5. LAIKIPIA AND SAMBURU: THE REGIONS, THE PEOPLE & AREA MAP
6. TRUSTEES: CHAT AND NCT
1. THE COMMUNITY HEALTH AFRICA TRUST (CHAT)
The Community Health Africa Trust is a Kenyan
registered Community Based Organisation (CBO), which
is located in the Laikipia region of Northern Kenya.
This organisation was established in 1999 and
originally formed part of a community outreach
programme for those communities surrounding the
world-renowned Mpala Ranch in the Laikipia region.
At its inception this project was known as the Mpala
Mobile Clinic, which operated under the auspices of
the Mpala Community Trust. (www.mpala.org/mct)
Over time this Trust has successfully increased its
capacity in the Laikipia region and has recently
transformed itself into the Community Health Africa
Trust (CHAT). This organisation works closely with
its sister organisation, the Nomadic Communities
Trust (NCT), which operates predominantly in the
neighbouring Samburu region.
In recent years The Community Health Africa Trust
(CHAT) has evolved into a robust well-administered
Community Based Organisation that provides reliable
health services, education and counselling, basic
curatives, immunisation and reproductive health
education to the underserved people of the Laikipia
region of Northern Kenya.
THE LAIKIPIA REGION
The Laikipia region is located in the northern part of Kenya
and supports a population of over 420,000 people.
Approximately 80% of these inhabitants live in remote rural
areas. These people are largely transient, semi-nomadic
pastoralists who comprise of a number of ethnic groups. The
majority of inhabitants in central and north Laikipia live
in extreme poverty, subsisting on under one US$ a day.
Natural resources such as water and grazing space for
livestock are limited. A high demand for these resources
often gives rise to inter-group conflict. Apart from local
insecurity, the people of this region are faced with
significant challenges such as: Preventable medical
conditions (including malaria), the HIV/AIDS pandemic,
illiteracy, unemployment, land degradation, drought/famine,
rapid population growth and a lack of educational
opportunities.
Poor road
infrastructure prevents access to the central and northern parts
of Laikipia. This in turn mitigates strongly against the
provision of basic health care and other essential services to
the rural people of this region. Traditional practices that are
common to male dominated societies such as polygamy, female
genital mutilation and female subservience present further
challenges for health and reproductive education.
CHAT PROVIDES
THE FOLLOWING INTEGRATED SERVICES TO THE UNDERSERVED COMMUNITIES
OF CENTRAL, NORTHERN LAIKIPIA AND SAMBURU
The Community Health Africa Trust
provides an outreach door-to-door service to those communities
of the Laikipia and Samburu regions that have been previously
underserved. This service operates in the form of a mobile
clinic. One of the sole health care providers to this region,
the mobile clinic uses an integrated system of vehicles, camels,
bicycles and walking methods to visit approximately 25 different
rural sites each month. Staffed with two nurses and a driver, a
well-recognised yellow Land Rover travels over 15,000km
annually. This vehicle has become a symbol of humanitarian care
and health management throughout the region. The mobile clinic
reaches approximately 50,000 people annually. The Community
Health Africa Trust also operates a fixed clinic at its field
station on Mpala Ranch.
The Nomadic Communities Trust is a Kenyan registered
Community Based Organisation (CBO), which is located
in the Samburu region of Northern Kenya. 'Samburu'
is the region directly north of 'Laikipia'. This
organisation was established in 2003 as a sister
organisation to the Community Health Africa Trust
that operates in the Laikipia region.
Since its inception this organisation has become
well recognised as one of the only providers of
reliable health care to the people of the Samburu
region. Like its counterpart, the Community Health
Africa Trust, The NCT works in close partnership
with the Kenyan Ministry of Health.
The Nomadic Communities Trust (NCT) currently
operates as an accountable, well established
community based organisation that provides reliable
health, education and counselling services to the
underserved people of the remote Samburu and
Laikipia regions in Northern Kenya.
THE SAMBURU REGION
This region supports a population
of 200.000 people extending across an area of approximately
21.000 square kilometres. 'Samburu' is more remote and less
accessible than 'Laikipia'. For this reason camel transport is
central to the integrated mobile health service that is provided
to this community. Camel caravans provide a highly effective
means of transport for those areas that often have little or no
road infrastructure. The people of Samburu are largely nomadic
pastoralists. A strong reliance on grazing for livestock makes
these communities extremely vulnerable to seasonal variation and
drought. Other significant challenges include: HIV/AIDS,
malaria, upper respiratory tract infections, famine, lack of
clean water, and extreme poverty.
