What We Do - Health

(KUAP-Pandipieri operates in Kisumu, Western Kenya. Kisumu is the third largest city in Kenya, situated on Lake Victoria. It is one of Kenya’s poorest cities, facing challenges of food insecurity, growing urban poverty and a high prevalence of HIV/AIDS. UN statistics show that approximately 60% of the population of Kisumu lives in slums and 15% are living with HIV/AIDS. Approximately 100,000 people are being targeted by KUAP interventions, about one third of the total population of the area. Children, people living with AIDS (PLWA) and people living in the informal settlements (slums) are the main beneficiaries.

In contrast with the peri – urban environment of Kisumu, the Diocese of Lodwar is based in the Turkana, a semi-arid area in north western Kenya. The population is made up of nomadic pastoralists who travel long, arduous journeys in search of water. Due to the shortage of water, the region and its inhabitants are vulnerable to persistent drought, food insecurity and violent clashes between neighbouring tribes. Being unable to easily access clean water is not only a source of conflict between neighbouring tribes but also a cause of poor standards of health and high levels of malnutrition among the nomadic population.

While the two health care partners target very different communities and face different challenges, both are achieving their stated objectives and indications are that the health of the local populations is improving as a result of their interventions. KUAP are primarily focused on training community workers to provide health services to children. The Diocese of Lodwar is the main provider of health services to the people of Turkana, from running primary health care clinics to the operation of one of the regions only hospitals, the Kakuma Mission Hospital.

Aidlink’s health programme is funded by Irish Aid under a three year block grant. The funding for the health programme is supporting the Diocese of Lodwar in its ongoing running and maintenance of the primary health care facilities for the rural, nomadic population and helping KUAP in the delivery of healthcare to the people living in the slums of Kisumu.

(The Diocese of Lodwar works with the Turkana community at a grassroots level across the region. Through its network of 25 parishes, 300 outstations and 6 development departments (Health, Water, Education, Women, Youth, Justice and Peace), the Diocese provides the majority of health services in the region and is the major development actor in Turkana.

The Diocese of Lodwar’s health programme provides 65% of all healthcare in Turkana. Through its well equipped Mission Hospital in Kakuma, 9 primary healthcare centres and 2 health clinics, almost 400,000 men, women and children in Turkana benefit from some aspect of the Diocese’s health programme. The reach of the health programme is further extended to isolated nomadic communities through outreach work and a health education programme in all schools across Turkana.

The main activities of the health programme are the operation of the medical facilities, training of medical staff, HIV and AIDS programme; maternal health services; nutritional programmes; building community awareness of health and sanitation issues.

(HIV and AIDS permeate every aspect of life for the people of Kisumu, Western Kenya. Rapid urbanisation in the last decade, coupled with low investment in infrastructure and basic services, has resulted in enormous pressure on the urban environment. With an annual growth rate of 3.35% and a population density of 828 people per square kilometre, Kisumu has one of the highest population densities in Kenya, bringing with it the associated complexities of urban planning. There has been a marked increase in the urbanisation of poverty, with huge increases in informal settlements and a corresponding increase in disease infection rates associated with the lack of health facilities and foul environmental conditions.

Kisumu has very high poverty levels. Over 60% of the rapidly growing urban population of 500,000 people live in the peri urban settlements (slums) and lack adequate shelter or access to basic services. 73% of the population of Kisumu is below 30 years. The rate of people living with HIV and AIDS are very high in Kisumu - approximately 15% of the population, compared with an average across Kenya of between 7-8%. (Ireland’s rate of infection is 0.2% of the 15-49 year age group).

In 2005 in Kisumu, there were 3,000 deaths recorded as a result of HIV and AIDS complications and approximately 70,000 AIDS orphans. Against this backdrop, KUAP’s programmes take an integrated approach to tackling poverty and to providing basic health, education and social services to the most vulnerable people of Kisumu, particularly people living with HIV and AIDS, vulnerable youth and orphans and vulnerable children.

Photo: Eric Luva (left) and his family in Kisumu. Eric (8) and his brother were taken in by their aunt Lorna in January 2009 as their parents could no longer care for them. Lorna now has 5 children to care for and is supported by KUAP through their health, education and child services programmes.

For every additional vulnerable child placed in a household, there are far reaching consequences for both the child and the guardian. The most cited constraint is economic changes brought about by spreading out the already limited resources of the household. Such concerns constrain people and make caregivers shy away from taking in orphans and most vulnerable children. Conversely orphans joining poor families only increase the level of poverty in the households. Helping the child thus entails helping the caregiver and the community, and educating all those concerned with providing support for the child.

KUAP’s integrated community health programmes link the Patient Support Centre, HIV and AIDS project and the Child Counselling project, to promote adherence to Anti Retro Viral treatment (ART) and to reduce the spread of HIV and AIDS in the community, through continuous education and support.

The community education and outreach components of KUAP’s programme includes nutritional education in Prevention Care Demonstration and Education Clinics, school visits, community awareness sessions, formation of HIV and AIDS prevention clubs, and use of Theatre for Development (TFD). In 2009, approximately 12,000 people (men, women, youth, children, church leaders, and teachers) received health education through KUAP’s schools and community outreach programmes. Football team members were also trained on behaviour change and HIV and AIDS. Many youth had only a vague understanding of HIV and AIDS and did not know enough to prevent its transmission. Four of the football teams formed Behaviour Change groups and are making a difference to peers in influencing them not to engage in risky behaviour. The group aims for a healthy life free from HIV and AIDS and they are committed to achieving this aim.