Activity Report Kenya 2011
International employees: 4
Local employees: 70
HIV/AIDS, infectious diseases, malnutrition, mother and child care
Kenya belongs among the countries with low income and a food deficit, its GDP is 1,242 USD per capita (World Bank data, 2007). In the UNDP Human Development Index statistic, Kenya was among the countries with average human development in 2007 and it ranked in the 148th place among the developing countries (total 177 countries).
Kenya’s population is 39 million, 20% percent of the population lives in cities. More than 80% of the population finds their job in agriculture. The average life expectancy increased from 51 to 53 years and child mortality decreased from 120 to 55 deaths per 1000 births. Literacy increased as well, the male part of the population is around 90% while female is around 80%. The GDP per capita is $1,600 after several years of economic growth (around 6-7% yearly). The growth fell again in 2008 to 2.2%. Despite this, one fifth of the population remains to live below the border of poverty, living from less than $1.25 per day. Kenya is on the 148th place in the Index of human development and on the 60th place in the Index of poverty (2007/2008).
According to last estimates from 2009, there are 2.2 million people with HIV/AIDS in Kenya, which amounts to almost 7 % of the population. In that, 130–180 thousand are children under 14 and 800 thousand to 1,1 million are women of childbearing age above 15 years. Women account for up to 60 % of infected adult population above 15 years of age. The level of HIV/AIDS occurrence in the adult population (15 to 49 years) is 8–10 %.
Statistics as well as actual data about the occurrence of HIV/AIDS and information about specific regions are not available or are inaccurate. Despite some good news – the overall decrease of the occurrence of HIV/AIDS in the total population for less than 5% of the stabilized increase of new infections (around 55,000 yearly), the situation remains to be alarming. The evaluations of the implementation of the national strategic plan regarding HIV/AIDS are a cry for the increase in medical and social services and their reliable and continual financing. According to figures from 2007, around 300 Kenyans die daily because of HIV/AIDS, only 200,000 receive ARV treatment even though 500,000 are in need of it, and the number of orphans that lost their parents due to HIV/AIDS is from 990,000 to 1.4 million.
The main source of infection in children is the mother to child transmittion (MTCT). The transmittion can occur during pregnancy, labor or during breastfeeding. During pregnancy, 5-8% of children are infected through the placenta. During labor the risk of infection is bigger, around 10-20%. If the mother decides to breastfeed, 10-15% of children are infected. Statistics show that without breastfeeding and without ARV, 15-30% infants are infected. If the mother decides to breastfeed, the percentage is around 25-45%, depending on how widely spread the virus is. A significant problem is that a lot of infected children receive ARV treatment too late- without this treatment, 70% of HIV positive children die before they reach 1 year of age. It is therefore extremely important to identify the virus in time, so that the treatment and hence the elongation of life can be implemented.
The situation is complicated by the fact that the majority of the population (83%) in Kenya is not aware of their HIV status.
High prices of food are significant in the everyday life of the Kenyans. An estimated 5.6 million people face uncertainty about everyday food supplies due to the rise in prices of food and fuel. To overcome the price increase every day, people must decrease daily food intake or buy cheap, available food. There are many critical cases of malnutrition. As far as 25% of children suffer from acute malnutrition in some Kenyan districts.
Approximately 31% of children under the age of 5 shows insufficient growth development and about 20% suffer from malnutrition. The level of stunted growth development and underweight children is about 10% higher in the countryside than in urban areas. Furthermore, 3 in 4 children in the above- mentioned age are anemic, along with 50% of women and one in 5 men. Almost half of Kenya’s children under the age of 5 and women in the reproductive age also face lack of zinc.
The lack of vitamin A is prominent among children and women in general, along with specific subgroups of men. Significant problems in terms of public health are caused by a wide lack of many microelements and also by the lack of vitamin A, zinc and iron.
Estimations say that the deaths of more than 23 thousand children are connected with increased predisposition to infections which is caused by the lack of vitamin A and that about 70% of children in Kenya grow up with reduced immunity. In general we can say that the nutrition situation of the population in Kenya is still desperate.
MAGNA has started its activity in Kenya in 2006, in the province of Nyanza. MAGNA ended its activities there in 2010 and relocated to the east coast region of Kwale, to the local hospital Msambweni.
The year 2011 for MAGNA project in Msambweni District brought many challenges but also successes. One of the main improvements was the fact that due to high needs of our services, MAGNA instead of one health facility in Msambweni District Hospital extended project activities to another two health facilities – Lunga Lunga Dispensary and Vitsangalaweni Dispensary. The high number of people in need of our services made us to stretch our programs and to bring support to the remote areas, closer to our patients.
