Camel carries the day to deliver healthcare
By Lilian Kaivilu @liliankaivilu
Long distances, threats from wildlife have kept Samburu residents away from medical services but an ingenious solution has come to the rescue
In what looks like a well-coordinated exercise, herders and camel handlers use sound signals to settle a group of camels. Slowly, they fold at their knees, starting with their forelegs, then hind legs. The process is completed with a satisfied grunt, and to prevent them from moving away at night, the fore legs are tied.
This is one of the vital steps for the journey that will take healthcare workers to the remotest parts of Samburu and Turkana counties— an ingenious way of tackling challenges facing many pastoralist communities in accessing vital healthcare.
“By the time we go to sleep, we must ensure all animals are present,” Koimai Lewarges, a camel handler and herder says, as he checks all 12 camels for injuries. He identifies a neck bruise on one of the youngest camels and quickly fixes it. “We just spray medicine and we are good to go. This is to keep away flies,” he explains.
It is their 14th day of the quarterly Camel Mobile Clinic outreach, an initiative funded by USAID through Afya Timiza project and implemented by Amref Health Africa in Kenya. Work starts as early as 4am every day for 30 days as herders and healthcare workers traverse from Samburu East and Central to parts of Isiolo county.
Gilbert Wangalwa from Afya Timiza Project says the camel outreach initiative is being implemented in Samburu East, Samburu Central, Kibish, Loima and Turkana South Sub counties. They selected these areas due to the low coverage of family planning, reproductive, maternal, newborn, child and adolescent health services. “There is a high unmet need for reproductive health in these counties. A bigger portion of Samburu county is covered by conservancies and poor road network, a challenge for the locals when accessing health services,” he adds.
Using the 12 camels, the handlers, together with a team of healthcare workers pitch tent close to manyattas, where a few pastoralists stay. They conduct clinics, counselling and health education for about four days for each community.
As 5am approaches, the camel handlers get busier. They must ‘wake up’ individual camels tethered the night before to prevent them wandering. In preparation for the seven to eight-hour journey ahead; order is key. This is evident in how precise their packing, complete with speed, order and coordination within the team is.
On this morning, Lewarges and his colleagues take about an hour to load the luggage on the camels. “We have to ensure all drugs are well packaged to protect them from excess heat. In addition, the weight of food items and drugs must be well distributed to ensure balance,” he says. A camel can carry up to 40 kilogrammes of luggage.
To residents of Resim location in Samburu East, the camel outreach is a much-needed solution to the limited number of health facilities, poor road network, and shortage of healthcare workers in the area. Locals walk tens of kilometres in search of healthcare. With a population of 58,122, Samburu East constituency is served by 28 health facilities, according to the Ministry of Health, meaning that one health facility serves at least 2,000 people.
Misawa Learat, a resident, says threats from wild animals, difficult terrain and long distances are some challenges she faces in search for health services. The mother of seven recalls the long walks to the hospital when her children were younger. “Three years ago, I walked over 40 kilometres to access maternal and neonatal health, family planning services and treatment for general ailments in Wamba Health Centre,” she says.
With the lack of transport to the nearest health facility, she often opted to stay home. When she managed to go to a health facility, it was a whole-day affair. “I would walk about four hours one way and by the time I got treatment, it was already late in the evening. This meant I had to walk back with my children who were already tired,” she explains.
For Learat and other residents, the dry season signifies migration to the next available pasture for their livestock and food for their children. “Health services would find us moving,” she says. However in September, every year, residents receive free health services through the camel outreach initiative.
Learat is the first client on this day of the camel outreach. The 30-year-old has come for family planning services and routine medical checkup. She benefitted from the services in 2016 when she and two of her children were unwell. “I always look forward to these outreaches. They have saved me a lot of time and resources. Hadn’t the camels come, I wouldn’t have come for family planning services,” she says.
The outreach comprises a temporary doctor’s room in a tent, complete with medicine, family planning commodities and immunisation drugs among others. There is also a nurse, two community health workers, a clinical officer and a community resource person. At 7pm, the team closes the exercise and immediately begins preparations for the next day.
Sylvester Sang Murei, the clinician attending to patients at the outreach, says about 70 patients from Resim area sought medical services on the first day, including treatment, immunisation and referrals. “This is a free service. Since the health services are brought near the people’s homesteads, we believe the numbers will be higher,” said Murei.
A session takes up to 10 minutes per patient and includes pre-counselling, treatment and post-counselling sessions. In some parts of the county, there is stigma that comes with walking into a hospital building. But in this case, since we come to their homesteads, the patients are more at ease while seeking medication,” he added.
In these outreaches, Murei says, there are more women and children coming for healthcare services as the men are often in the fields with their livestock.