Chai Brady
In a land where Irish missionaries have delivered life-saving services and education, there is profound gratitude towards Ireland, but now conditions in Kenya have become utterly dire.
A woman breastfeeds her child despite being severely malnourished, and still smiles after walking 30km in blistering heat from her village to a health centre.
Helen Eipa, who doesn’t know her age, has a young girl called Josephine who is a year old. The baby has qualified for the supplementary food programme in St Patrick’s Health Clinic in Northern Kenya, which is for children between six months and five years old.
The clinic is in Turkana County, in the city of Lodwar, where Irish missionaries founded a Catholic diocese half a century ago.
The Diocese of Lodwar encompasses the whole of Turkana – which is the same size as Ireland. It runs 60% of the health services and operates a large proportion of the education and water utilities. With the help of Trócaire, the Irish overseas development charity for the Catholic Church, it delivers emergency aid in clinics like St Patrick’s across the county.
The Turkana people have experienced drought many times, but for the last two years the weather has been harsher than ever.
For millions of years humans have lived in Turkana, which is said to be one of the areas where humankind evolved. A skeleton of an eight-year-old boy was found close to Lake Turkana, which dates back 1.5 million years.
Bonds
The communities there have created strong bonds with the land, their family and friends, as well as a unique culture and way of life.
Mrs Eipa’s family were pastoralists, and owned camels, but due to drought all their livestock have died. She has resorted to cutting down trees, and transporting and selling heavy charcoal.
Charcoal burning is catastrophic to the delicate eco-system, the trees are essential for the land but desperation leaves no other option. This negative coping mechanism is among several that humanitarian agencies are working to tackle.
Mrs Eipa told The Irish Catholic that prayer is what gives her hope, adding that: “I pray for help.”
The Turkana County Department of Health, Save the Children, UNICEF and several other NGOs have conducted a recent survey that reveals the extent of the situation. Already over 60,000 children are at risk of death in Turkana unless they receive life-saving aid, 17,000 of these children are severely malnourished.
In Southern Turkana 12% of children under five are severely malnourished, which is the demographic the clinics are targeting.
For the last two years infrequent and unpredictable rainfall has had a devastating impact on the soil, which leads to a lack of forage for the pastoralists’ goats, camels and cattle. It’s challenging and distressing for people to try and maintain dignity when their livelihood is snatched away. Many resort to means they never considered due to the severe drought.
Over 60km away from St Patrick’s health clinic in Lodwar, is St Mary’s health clinic in Kalokol, which is very close to the Western side of the saline Lake Turkana.
A 22-year-old woman attending the clinic sits beside her baby, Lokunyuk Lonyala, who is receiving antibiotics intravenously.
Jane Akal’s child is 20 months old and weighs 7kg, and although the clinic she attends can’t provide all the food the baby needs, it gives supplements of high protein and vitamins needed for healthy growth.
At home, the family are only able to afford one meal a day, which is a maize based porridge in the evening. This is characteristic of the Turkana region which has about one million people living there, with 80% earning less than 90c a day.
Her baby is malnourished and has a MUAC (Mid-Upper Arm Circumference) reading of 11cm, which is easily enclosed by an average adult’s thumb and forefinger. This points to severe acute malnutrition.
Resources
The clinic currently has 1,500 children on its programme, and has had to turn 1,200 eligible babies and children away due to lack of resources. This is a common theme across all the Turkana clinics.
“After three months on the programme, if we have consistence of the food supply, the baby should have peaked to 11.5cm (MUAC),” said John Mogoi, Clinical Officer of the Kalokol Health Centre, which is one of the oldest created in Turkana.
Each child gets 10kg of food – 5kg every two weeks – then a second round of supplementary feeding will begin in July, but the clinic’s supplies will run out by August, next month.
“Basically malnutrition comes with complications so the first thing that we do, because this is a dispensary, not an inpatient set up, is rehabilitation,” said Mr Mogoi. “We stabilise the baby, we do what we call electrolyte imbalance, we check for hypothermia, dehydration – there are 10 steps that you have to do before you enrol the baby into the nutrition programme.”
Mr Mogoi’s clinic is supported by Trócaire, but does not have enough medical supplies due to lack of funds, and has made use of what he has for extremely severe cases of malnutrition.
A two-year-old he examined last month had a MUAC reading of 8.6, which means his upper arm was the same size as a bottle cap.
Malnutrition
The baby, called Damien, was born weighing 4.6kg, and two years later now only weighs 5.6kg. While this would be a medical emergency in Ireland, Mr Mogoi described the case as “a challenge” especially because they did not have the correct supplements to help a child in that state of malnutrition.
Normally Formula 75 (F-75), which is a therapeutic milk, should be used to treat severe cases. Other food supplements such as peanut-based Plumpy Nut and Plumpy’Sup are used to treat severe acute malnutrition and moderate acute malnutrition respectively.
“The baby was to go for stabilisation first, but because we didn’t have the F-75 to give to the baby, we decided to enrol the baby for F-100, which is the Plumpy Nut,” he said, adding that the baby’s programme would run for 30 days and should be supplemented with food provided by the mother.
However, he said: “The main challenge was the mother was an orphan, she had that baby at the age of 20, she comes from a family of five, where they only depend on the brother who is a boda boda (bicycle/motorcycle taxi) driver.
“So they only have one meal per day, and it depends on whether the brother gets money to buy the food… so they take just one meal per day. This baby is two-years-old, he has to grow, he needs a lot of energy to grow, so the baby is malnourished due to poverty,” he said.
Mobile Clinics
The battle to help children like Damien continues thanks to the work of people like John Mogoi, who regularly operates with limited resources.
However, there are some people who can’t make it to the clinics, because of geographical distance and ill health. Therefore the clinic also operates an outreach programme, in which mobile medical units are sent out to supply life-saving medication. They travel up to 45km away to reach communities.