NCT PROVIDES THE FOLLOWING INTEGRATED
SERVICES TO THE UNDERSERVED COMMUNITIES OF THE SAMBURU AND
LAIKIPIA REGIONS
The health care services offered to the Samburu and Laikipia
regions by the NCT include:
1. Reproductive Health. This includes Family Planning
and anti natal clinics (ANC). A component of HIV/AIDS
education and counselling is also included. This involves
Testing and Counselling (TC) and Prevention of Mother to
Child Transmission (PMTCT), Prevention with Positives (PWP)
and other Prevention (OP) such as condom distribution.
2. Basic curative health care. This focuses on treatment
for malaria and also involves a component of HIV/AIDS
treatment for opportunistic infections (OI) and Sexually
Transmitted Infections (STI’s). A non anti-retroviral health
service is also provided.
3. Immunization and information on Female Genital
Mutilation.
The mobile team uses various forms of transport to reach an
average of 17 communities per month. Statistics show that
approximately 35.000 people attend the NCT clinic annually.
The Nomadic Communities Trust has a field base in Maralal
town (Samburu Region).
3. ORGANIZATION HISTORY
THE COMMUNITY HEALTH AFRICA TRUST AND THE NOMADIC COMMUNITIES
TRUST: HISTORY
The Community Health Africa Trust
has its home base on Mpala Ranch in the Laikipia region. This
Ranch is funded through the Mpala Wildlife Foundation (MWF) and
supports an internationally recognised centre for ecological and
social science education and research. This research centre is
administered through the Mpala Research Trust in collaboration
with Princeton University, the Smithsonian Institution, the
Kenya Wildlife Service and the National Museums of Kenya. In
1999 Shanni Wreford-Smith approached the trustees of The Mpala
Wildlife Foundation with her vision to create mobile clinic
services to surrounding communities who were clearly in need of
urgent humanitarian assistance. The original owner of the ranch,
George Small agreed to purchase a vehicle and allowed the clinic
to establish its home base on Mpala ranch. The most significant
contributors at this time were Marie Stopes, Mr Brad Hall (from
San Fransisco) and his partner Dierdre. In 1999 the Mpala
Community Trust and its outreach arm, the Mpala Mobile Clinic
were established. The brainchild and initiator of this
organisation, Shanni Wreford-Smith, has since extended this
programme beyond Mpala Ranch into central and north Laikipia and
has subsequently re-visioned the activities of the Mpala
Community Trust (MCT) into the Community Health Africa Trust
(CHAT). In 2003 she established a sister organisation: The
Nomadic Communities Trust (NCT), which provides similar services
to communities in the neighbouring Samburu (and Laikipia)
regions. Ms Wreford-Smith continues to seek funding for the
development of these community-based organizations.
The Community Health Africa Trust and The Nomadic
Communities Trust believe that childhood
immunisation is a basic right
The
Community Health Africa Trust and the Nomadic Communities
Trust have created a unique model of sustainability that has
proven to be highly effective in the remote areas of
Laikipia and Samburu. This project model entails engaging
the assistance of local people and relevant government
ministries to provide health care to previously underserved
communities using integrated transport options such as
vehicle, bicycle, foot and camel transport. By training
local community members in key roles to facilitate service
delivery, and by mobilising support from community leaders
this model has the potential to empower communities towards
establishing their own systems of basic healthcare. It is
hoped that this will in turn lead to the expansion of
economic opportunity and increased wellbeing for people in
poor remote communities
The effectiveness
of this model in the Laikipia and Samburu regions of Kenya
raises the possibility that such a model can be re-produced in
other parts of Kenya and Africa for similar communities that
have received little or no intervention due to their remote
location.
THE MODEL OF SUSTAINABILITY USED BY CHAT/NCT
Enter
into previously underserved regions that have requested
assistance for clinic services
Engage
local communities using integrated mobile clinic options
such as: vehicle, camel, foot and bicycle delivery
Educate
indigenous community based counsellors and Health care
workers
Empower
communities towards self-sustainable health care
Enhance
the well being of previously marginalized and
disadvantaged communities
Exit
once a framework of strong human and institutional
capacity is in place with good management and leadership
capability.
5. LAIKIPIA AND SAMBURU: THE REGIONS,
THE PEOPLE & AREA MAP
THE LAIKIPIA REGION AND ITS PEOPLE
The Laikipia region supports a mixture of well-watered areas
in the south to the more semi-arid areas of the north.
