Who is CHAT?

Community Health Africa Trust (CHAT) runs mobile health clinics providing services in very remote northern Kenya. They offer antenatal care, child growth monitoring, child immunisations, basic curatives, HIV/AIDS testing and counselling, and health education on HIV prevention, hygiene, and the dangers of female genital mutilation awareness. However, the core focus is reproductive health and family planning.

“Family planning could bring more benefits to more people at less cost than any other single technology now available to the human race.” - UNICEF

But the challenges are huge. These people are soooo poor.

Currently, the Kenyan population has reached 37 million and is growing at a rate of 1.3 million new babies each year. On average, each woman in the nomadic communities of northern Kenya has seven children!

What does CHAT do?


CHATs services are delivered by vehicle, bicycle and on foot. And when traveling to the most remote, nomadic communities, we travel with camels. The mobile camel clinic’s routes and the location of its stops are constantly adapted to suit the communities we serve. If the community has moved in search of water and pasture, then the clinic follows them. Our motor clinics (in distinctive yellow Land Rovers) use a more regular route, with set dates at each station. The clinics are organized to reach at least 35-40 communities monthly. The result is that each time the mobile clinic team arrives at one of its various locations; they find a group of people waiting for them, often under the shade of an Acacia tree. The vehicles, bikes, or camels are parked, a table or two is set-up, medicines un-loaded, and the treatments and consultations begin. And they continue for as long as the light permits. The strategy is basic, flexible, and effective.

Family Planning


In 2011 CHAT provided 10,000 women with contraceptives. Until 2008, most women used the Pill or the injectable Depo Provera for contraception. However, in the last two years (2009-2011), with increased awareness-raising and availability through CHAT, over 11,000 women have taken up the five-year protection offered by implants and over 200 have received tubal ligations. Currently, demand for long-term methods of family planning in these areas is exceeding CHAT’s capacity to provide them.

CHAT has a real problem trying to get funding for family planning, it just doesn't seem to be 'fashionable'! (Like HIV/AIDS funding). So CHAT relies on little bits and pieces, for example, $10 per month donated by ex-volunteers or friends of volunteers. like YOU!

Female Genital mutilation


The cultural practice of female genital mutilation is illegal in Kenya. However, this traditional "rite of passage" for young women is deeply embedded in the cultural fabric of many tribes and is still widely practised in all the communities that are served by CHAT’s mobile clinics. Clinic staff attempt to raise awareness of the physical and emotional dangers attached to this activity. Concerns are addressed through community discussion groups and local schools. Awareness education is supported by the use of video material. Education efforts target young men who are encouraged to debate the ongoing necessity for such a practice and to eliminate their expectation of a “circumcised” bride.


HIV/AIDS


Since 2004, CHAT through its clinics and network of community-based counsellors, has succeeded in counselling and testing an increasing number of people for HIV, from 641 in 2004, to a staggering 16,000 in 2011. Of those tested for HIV, CHAT found a total of 1,345 to be HIV positive and has assisted these people with treatment for opportunistic infections, support groups, and has linked them with other organisations offering further support, such as antiretroviral treatments.

CHAT has reached an average of 40,000 people – adults and students - every year with HIV prevention messages through video shows, discussions, condom demonstrations and information about the prevention of mother to child transmission and prevention with positives.

It is all about the Community Workers


Because of fluctuating funding, CHAT’s mobile clinic is only able to visit a community approximately once a month and, of course, problems persist in our absence. Many of the communities we serve are so remote that we are the only source of reliable health care. Because of this, we train individuals in communities to become family planning community based distributers and community based HIV/AIDS counsellors and testers. These people provide on-going support to the local populations when the clinic is not present. They also serve as CHAT’s “ears” on the ground, giving us regular feedback, through their formal and informal reports, on the community’s satisfaction with the services we provide, on the needs of the communities, and also on the community’s whereabouts as they are often on the move.

It's all about family planning services

I've just written another report to be loaded on to the US website that asks for donor funds...
http://www.globalgiving.org/projects/chats-family-planning-environmental-initiative/



A new patient looking for family planning advice

Hello there!

 We hope this report finds you well and enjoying summer.

Some exciting news has taken place since our last report that we thought you might enjoy hearing about. The London Summit on Family Planning has just recently raised 4.6 billion in pledges- the Bill and Melinda Gates Foundation leading the charge with a pledge of over 1 billion, followed by 2.6 billion from a group of wealthy nations, and 2 billion from developing countries. These monies are estimated to deliver contraceptives to 120 million women by 2020.

