Kenya 1997-1998

Flooding and epidemics wreak havoc The worsening political and social situations are severely affecting the health services: deteriorating buildings, demotivated staff, no response to the growing problems of AIDS and TB. Those most affected live in urban slums or the under-resourced northern and eastern provinces. In Nairobi's slums, MSF focuses on AIDS and primary health care. In Kibera and Dandora (pop. 300,000), comprehensive AIDS programmes provide home-based care with community participation while two health centres and a referral hospital are supported. In Kibera, MSF also develops an urban health project based on a clinic constructed with community help and supplies organisational, material and technical expertise for treatment, prevention and health promotion. MSF also supports Mathare community dispensary and has provided training for 36 traditional midwives. In November 1997, MSF closed nutritional programme in Garissa and Marsabit. In Marsabit, 22 supplementary feeding centres for moderately malnourished children and three therapeutic centres for severe cases helped save 2,000 children and a further 5,000 were vaccinated against measles. Kenya hosts a large refugee population, mainly from Somalia and South Sudan. Funding cutbacks limited activities in Dadaab camp (pop. 120,000) in 1998 to epidemiological surveillance, preventive care and a nutrition programme. This includes support for nine health posts and Hagadera referral hospital with its operating theatre and therapeutic feeding centre. In February 1998, emergency interventions were carried out on behalf of 1,500 IDPs from Likoni and another 12,000 in Laikipia and Njoro. This consisted of measles vaccinations, drugs supplies and water and sanitation support. In Homa Bay (Nyanza province), MSF targets a population with an estimated HIV incidence between 30 and 40%, as well as high TB rates. A three-year programme reinforces the national TB programme, improving blood transfusion security, and providing training and supervision in the treatment of STDs. Close by, Nyarongi dispensary has been upgraded into a health centre. The team works with the community to protect water points and provides training for traditional midwives. Flooding and epidemics A water and sanitation project was running successfully in Wajir district, Northeastern Province to help offset the effects of drought when the area was hit by catastrophic flooding in October 1997. MSF responded to escalating mortality rates caused a malaria epidemic and severe malnutrition due to the exacerbated food situation. Teams provided supplementary and therapeutic feeding programmes for under-fives and pregnant women and tackled the epidemic by opening a special unit in the local hospital, operating six mobile clinics and implementing a vector control programme. In Mandera, floods in early 1998 forced the extension of a nutritional programme covering 62,000 people to include therapeutic and supplementary feeding centres and general food distributions. In Nyanza province, MSF mounted a large-scale emergency intervention to counter a lengthy cholera epidemic that began in June 1997, but spread extensively. Teams in seven provinces had treated over 30,000 patients by end-May 1998, when the outbreak had begun to decline. In June, MSF still retained responsibility for cholera activities in Western province and monitored the situation in the other six, already handed back to the MOH.