This region is located on the Equator in the northern
part of Kenya. Laikipia is home to a diverse population
of ethnic communities: The Kikuyu people make up about
60% of the population, with the remainder comprising
other ethnic groups such as Maasai, Samburu, Meru,
Borana, Kelenjin, Somali, Turkana and Pokot. This
region, which is similar in size to Wales, covers an
area of 9,500 sq kms and supports a population of
approximately 420,000 people. Whilst tourism and
agriculture play a role in the economy, the vast
majority of people (80 percent) live in rural areas and
subsist as pastoralists and cultivators with some
nomadic groups in the north. The life of the average
person in this region is largely shaped by the search
for water and grazing land for their animals. Parts of
Laikipia are harsh and inhospitable, with poor road
infrastructure, making travel between urban centres and
outlying areas extremely difficult. The Mpala Community
Trust began operating mobile health clinics in this
region in 2000.
THE
SAMBURU REGION AND ITS PEOPLE
The Samburu region is a semi-arid area situated north of
the Laikipia region.
This region is characterised by low grass plains interspersed
with rocky outcrops and high mountain ranges. This remote region
is home to the Samburu ethnic group as well as smaller groups
such as Turkana, Somali and Rendille communities.
Samburu, which is similar in size to Israel, covers an area of
approximately 21,000 square kilometres, and supports a
population of approximately 180,000 people. Only 3 percent of
the land in Samburu is cultivated for crops. The Samburu Tribes
are generally termed "nomadic pastoralists" relying on goats,
sheep, cattle and camel ownership for their livelihood. The men
move livestock seasonally to fresh pastures while women and
children are becoming more sedentary, living close to a small
number of schools, clinics and development projects that have
been established in the region. The Samburu people share some
customs that are similar to the Maasai.
Due to their severe isolation, the population of this region has
received minimal access to health care and education. In 2005
the Nomadic Communities Trust (NCT) began providing services to
the people of this area using camel caravans as part of an
integrated mobile health system.
WHY DO THE PEOPLE OF LAIKIPIA AND SAMBURU NEED ASSISTANCE?
Many of the inhabitants of both Laikipia and Samburu live in
abject poverty and have little or no access to professional
health care and other essential services. The social, economic
and cultural aspects of the nomadic people in Laikipia and
Samburu present enormous logistical and methodological
challenges to Government and non-Governmental organisations.
Approximately 60% of this population lives below the poverty
line (compared with the national average of 50%) and 75% of the
population is illiterate, with the majority being females. HIV
prevalence in the Samburu region is 6.1%, and 5.4% in Laikipia
region. The World Bank states that people who live on less than
$1 per day are in extreme poverty. Extreme poverty correlates
with hunger, lack of shelter, illiteracy, child mortality,
joblessness, political powerlessness, and poor or non-existent
healthcare.
The Mpala Community Trust (established, 1999) and the Nomadic
Communities Trust (established, 2003) evolved out of a
recognition that many people in Laikipia and Samburu were in
dire need of humanitarian assistance and qualified as 'living in
extreme poverty'. For the most part, these regions were not
receiving adequate health care from government and
non-governmental agencies. This was largely due to
inaccessibility, remoteness and poor road infrastructure.
The Laikipia and Samburu
regions face increasing pressure from a lack of basic health
care, family planning education and exposure to the HIV/AIDS
pandemic. Challenges include the cultural practice of male
domination, gender inequality and female genital mutilation.
Other challenges are illiteracy, unemployment, land
degradation, drought/famine, rapid population growth, a lack
of education opportunities and local insecurity. A lack of
clean drinking water and poor sanitation makes these
communities vulnerable to infectious and preventable
diseases such as Trachoma. Effective intervention is
hampered by access and a lack of education. Illiteracy
presents ongoing challenges for communication and education
strategies.
Conflict in the Laikipia and Samburu regions between various
groups of pastoralists and cultivators is frequent. This is
generally related to competition for essential resources such as
grazing for livestock and water, especially in times of drought.
Livestock theft and subsequent raids to recover livestock is
another a source of conflict. These incidences of group conflict
can be violent and often fatal.
Mr Michael Shaw (Registered Attorney: Kenya, Nairobi)
Dr John Tole (Registered paediatrician and administrator of the Aga
Khan Hospital: Nairobi, Kenya)
Ms Shanni Wreford-Smith
Mr Ken Wreford-Smith
NOMADIC COMMUNITIES TRUST (BOARD OF TRUSTEES)
Dr Duncan Blaikie
Mr Charles Hewett-Stubbs
Mr Toby Aykroyd (Population Sustainability Network)
Dr Patrick Ochieng
Ms Shanni Wreford-Smith
