Thursday 27th Sep 2019, 1.00pm, the skies of Kakuma Refugee Camp are quickly gathering dark Columbus clouds, lightening flashes across the hills of Turkana as thunder rumbles through the overcast air, a clear indication that heavy rains are about to irrigate the otherwise severely arid land of Kakuma. The hot humid air suddenly turns into a stormy breeze carrying the smell of rain from the neighboring Kalobeyei Village. Screams of children excited about the anticipated rains engulf the camps’ air.
Inside Kalobeyei Red Cross Maternity Hospital are women celebrating new lives. And heavens are about to shower more blessings upon them. One of the women is a 27-year-old Congolese refugee, Claudine Mukuraneza. She admiringly stares into the beautiful innocent face of her new born baby as she awaits her husband to come and name him.
“He is 4.0kgs!” She excitedly announced.
Quite a healthy one-day-old baby he was! Claudine is so overjoyed that she ignores my curiosity on how the delivery went. Anne, a nurse who is busy attending to other new mothers and their babies nearby discloses that Claudines’ baby was born without any complication.
Claudine attributed her healthy baby’s condition to her adherence to ante-natal visits and consistency in attending health talks at the clinic.
“I came for all my ante-natal visits and health talks at this hospital. I was given iron tablets, multivitamins and was taught hygiene and nutrition. I followed all the advice,” she said.
She also mentioned that safe motherhood promoters regularly visited her at home to monitor her condition and remind her of the next hospital visit.
Claudine is happy that safe motherhood promoters have also helped her space her children well.
“Safe mothers also taught me about family planning methods. I use Norplant. I am happy that this is my third child, and comes three years after my second one. I will continue using family planning,” she stressed.
Rebecca Diing, a community leader and safe motherhood promoter working for Red-Cross Kenya at Kakuma Refugee Camp said her work within the community has been quite significant in the lives of expectant mothers and their babies.
“I identify pregnant mothers, speak to the them about the importance of antenatal visits and hospital delivery. I also monitor their nutrition and watch out for any danger signs within new born babies,” she said.
During her work, Rebecca battles with cases of women attached to local birth attendants especially ‘new arrival refugees’ who do not know the importance of hospital delivery.
Rebecca is concerned about diverse cultural norms and religious beliefs which influence sexual and reproductive health choices of women within the refugee community.
“Some cultures and religious beliefs prevent women from seeking these services,” she lamented.
Rebecca is happy that training offered by UNFPA Kenya and the International Rescue Committee (IRC) has helped her learn a lot regarding maternal health, family planning and gender-based violence, which in turn has helped women at the refugee camp.
Reproductive Health in humanitarian settings
Sexual reproductive health needs are threatening in emergencies. Mostly affected are women of reproductive age, youth and adolescents. The situation is also acerbated by the unmet need for contraceptives.
The Kakuma Refugee Camp and Kalobeyei Integrated Settlement host about 190,000 refugees, 46% being women and girls of reproductive age. This is a population that is in dire need of reproductive health services right from the moment they are displaced up to arrival and residence in the refugee camps.
John Wafula, Humanitarian Specialist at UNFPA Kenya shared about a project implemented by Kenya Red Cross, IRC, UNHCR, The Government of Japan, UNFPA Kenya, Refugee Affairs Services and the County Government of Turkana West.
“The one-year project that is winding up this month aimed at providing adequate and sustained access to reproductive health and GBV services, and to build the capacity of the community to demand and utilize these services. The project supported about 8000 women to deliver in health facilities in Kakuma and Kalobeyei between Jan 2018-Aug 2019,” said Mr. Wafula.
The agencies sustained medical supplies needed for provision of sexual and reproductive health and also trained health care providers on clinical management of rape and Minimum Initial Service Package (MISP) for reproductive health, adolescent sexual reproductive health, and sensitized the community on services offered at the facilities.
The project not only covered the camp but also extended across the entire Turkana West Sub-county through the work of a robust SRH working group.
Claudines’ nurse (Anne), however shared that the facility carries out an average of 8-10 deliveries in a day. She is concerned about the need for more ambulances to strengthen referral services for women seeking ANC and delivery services, and establishment of a modern theatre at the hospital since most cases that require surgery are often referred to Lodwar, a situation that compromises the need to deliver services timely.
Mrs. Diing has emphasized strategies that will increase uptake of family planning among men, and measures to address the high rate of teenage pregnancies and school drop-out cases in the camps.
On sustainability, Mr. Wafula is confident that the County Government of Turkana, which has mandate for health, is able to take over the project, following the great involved of the leadership of Turkana West Sub-County in line with the approach to integrate services for the host population and refugees. The project invested immensely in capacity building of community leaders on various aspects of reproductive health for sustained awareness creation and advocacy.