“It has been quite a safe delivery” Said Christine Acholi, a South Sudanese Refugee, as she admiringly looked at her 1-day old baby.
The 21-year-old mother who came to Kakuma in 2017 shared her delivery chronicles at a ward, at Kalobeyei Red Cross Hospital. As a second time mother, she compared her first birth experience to her second one; “My first birth was in 2017 when I had just come to the camp. It was at a clinic at this camp, but my delivery experience here is far much better compared to the other one” She noted
Christine’s statement is not far-fetched; The hospital that offers free maternity care to the refugee and host communities was unveiled back in 2017. On entering, there is a reception on the right and a consultation room on the adjacent left. Well-dressed charming nurses briskly whisk their way up and down the neat, wide corridor, symbolizing the volume of work at the facility.
The facility has spacious admission and labor rooms, a spotless delivery room fitted with modern equipment, a nursery room tailored with incubators and a spacious ward area where new mothers and their babies are monitored before they are discharged.
“We are very happy about services here,” Said, a content father (Christine’s’ husband) who had just stopped by to check on the wife’s and child’s progress.
Anne Wangui, a nurse that has been working at the hospital for two years said that the hospital admits sick mothers, sick babies and pregnant mothers. It receives an average of 3-4 women a day and performs 90-100 safe deliveries every month.
Since she started working at the hospital, Anne notes that there is an increment in the uptake of delivery services; from 10% in 2018 to 20% in 2019; that more women from the refugee and host communities are accepting maternity care.
“When we started, admission was low, but now more women are coming to the facility,” She said.
“In the last two years, we have lost one woman, a South Sudanese national from the refugee community. She over bled and died before she arrived here. We were however able to save the baby. Had the mother arrived in good time, we would have saved her too” Said, a despaired Anne.
Anne attributed the increment in hospital deliveries to efforts by Red-Cross Kenya, International Rescue Community and UNFPA Kenya. The agencies have safe motherhood promoters and community health workers who visit homes and monitor pregnancies and deliveries of women.
Anne also noted that technological advancement such as the introduction of the “balloon tamponade” has managed postpartum hemorrhage. As a mater of fact, the facility can manage all deliveries apart from Cesarean Sections. In such cases, patients are referred to other hospitals within the Sub-County of Turkana West.
In addition, 24-hour emergency services have encouraged women to deliver from hospitals. “With the uneven terrain and vastness of Kakuma and Kalobeyei, women had challenges accessing hospitals, but with the introduction of ambulances, women are picked and rushed here whenever they start laboring. The ambulances also rush referred patients to hospitals in case of emergencies” Said Anne.
However, Anne endures both religious and cultural challenges from her patients. She noted that most of the patients are from strictly religious and cultural backgrounds. She gave a case of a Muslim woman who, during a blood transfusion, insisted that she could only receive blood from a fellow Muslim.
In yet another case, a patient claimed that her culture allowed her and her baby to bathe a week after delivery. A situation that poses a health risk to both the mother and the child.
She noted that some cultures do not allow women to make decisions. In cases like Cesarean section the women cannot accept the services without their spouses’ consent. In such scenarios, Anne must respect her patients’ decisions, regardless of the risks at hand.
Illiteracy, ignorance and language barrier are common challenges that Anne battles with daily.
The Kalobeyei Integrated Social Economic Development Plan (KISEDP 2018-2022 has suggested activities to improve the healthcare of both refugee and host communities.
The activities include: Scaling up of a strong healthcare financing mechanism for host communities through the transforming health for Universal Care project; Working with NHIF to ensure government and NGO facilities are accredited and start accessing funds provided in the Linda Mama programme; Staffing and equipping of facilities in line with NHIF requirements to accelerate accreditation; Advocating for a policy framework to facilitate the enrollment of refugees/asylum seekers in the National Hospital Insurance Fund; Increasing awareness among communities on need for enrolment for health insurance to avoid high spending on health; Piloting and advocating for mass enrolment of population from both host and refugees in the NHIF scheme.