 As our team at CHAT has been working tirelessly for just over ten years to teach about and give access to safe and affordable birth control, we were very pleased to catch wind of this recent progress and focus. Many women and the communities in which they live, men included, are slowly beginning to trust in the positive aspects of birth control, despite their often strident cultural norms. The demand is there, and as long as funding allows, we will continue to ensure that it is met. Our hope is the promotion of healthy, empowered women and, therefore, healthy babies-the result of access to safe and affordable birth control.

Interview by Misha Mintz-Roth while on the CHAT mobile clinic

 Sunday, July 1st, 12PM, near Sogotan village, Laikipia

Jeremiah Lerangere is his mid-to-late 20s. I interviewed him at his family’s boma, which is about a 2 hour walk from Sogotan village. 16 people live in his boma: 1 senior (mzee); 5 wives (bibi); 4 men (morans); and 6 children.

Jeremiah told me that his family first learned about CHAT’s mobile clinic and family planning services in 2007. He and members of his boma had first met up with the clinic when it came to stop at location in front of a nearby river. He said they had originally come to the clinic not in search of family planning services, but simply in order to treat members of his family who were sick at the time. He saw the clinic primarily for its counselors who could tell him whether his, or his children’s sickness, was so bad that he would have to go to the hospital. But he remembers only being told to take medication.

At this meeting in 2007 his family members first learned about family planning. But it took them three years, until 2010, before the wives of the Boma decided to start using family planning methods. Jeremiah said that everyone, including the mzee, wanted the women to start using it. Every women, he says, is now using 3-year or 5-year contraceptive injections. When I asked if there was any stigmatism about using it he replied there is no such problem. He said that all the women need the consent of the mzee, and so long as they have his consent it is fine. In the case of his boma, Jeremiah says that the mzee encourages family planning methods.

Nowadays they receive information about the mobile clinic through Pauline Lokipi, one of CHAT’s mobilizers. He says they receive her information through their mobile phone. Despite using instantaneous communication, it is important to let them know at least a week in advance, because they are not always in a place a mobile network. In addition, because they often have to prepare to walk some hours to the clinic location, it is best they the exact date ahead of time. But he says once they know a date for the clinic and that they are able to spread word, they will do so.

  

We send you lots of salaams, as always, and will check back in a few months from now.

 Tutaonana badaaye (goodbye until later, one of my favorite swahili sayings)!

 ~The Team at CHAT

Always good to set up under the shade of a tree





The long road ahead









A "boma"

Return of the Camel Clinic

I am volunteering for a community based organization called CHAT (Community Health Africa Trust). Run by an amazing lady called Shanni, who organizes mobile health clinics out into the remote Maasai, Samburu, Turkana communities north of here. The clinics are out there for a week in a yellow 4WD with one nurse & a driver. Or out there for a month travelling by camel, walking 12 hours a day: a nurse, doctor and HIV counselor. The main focus is family planning, but they also provide general medical support, immunizations for children, HIV testing and counseling, and FGM (female genital mutilation) education.

Today I ventured to Mpala Ranch (the adjacent property to Shanni’s) and welcomed the return of the Camel Clinic. This particular camel clinic was away for 4 weeks: there were 6 camels carrying all the provisions, 4 camel handlers, a doctor, a nurse .. Susan who features in this utube video http://www.youtube.com/watch?v=FsOlILl2jlc&feature=player_embedded .. and a HIV counsellor.

The group walked a 300km round trip, walking up to 12 hours a day. 




Shanni, the boss
Samuel, the HIV cousellor
Susan, the dynamo nurse
Joseph, the doctor

Astounding stuff!

The most amazing thing about this whole situation is the demand. Statistically in this area, the women are having 8 to 12 babies in their lifetime. There is some stigma from the men, but the women are certainly open to the family planning message. Susan, the nurse, tells me that on this trip she inserted (or reinserted) 700 long term (5 year) and over 100 short term implants (3 months). Joseph, the doctor told me that in one area, many many young girls came to see him; they had un-safe abortions (ie village hack jobs) and they came to see him (in the night, so not to get in trouble from the community) and asked for family planning.

The camel clinic had been to this area previously a year ago. But there is never enough funding for the camel clinics and Shanni schedules one whenever a donor gives her some money for them. It costs just 6,000 USD$ for a month-long camel clinic and the effect they have is enormous. I had hoped to be able to join a camel clinic while I am here, but unfortunately, this is the last camel clinic scheduled right now, as Shanni has run out of money.


