Ten months after the launch of Beyond Zero Mobile clinic by the First Lady Margaret Kenyatta were enough for the Samburu County leadership to appreciate the importance of health services provided by the clinic.
The vastness of the county, the hilly terrain and the circuitous and poor road network to access the three Sub-counties of Samburu North, East and Central were sufficient grounds for the County Government to secure some Sh26 million to purchase two additional mobile clinics to facilitate equity in health service provision to its people.
Each of the three mobile clinics now serves one particular sub-county to ensure adequate service delivery to some of the most hardest to reach populations including hundreds of nomadic pastoralists who move from place to place looking for pasture.
The Beyond Zero mobile clinic delivered to the County by the First Lady on August 21, 2014 is detailed to provide services in Samburu Central Sub-county while the other two provide outreach health services in Samburu North and East Sub-Counties respectively.
The vast over 21,000 square km County borders the Counties of Turkana to the North West, Baringo to the South West, Marasabit to the North East, Isiolo to the East and Laikipia to the South.
Despite the vastness of the county, the disease presentations across the three sub-counties remain almost the same.
The three mobile clinics provide medical interventions among the top ten diseases that include Upper and Lower respiratory tract infections, Diarrhea related illnesses, skin conditions, Malaria, Eye and Ear infections, all manner of injuries (animals, conflicts, ) and Typhoid in that order.
Due to the successful work of these mobile clinics, health indicators are improving steadily. Health talks, education and sensitization of women over the need to attend Ante-natal and post-natal services has also witnessed a rising number of women seeking to deliver in health facilities.
In 2013 for example, the number of women giving birth at health facilities stood at 2400 but that number now stands at about 4000 mothers (2015 figures).
The three mobile clinics are allocated funding through a budget by the County government.
Besides proving curative , preventive and promotive health services , the Beyond Zero initiative and its partners have started an advocacy, education and empowerment of the girl child through an aggressive campaign dabbed the Alternative Rite of Passage (ARP) to replace the retrogressive and outdated FGM.
So far, a total of 1200 young girls have undergone the ARP initiation programme since 2014. The programme covers counseling, life skills, the importance of completing school for the girls and cancer screening( cervical and breast) for their mothers.
These sessions are also used to popularize the Beyond Zero brand as a key facility for the health of mothers, adolescent girls and children.
Frontline partners involved in the ARP and other health services in Samburu include Amref, Afya Plus and World Vision.
Although the HIV/Aids scourge that is consuming other counties is not a big threat in Samburu, the County has however launched a HIV strategic Plan ( 2015/2020) to ensure alertness and preparedness to the pandemic.
The County’s prevalence stands at 2.2 per cent (according to the Kenya HIV Estimates 2015) compared to the national prevalence of 6 per cent.
The HIV prevalence among women in the county is higher (3.1%) than that of men (1.8%), indicating that women are more vulnerable to HIV infection than men in the County.
Samburu has contributed only 0.2% of the total number of people living with HIV in Kenya, and is ranked the forty second County nationally.
By the end of 2015, a total of 2,965 people were living with HIV in the County, with 15% being young people aged 15-24 years and 9% being children under the age of 15 years.
In 2014, there were 344 HIV positive pregnant women and 883 children living with HIV.
Some of the key drivers of the HIV epidemic in the County include socio-economic and cultural factors such as early marriages, poverty and insecurity , multiple sexual partnerships, generational sex, sharing of circumcision and FGM tools.
The other challenges are sex tourism, low condom uptake, early sexual debut by morans, wife inheritance and polygamy, unskilled deliveries and foreigners involved in the ongoing road construction work who induce the young girls with money.
Other key challenges directly facing the health sector in Samburu include inadequate funding, shortage of critical staff and inadequate and congested maternity facilities ( including at the referral hospital) .
Samburu County has a population of 273,804 people comprising a 50;50 ratio between men and women.
According to the 2015 Kenya National Bureau of Stastics children below 15 years constitute 48% of the population, while youth aged 15-24 years constitute 21% of the population in Samburu County.
Nalotu Esha Lemasagarai smiles broadly as she cuddles her baby girl aged one year and four months .
Although the baby girl is Nalotu’s fourth child, the 32 year old mother has a special connection with the daughter of whom she talks fondly as though the toddler can even understand her mother’s special attachment.
