Kenya

Background
Kenya, an east African country bordering the Indian Ocean, gained its independence from British colonial rule in 1963 after more than a decade of guerrilla warfare and political unrest. The most infamous participants of the nationalist revolt were members of the Mau Mau movement, a group dedicated to the violent expulsion of Europeans and the recovery of lost land. Although British forces eventually crushed their 1959 uprising, the Mau Mau movement propelled Kenya toward political independence.

In the post-colonial years, Kenya has been one of the most politically stable countries in Africa, until December 2007, when the disputed presidential election results ignited widespread violence that has killed 1,000 and displaced at least 300,000. The unrest has left thousands homeless, without income or access to health services, as brutal clashes between political opponents and marauding bands have looted homes and businesses and destroyed communities, particularly in the northwestern Rift Valley province and the capital, Nairobi. As of February 28, 2008, both parties have agreed to a power-sharing coalition government, which may help break the political stalemate, although the humanitarian crisis facing displaced populations persists.

Even before the recent conflict erupted, Kenya ranked among the 30 poorest countries in the world. Pre-election estimates suggest that 56 percent of Kenyans live below the poverty line and 44 percent are undernourished, as the majority of households experience chronic food insecurity. Thirty-five percent have no access to health services and life expectancy stands at a mere 46 years. This is partly a result of Kenya’s struggle with one of the highest HIV/AIDS infection rates in the world. Currently, there are 2.5 million HIV-positive Kenyans, approximately 150,000 Kenyans are lost each year due to AIDS and roughly one million children have been left orphaned by the disease.


What IMC Is Doing
Immediately following the post-election violence in December 2007, International Medical Corps implemented an emergency response program with three mobile medical clinic outreach sites, and teams in Rift Valley Province and Nairobi’s slums. With funding from the United States Office of Foreign Disaster Assistance and the Bill & Melinda Gates Foundation, IMC is addressing the primary health needs of Kenya’s displaced populations. IMC is also expanding its services to include mental health and nutritional support.

In each site where International Medical Corps works, there is high demand for curative services among IDP communities, particularly for malaria, acute respiratory infections, and diarrhea, immunizations, and child and maternal services. IMC currently sees 3,600 patients per week and collaborates with the Kenyan Red Cross and the Ministry of Health (MoH) to increase its medical outreach. IMC remains concerned that demand for health care services may not be met by current the national medicine supply. With treatable, preventable diseases, like malaria, acute respiratory infections, and diarrhea, prevalent, medicine is a critical, much needed element in the humanitarian response to Kenya. In addition to the high demand for drugs and medical supplies, displaced populations require additional nutritional, psychosocial and water and sanitation support in the villages and camps where they currently reside.

Prior to its 2008 emergency response effort, International Medical Corps has operated in Kenya since 1998, when it initiated local emergency medical training in the aftermath of the U.S. Embassy bombing in Nairobi. IMC’s Kenya efforts later evolved to include one of its most ambitious HIV/AIDS programs. To support the millions of Kenyans affected by HIV/AIDS, IMC launched a multi-faceted program in 2002 that includes: home-based primary and mental health care, nutritional support, prevention of mother-to-child transmission, education and awareness, local health care training, and treatment of opportunistic infections such as tuberculosis (TB) and malaria.

Reaching out to some of Kenya’s poorest citizens, International Medical Corps’ AIDS/HIV program includes a grassroots project to improve the quality of life of those living with HIV/AIDS in one of the largest slums in Africa, Nairobi’s Kibera. To reach out to Kibera’s 1.2 million residents, IMC established a mobile clinic program with a local community self-help organization to provide primary health care services, including home-based care, to those affected by HIV/AIDS. The program focused on the physical and emotional needs of women and children, and included an education and awareness campaign to combat the stigma associated with the disease. During the first two years, IMC enrolled more than 3,500 people in need of medical care and emotional support, and reached nearly 8,000 others in need of services by training community members to work as home-based caregivers.

In 2004, International Medical Corps expanded its HIV/AIDS strategy in Kibera by implementing a program to prevent the transmission of HIV from mother to child (PMTCT). PMTCT is a critical element in the war against HIV/AIDS, involving specialized care for HIV-positive mothers and the promotion of appropriate infant feeding and weaning practices. IMC extended its PMTCT activities to Kenya’s Coastal and Nyanza Provinces, including Suba, Taita-Taveta and Tana River districts, where it provides medical care and nutritional support to more than 1,200 HIV-positive mothers. In total, 9,810 pregnant women have benefited from IMC’s HIV/AIDS counseling and testing services.

In Suba District, International Medical Corps is working with Kenya’s MoH on a five-year program to support and enhance the response to the HIV/AIDS epidemic. IMC has initiated activities to support access to care and treatment for nearly 50,000 HIV-infected individuals in the district, including: training health workers in delivering appropriate care, promoting counseling and testing, increasing community awareness, and providing drugs for the management of opportunistic infections. IMC has already provided HIV counseling and testing services to more than 5,000 residents of the district.

With rates of opportunistic infections such as tuberculosis and malaria high, International Medical Corps works to protect the weakened immune systems of those living with HIV/AIDS through integrated diagnostic counseling and testing services into all HIV/AIDS care activities. By training health care workers to diagnose and treat these diseases and promoting educational outreach, IMC helps to prevent disease-related deaths and improves HIV/AIDS patient compliance with treatment regimens. To reduce the spread of tuberculosis (TB), IMC has upgraded five TB labs in Kenya and actively collaborates with other parties to halt the spread of malaria. As a member of the Global Fund, a partnership of governments, civil society, private sector, and affected communities, IMC works to implement a comprehensive malaria-control program in Kenya’s Suba District and coordinates local and international agencies to combat malaria in its role as the Deputy Chair for the Kenya Nongovernmental Alliance Against Malaria (KeNAAM).