Ekapuan Elipan, a community health promoter in Lodakch, Kenya, gives a mother therapeutic nutritional supplements for a malnourished child July 26. Lucy Makori / Doctors Without Borders
The Ekope family lives in one of the villages of Lodakach, Turkana County, Kenya. Its members bear the burden of a triple burden: an outbreak of measles that has hit the region since March last year and has already killed eight people, as well as malaria and malnutrition. On the day I write these lines alone, the Doctors Without Borders (MSF) team has carried out more than a hundred medical consultations in the city.
The mother, Hellen Adir, comes worried to the office in Lodakach where I am. With her are two of her three children, Ekidor Ekope, two years old, and Abenyo Ekope, 10, who accompanied her to the doctor’s appointment. Abenyo looks frail as he goes through triage. The scorching sun makes her fever and pain symptoms almost unbearable. The girl watches the MSF mobile clinic team while one of my colleagues asks her mother about the little girl’s condition.
“His joints, stomach and legs are starting to hurt. I came to get medicine for her. “I suspect it’s malaria,” says Hellen. “I haven’t had any peace for two weeks. One by one the children get sick. My five-year-old son Longem is at home, also recovering from measles and malaria. I took him to the pharmacy in Lopur last week and he was treated there,” he added.
His joints, stomach and legs start to hurt. I suspect it’s malaria
Hellen Adir, mother of 10-year-old girl Abenyo Ekope
My colleague Nancy Gichiki, clinical director of MSF, checks Abenyo’s temperature and finds that it is very high, which is consistent with what she has observed during external medical activities in children and adults. He also notices some rashes around Abenyo’s ear and asks him to open his mouth to check if he has a sore throat. The symptoms confirm measles. The next step is to check if he has malaria as he also complains of body pain. The test is positive and treatment must be started immediately.
Abenyo is one of 451 measles patients and 1,475 malaria cases detected in the West Turkana sub-county alone. Many people are affected by these problems, from babies to the elderly. The blazing sun didn’t stop her from going to the doctor. Some of them are sick and are lying in the shade to escape the heat, waiting for medical attention. Most older people complain of joint pain, but children under five years of age are most affected.
The effects of drought
But that is not the only struggle of this pastoral community, which has not been forgiven by the drought. The terrible effects are evident in malnutrition among boys and girls as well as among pregnant and breastfeeding mothers. With many residents’ livelihoods destroyed by the death of livestock, they go to great lengths to find food for their families.
Hellen’s two-year-old son Ekidor has undergone a nutritional evaluation and has just received a two-week therapeutic supplement for severe acute malnutrition from Phinnah Botta, my fellow nutritionist. Médecins Sans Frontières medical teams have been conducting nutritional tests in mobile clinics and health centers on the most vulnerable people – children aged nine months to five years, pregnant and breastfeeding mothers. We refer people affected by malnutrition to nearby centers where they are monitored and their development is checked.
The mobile clinic team continues to ask parents the following question: “Are there children at home with symptoms of measles or malaria or malnutrition?” Please bring it with you.” A distressed father responds. “I didn’t have the energy to carry my other son, he weighed too much and was very weak at the same time. At least I was able to transport another child on my bike,” he explains. The team listens to him and asks if he could lead the community health promoters to his house. Eventually they manage to reach the house and return with the child.
A stone’s throw away, the distribution of mosquito nets continues. 8,403 were given to families with children under 15 and pregnant and breastfeeding mothers. Ekidor’s family also received a mosquito net for the little boy and his recovering siblings.
MSF has been working with the West Turkana sub-county team since June to jointly combat the dual threat of measles and malaria through mass vaccination, integrated case management, treatment at two health centers and teamwork. Essential community-based mobile doctors. It’s a race to leave no child unvaccinated against measles or untreated against malaria.
In total, the mass measles vaccination campaign in the vast sub-district vaccinated 26,862 children, reaching villages more than 170 kilometers away. This is accompanied by strengthening health promotion through community involvement, awareness and monitoring. For those who live far from healthcare facilities, bringing vital medical services closer to Turkana villages is of great importance.
Lili Marie Wangari She is the deputy medical coordinator for Doctors Without Borders in Kenya.
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