The idea to interview David O’Ranga came up because he is really committing himself in the project “No one out! Empowerment for youth inclusion in Nairobi informal settlements”. David is one of the Health Care Providers engaged in activities with young people from 14 to 25 years on HIV testing, counselling and prevention in the Mathare North Health Centre, one of the public health facilities where Medicus Mundi Italia is working since April 2017.
So this is the story of David resulting from the interview: David was 17 years old when he moved to Nairobi from Migori County (Western Kenya, near Victoria Lake) with some relatives who took care of him. As soon as he arrived in Nairobi he finished the last two years of Secondary School and then he attended the Thika College for obtaining the diploma in HIV & AIDS Management. Finishing the college he decided to study for a certificate in HTC (HIV Testing and Counselling) with NASCOP (National Aids and STI’s Control Programme), a programme born in Kenya 1987 in order to guide the interventions of the Ministry of Health against HIV and AIDS. NASCOP is working as an operative unit inside the Kenyan Ministry of Health.
David decided to study this topic because he lost his mother of HIV and it seems she was not aware of it and therefore she never received the necessary treatment. This is the main reason which pushed David to become what he is today. He is eager to help both youth and people living with HIV to be informed, prevented and treated. He did his internship in Mama Lucy Kibaki public hospital, then he has been employed both as an HTS Counsellor and focal person for antiretroviral in the CCC (Comprehensive Care Clinic) in Mathare North Health Centre through the Afya Jijini programme (a programme of IMA WorldHealth which is helping Nairobi City Council to supply health services with an integrated approach which means together with the public health facilities).
When the Afya Jijini programme finished to pay his salary because of some constraints, he decided to remain in the Mathare North Health Centre while looking for another job. Since April 2017 David has followed all our trainings, monthly meetings for follow-up on the community strategy through the Community Health Volunteers (CHVs) engagement and he is also taking part in all our youth awareness activities. In Mathare North Health Centre he is recognized as a friendly Health Care Provider – the youth feel free to go to him – and also his relationship with the Community Health Volunteers has improved in terms of completing referrals from the community and actions taken. He is recognizing that “No one out!” awareness activities are increasing the number of youth from 14 to 25 years volunteering for HIV testing and consequently also reducing the cases of new HIV infections. David’s motto is: “HIV doesn’t kill if you accept your status and work hard for it! It is possible to live!”
Why is the story of David a story to be told? Because it has a cross-section of the informal settlements of Nairobi where Medicus Mundi Italia is operating. These are not easy environments, but full of challenges and poverty where health is an important component.
The implementation of a community strategy inside the Ministry of Health curriculum has really helped to discover which are the most common diseases in those areas and how to treat them.
In fact the most important aspects about any community strategy is the creation of awareness of how health is important in life. To feel healthy or to treat as soon as possible a symptom is a behaviour that has to become a kind of life routine and especially to feel free to go to the nearest public health facility to be assisted and treated. People of the slums are often very reticent to approach the facilities because of fear of stigma and that’s why the community sensitization activities have an important role.
Medicus Mundi Italia is implementing the project considering this important aspect through strengthening the relationship between the Community Health Volunteers and the Health Care Providers in five health facilities in different slums areas (Korogocho, Dandora, Babadogo, Mathare North and Kariobangi). In this way the referrals system is becoming stronger. The other aspect of the project is related to youth. Opening the health centres on Saturday morning allows to make a community dialogue on sexual and reproductive Health, HIV and AIDS testing and prevention, family planning. This contributes to a better understanding and use of the services available
The slum areas are really demanding; sometime is not easy to recognize if the implemented activities are helpful as MMI is really covering a large area but sensitization and advocacy with large number of youth and different population can become a word of mouth in the communities. From when the project has started almost 1800 youth have been reached during awareness activities.
As stated in the Strategy for Community Health 2014-2019 of the Kenya Ministry of Health, facilitating people’s participation is a key element of the Community Health Strategy. The recognition and introduction of level one services which aim at empowering Kenyan households and communities to take charge of improving their own primary health care is one of its key innovation”.
This is the direction that MMI is following with its intervention. The project is really working very close to the Ministry of Health authorities in order to support and improve the aspect of Community Strategy which in Kenya is well structured in terms of manuals and regulations but not always implemented.
The job of Medicus Mundi Italia in Nairobi is not a foregone job, full of challenges but also very interesting and exciting, every day is an experience which gives meaning and value to the implemented job.
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Author: Grazia Orsolato, Medicus Mundi Italia, health coordinator “No one out” project
Further information: https://www.medicusmundi.it/en/projects/projects-under-way/636-kenya-no-one-out-project.html
Contribution by Medicus Mundi Italy to the 2018 Annual Report of the MMI Network