MAGNA project improved the working system with daily counseling services in CCC (Comprehensive Care Clinic) for HIV patients in all three facilities and done effective changes in Paediatric Ward, where set up inpatients stabilization centre for malnourished children. The significant change was noticed in care of HIV patient and their relation to HIV illness. The number of defaulters dropped from 30-35% per a month to 5-8%. The trust in medical and supporting staff working in CCC clinics plaid an important role in patients regular medical check ups. MAGNA with its approach and the way of working build comprehensive system of provided care, including regular laboratory testing, HIV counselling, community home base care and psychosocial care.
In 2011, MAGNA programs provided care for 1,789 patients, of which 158 were HIV positive paediatric patients and 135 were HIV exposed children. Psychosocial support and advice on HIV is not a part of public healthcare, which MAGNA focuses on. In 2011, we provided 2.935 individual consultations for HIV positive patients, 2.174 individual consultations for HIV positive women and 2.177 pre-natal examinations.
Visiting patients in an environment they are used to and understanding their daily problems that can negatively affect their fight against HIV and malnutrition is the main objective of communal medics. 4.324 home-based visits took place in this program.
Malnutrition in children was another challenge that MAGNA reacted on in 2011. With skilled nutritionist and community health workers screened almost 6,500 children to identify their nutritional status. 486 children that were in need of nutrition interventions registered in 3 medical centres. 59 children with severe acute malnutrition with complications were hospitalized in the local hospital Msambweni.
Kenya, alongside other countries in the Horn of Africa, has for most of 2011 faced a severe food crisis due to a climatic disaster that has become a recurring phenomenon in shorter cycles, negating efforts to reduce vulnerability. A combination of drought-induced crop failure, poor livestock conditions, rising food and non-food prices and eroded coping capacities are some of the key factors contributing to the food crisis, which has made 3.75 million people in Kenya food-insecure.
The regions that went through the most severe droughts are also exposed to long-term poverty and recurring conflicts that continue to worsen the situation of food insecurity.
An estimated 385,000 children under 5 and 90,000 pregnant and lactating women are suffering from acute malnutrition. The eastern parts of Turkana have reported 37.4% global acute malnutrition, which is far above the emergency threshold of 15%.
The recurring conflict and instability in Somalia coupled with the Horn of Africa drought has caused massive cross-border influxes at the rate of 30,000 arrivals per month in the Dadaab refugee camp alone. The arrival figures have however drastically decreased to approximately 100 per day because of increased insecurity along the Kenya/Somalia border and a halt to the registration of new asylum-seekers from Somalia in October 2011. Overall refugee and asylum-seekers in the country numbered 590,921 as of September 2011.
Due to continuous increase of staple food, fuel prices and drought conditions, food insecurity for the poor and very poor households in northern and eastern pastoral areas deteriorated to Crisis and Emergency levels in July 2011.
Iftin subdistrict’s hospital was chosen for the establishment and improvement of the existing services in the nutrition centre. Therapeutic food centre (TPC) and walk-in care in the OTP and supplementary food program (SFP) were poorly equipped with insufficient staff, making the overall care provided ineffective. In many cases, it did not reach people in need- malnourished underweight patients, mainly children.
After a detailed research of areas in Garissa District, in 2011, MAGNA implemented a project in reaction to the humanitarian crisis in the Horn of Africa. Garissa District that is neighboring Somalia is the one of the places where thousands of Somalis people seek refuge.
MAGNA established a therapeutic food centre (TFC) and enhanced ambulant care in the outpatient therapeutic program (OTP) and supplementary food program (SFP) in the district hospital Iftin in Garissa.
In all health facilities was introduced and implemented system of registration, referrals, records keeping with filing arrangement for medical files, which is helping nutritionists and medical staff to follow patients and provide adequate care. Screenings of all patients visiting health facilities and also living in surrounded communities become a standard way of working for community health workers.
With the setting and system that was implemented in the beginning of the project in August 2011 we have managed to register and provide nutritional services to almost 4,300 underweight or malnourished pediatric patients.
Horn of Africa is still dealing with the humanitarian crisis and people are still in need of humanitarian intervention. MAGNA with its humanitarian project is continuing with planned activities in the partnering facilities to stabilize current catastrophic situation and to build sustainable system that can benefit to all people in the area.
Magna Children at Risk has been operating in Kenya since 2006.