation.

Despite the challenging working conditions, Marwa has found ways of adapting and plans to continue serving this community with pride.

She explains, “Somalis are very close. We share everything and look after each other. I live in the same homesteads with the community and also share with them what I have. This has made this community accept me. I may not have the luxuries that health workers in other areas may enjoy, but I know my presence here is needed.”

The Maternal and Newborn Health programme supported by UKAid and UNICEF continues to strengthen health systems and community health services in Garissa using the model of the Centres of Excellence. Implementation of the Nomadic Strategy is integral to ensuring that the most vulnerable populations in high-burden counties in Kenya, receive the life-saving health services that they so much need and deserve.



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