On the critical date of the child’s birth on July 16 2015, Ms Nalotu had woken up well preparing to attend a routine ante-natal clinic and health talk at the Beyond Zero outreach mission in her Sirata village in Samburu Central Sub-County when labour pains suddenly hit the unsuspecting mother.
A little concerned with the sudden change of events, Ms Nalotu had to quickly bypass other mothers on the queue awaiting services when the Beyond Zero Staff realized she was on the throes of giving birth.
The Beyond Zero medical staff quickly but temporarily abandoned the other clients to ensure they saved Ms Nalotu and her baby who apparently knew she was entering the world in the right environment but at the wrong time and place.
Nalotu successfully delivered her bouncing fourth child under the skilled hands of the Beyond Zero medical staff before she was linked to the “nearby” Sere Olipi health centre for her postnatal clinics.
Nine months earlier, the Beyond Zero medical staff had found themselves celebrating another successful feat when they made their first skilled delivery inside the same Beyond Zero mobile clinic on October 21, 2014, only two months after the First Lady Margaret Kenyatta launched the clinic in Samburu County on August 21 of the same year.
On this date, labour pains again hit 27 year old Ms Beatrice Leseketeti at Kirimon village during the first Beyond Zero outreach mission in Samburu Central Sub-County.
Ms Leseketeti delivered another bouncing baby girl under the watchful and skilled hands of the Beyond Zero medical staff.
The two mothers gave birth through a process referred by experts as the Simultaneous Vatex Delivery ( or normal delivery ). The two healthy babies now represent the many skilled deliveries that have taken place inside some of the 47 mobile clinics spread across the county.
These deliveries are testimony over the need for mothers to seek skilled services to save themselves and their babies during the critical time of birthing.
But even as the Beyond Zero teams are celebrating the successful births of babies under their watchful eye and skilled hands across the country, one young husband in Samburu Central Sub-County is still mourning the sudden , untimely and unnecessary death of his wife who bled to death during child-birth under the unskilled hands of her mother in law.
Mrs Noltualan died on July 27 this year as her mother-in-law insisted that she had no need seeking the services of a health centre because she had successfully delivered her previous three children at home in Lekamoru village of Samburu.
On this date at 2.00 am, the deceased delivered two children-a boy and a girl after prolonged labour following which she started bleeding profusely.
At the wee hours of 2.30 am, faced with a medical crisis the TBA could not handle, the family started calling for an ambulance as the mother writhed in pain.
Although the remote village was inaccessible by the Beyond Zero mobile clinic, its staff were able to finally make it to the home of the deceased at 3.30 am using a small ambulance.
It was however too late to save the mother who had already passed on through over-bleeding as her mother-in-law watched helplessly.
The medical emergency team however rescued her twins whom they immediately rushed and admitted to the Maralal referral hospital where they remained under medical watch for two weeks before they were finally released to the mourning father by the Sisters of Charity Homes who had assumed the role of foster mothers.
The five children are now under the care of their young father but the incident underscores the risks associated with giving birth in the hands of unskilled Traditional Birth Attendants (TBAs).
According to the Samburu County Director of Health Dr Martin Thuranira, unskilled births in the County are still high at 62-64 per cent in some regions.
“Every woman in Samburu is a TBA. Any woman can help deliver a mother in labour”, said Dr. Thuranira and attributed the high numbers of unskilled deliveries to the nomadic lifestyle and lack of health awareness among the communities in Samburu.
The three births are recorded as part of Samburu County’s Beyond Zero mobile clinic’s heavy workload of 5,631 cases during a total of 165 outreaches made by the three mobile clinics in the County in cluded two trucks acquired by the County at a cost of Sh 26 million to supplement the one delivered by the First Lady.
The three mobile clinics cover some of the most difficult, hilly and circuitous terrains, sometimes covering long distances from the Maralal Referral hospital where the Beyond Zero clinic is normally based.
Some of the furthest outreaches by the clinic have been conducted at Ndonyo Wasin, in Samburu East Sub-County covering 367 kms and at Nguronit village in Baragoi of Samburu North Sub-County, a distance of 300 kilometres from Maralal.
Samburu County covers over 21,000 square kilometres.