This is particularly useful for nomadic pastoralists, who move where there is fresh grazing land or water for their livestock, so they may be in different places each time.
The administrator for every clinic run by the Diocese of Lodwar, Sr Matilda Mutunga, says the outreach programme can be difficult because they don’t have food to give people due to lack of supplies, and can only provide medical support.
“If it was possible for me now, food would always be there when you go out, especially for the children, those who are under five and who come for a vaccination,” she said, “at least if you give a supplement you are assured that child will be ok”.
Sr Mutunga has been a nun for 30 years and has worked in healthcare across Kenya. Every month she visits the clinics for support supervision to train staff.
When food is donated Sr Motunga co-ordinates the distribution, and inspects clinics to make sure the correct amount has arrived.
“I feel challenged, I wish I could do more. I see them as my brothers and sisters… and that is why we’re appealing to get something from well-wishers to be able to support them,” she said.
“You find some and they just wait for Providence, whether Catholics or non-Catholics – because when we are helping and giving services we don’t differentiate. And you find those who are not Catholics they even appreciate it more, because maybe they were not expecting to be a part of the services being given,” she added.
Choice
For women like Mrs Eipa they are faced with a choice between starvation and travelling about 600km in harsh conditions to a slum in Nairobi, Kenya’s capital, in the hope of a better chance of survival. Many are forced to prostitute themselves to provide for their children, and with sexual violence and disease being rampant the mortality rate is high.
Trócaire has been working tirelessly to stop people from leaving their communities, but their resources are wearing thin. Kibera is the largest slum in Africa, and the third largest slum in the world. Estimates put the population anywhere between 250,000 to one million.
The Country Director of Trócaire in Kenya and Somalia, Paul Healy, told The Irish Catholic he has met women from Turkana now living in slums.
He said: “Recently I was talking to women in Turkana in the slums of Nairobi and it is a dirty filthy place, it is not some place you want to stay or bring up your children.
“In fact each one of them, despite the drought in Turkana, were saying they would prefer to be hungry in Turkana than living in the slum in Nairobi, and that says something about the harshness of this life.
“But they lose everything, all the connectedness, the sense of family, the sense of community, the sense of belonging, the sense of culture, their heritage, all that goes when they move into the urban slums and they’re left destitute and abused by rich powerful people that give them little or no salary and they work for next to nothing.”
For some Turkana families slum-life is now a reality, as fear of starvation pushed them to make that decision. Although there are still supports available for the vulnerable people forced to live in abject poverty and fear in slums, stopping people from having to make that choice is the critical battle.
*To make a donation or to find out more about Trócaire’s response to the food crisis in Africa visitwww.trocaire.org/east-africa
-I thought I knew poverty but Kenya broke my heart-
I felt powerless as tears welled-up in the eyes of the mother in front of me, as she described how difficult it was to get basic necessities.
Terminating the interview immediately after Mrs Louwa became too upset to continue, I knew it was a moment that would stay with me.
Even on the plane home from my journey to Turkana in Kenya, I found it difficult to think about the families, mothers and children who are forgotten by their government and left to make gambles with their lives.
It was my first every journey to the Southern Hemisphere, and it will leave a lasting impression.
Many of us are given choices, and although there is suffering here in Ireland – such as our devastating homeless crisis – we don’t have to choose between leaving our communities and way of life for fear of starvation, and a slum where our families will most likely suffer beyond belief.
Although I have witnessed severe poverty before it was nothing like this, it was truly humbling. It’s so easy to forget the opportunities we are endowed with just because of where we’re born.
While the concept may seem foreign, similar choices, or lack of choices, were faced by men and women escaping poverty in Ireland during the 1900s after the famine.
Doomed
However many people were unable to leave, and were doomed as a result. I felt a distinct guilt as I easily left one of the most impoverished places in the world, knowing that a large majority of the population are trapped with that choice of starvation or slums.
There is very good humanitarian work being done in Turkana, where people work in very difficult conditions to help extremely vulnerable people in order to give them more opportunities and choices.
I saw a child who was so emaciated I initially didn’t think the baby was alive. The mother tried to hide the child from view, which was heart-breaking to see.
Paul Healy, the Country Director of Kenya and Somalia for the Irish charity Trócaire, lives and has a family in Kenya.
Despite being in the humanitarian sector for decades, he said he had never seen a baby so close to death, and seemed very affected.
The work that Mr Healy and his team are doing is absolutely invaluable. While developing sustainable communities is an imperative for Trócaire, right now they are trying to keep people alive: the most fundamental part of all humanitarian work.
That image of that child will forever be seared into my memory, whereas similar images I saw online and on other media didn’t have the same affect.
Definitely people are becoming desensitised, and I admit to it, as horrific images of malnourished children flood the internet and other media. It made me feel ashamed when I saw a baby first hand; that would most likely not survive the week.
Climate change
Temperatures rarely stray from 30C all year round in Turkana, sometimes reaching 40C, it is an oven. Since the 1960s the temperature has risen by an average of 3C, compared to the global increase of 0.7C.
This comes as Ireland, who have consistently failed to meet climate change targets, are unlikely to meet two of their EU 2020 pledges to reduce greenhouse gas emissions by 20%.
Ireland is among six EU countries that have actually increased their emissions since the 1990s.
The boiling heat in Turkana desperately needs to be punctuated with rainy seasons which occur during November to December and April to May, but they continue to fail.
The developing world is responsible for the majority of emissions, with China, the US and the EU being the top three (in that order), however ironically they are not experiencing the affects to the extent marginalised people in developing countries all over the world are.
As Irish people, and as dwellers on the planet Earth, we are obliged to do what we can to help those in whatever way we are capable. We are given more choices than many.