If you feel the urge to donate some money, please feel free to do so, on this website!
http://www.globalgiving.org/projects/chat-mobile-health-clinic-remote-kenya-camel/

 

A day in the life of the CHAT motor mobile clinic team

I've just finished uploading this story on the Global Giving website for CHAT...... http://www.globalgiving.org/projects/chat-mobile-health-clinic-remote-kenya-camel/

A day in life of the CHAT motor mobile clinic team

A high-pitched yelp of an African hyena wakes up Peter Obino at the crack of dawn. The CHAT mobile clinic driver quickly wakes up and it suddenly hits him that it is six in the morning and the mobile clinic Land Rover was not loaded last night, as is usually the norm.

He quickly summons up a young lady named Anne who is the clinic nurse and HTC counsellor Samuel. The trio then start the frantic job of packing boxes filled with curative medicine, Family Planning commodities, BP machines, record books, safety boxes, condoms...

After a rushed breakfast the motor mobile clinic gets underway driving through the undulating plains of Laikipia, dipping and curving towards ISIOLO Samburu - some of the most marginalized and remotest areas in Kenya.

Laikipia, Samburu and Isiolo counties are inhabited by poor, illiterate often nomadic communities without access to basic healthcare amenities and family planning services. Most of the inhabitants often confess that the 'yellow' Land Rover is the only hospital they have known all their 'poor, wretched' lives.

Barrelling for Kipsing village in Isiolo county where a mobiliser is waiting with a group of people, the driver endures a three-hour drive on a rough seasonal road often stopping to honk the horn after passing through manyattas, mobilizing people and informing them that the clinic will be camping in their village.

It is usual to meet young Maasai morans dressed in colourful shukas often stopping the mobile clinic for a pack of 'cookies', a rural slang for condoms which the clinic distributes under its HIV/AIDS programme.

A few kilometres to Kipsing, the car wobbles dangerously and it is a burst tyre yet again! It is now over 100 Fahrenheit and the Bridgestone tyres can't seem to take the searing tropical heat. Far into the distance, a crowd is already milling around the chief's camp eagerly waiting for the clinic's belated arrival. Peter, an old hand quickly changes the tyre and speeds towards the already lined up women, men and children who had been mobilized the day before by a local health worker who works alongside CHAT.

The unpacking and setting up the clinic takes one hour and then treatment gets underway. It is almost midday and the crowd is getting restless - they have come a long way, some of them as far as Lpussi and Lchakwai in the north, Samburu east district just for these services.

At this station alone 30 women choose long-term family planning while 3 expectant mothers are taken through the ANC clinic.  Two children with septic wounds are also cleaned and bandaged. Major diseases treated here include URTI, Malaria and a case of STI. All in all 17 people are treated and 20 are tested for HIV/AIDS.

At five in the evening the nurse and the driver assisted by the HTC load up the car and head to the chief's homestead to camp for the night.

It is the end of yet another gruelling day for the CHAT mobile clinic who will be camping out for the next 7 nights before returning to base in Laikipia

~ The Team at CHAT

Volunteering for CHAT in Nanukyi, Kenya

Well, I have arrived in Nanukyi in Kenya. I will be spending the next 3 months here, volunteering for 'Community Health Africa Trust' (CHAT). www.chat-africa.org


CHAT is an NGO that runs mobile health clinics to the maasai communities in this area. They provide family planning, tuberculosis, HIV & FGM (Female Genital Mutilation) education. Such essential work, this organisation is run by a Shanni, an amazing woman, who has a small cottage on her family property where I am living. Milima Tatu, literally 'three mountains', is the name given to the area, and I can see Mt Kenya (the second largest mountain in Africa) from my breakfast chair. I plan to hike the 5 days up to the top sometime in the next 3 months.


Volunteers for CHAT are provided with accomodation in a 2 bedroom cottage, it is simply furnished and the starlings and squirrels wander in at leisure! There is a 12v solar system that powers my lights at night, but sadly fails to power the small solar fridge (it is sitting under the sink in the kitchen picture). So I cannot keep any food or drink cold. This really requires careful shopping! Water for my shower comes from the river and is heated by a "donkey", Mweenie, my 'housemaid', comes every morning at 7am to to light the fire. Not very effective, I must say, and the water is but a dribble! I might be a little pissed off with this after 3 months!!! Toilet & washing water is also brown river water. Drinking water is taken from the rainwater tank and boiled by Mweenie. She also does my laundry by hand, again not very effective! But I do feel very spoilt to have her.


I can't walk around in the evening, there could be lepoards that come on to the property. So I make sure that my laptop is fully charged during the day and enjoy a movie and music on my ipod in the evenings. It is a pretty quiet and relaxing environment. During the day, Shanni & I go to town, 45min drive down a very BAD road, to the office. Or work from the cottage on the property. No internet or mobile phone coverage at the cottage, so this is certainly a different way of life for me!