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1.
THE COMMUNITY HEALTH AFRICA TRUST (CHAT)
(Formerly The Mpala Community Trust: MCT)
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The Community Health Africa Trust is a Kenyan registered
Community Based Organisation (CBO), which is located
in the Laikipia region of Northern Kenya. This organisation
was established in 1999 and originally formed part
of a community outreach programme for the world-renowned
Mpala Ranch in the Laikipia region. At its inception
this project was known as the Mpala Mobile Clinic,
which operated under the auspices of the Mpala Community
Trust. (www.mpala.org/mct)
Over
time this Trust has successfully increased its capacity
in the Laikipia region and has recently transformed
itself into the Community Health Africa Trust (CHAT).
This organisation works closely with its sister organisation,
the Nomadic Communities Trust (NCT), which operates
predominantly in the neighbouring Samburu region.
In
recent years The Community Health Africa Trust (CHAT)
has evolved into a robust well-administered Community
Based Organisation that provides reliable health services,
education and counselling, basic curatives, immunisation
and reproductive health education to the underserved
people of the Laikipia region of Northern Kenya.
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THE
LAIKIPIA REGION
The
Laikipia region is located in the northern part of Kenya.
And supports a population of 420,000 people. Approximately
80% of these inhabitants live in remote rural areas. These
people are largely transient, semi-nomadic pastoralists
who comprise of a number of ethnic groups. The majority
of inhabitants in central and north Laikipia live in extreme
poverty, subsisting on under one US$ a day. Natural resources
such as water and grazing space for livestock are limited.
A high demand for these resources often gives rise to inter-group
conflict. Apart from local insecurity, the people of this
region are faced with significant challenges such as: Preventable
medical conditions (including malaria), the HIV/AIDS pandemic,
illiteracy, unemployment, land degradation, drought/famine,
rapid population growth and a lack of educational opportunities.
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Poor
road infrastructure prevents access to the central and northern
parts of Laikipia. This in turn mitigates strongly against the
provision of basic health care and other essential services to
the rural people of this region. Traditional practices that are
common to male dominated societies such as polygamy, female genital
mutilation and female subservience present further challenges
for health and reproductive education.
CHAT
PROVIDES THE FOLLOWING INTEGRATED SERVICES TO THE UNDERSERVED
COMMUNITIES OF CENTRAL AND NORTHERN LAIKIPIA
The
Community Health Africa Trust provides an outreach door-to-door
service to those communities of the Laikipia region that have
been previously underserved. This service operates in the form
of a mobile clinic. One of the sole health care providers to this
region, the mobile clinic uses an integrated system of vehicles,
camels, bicycles and walking methods to visit approximately 25
different rural sites each month. Staffed with two nurses and
a driver, a well-recognised yellow Land Rover travels over 15,000km
annually. This vehicle has become a symbol of humanitarian care
and health management throughout the region. The mobile clinic
reaches approximately 50,000 people annually. The Community Health
Africa Trust also operates a fixed clinic at its field station
on Mpala Ranch.
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2.
THE NOMADIC COMMUNITIES TRUST (NCT)
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The Nomadic Communities Trust is a Kenyan registered
Community Based Organisation (CBO), which is located
in the Samburu region of Northern Kenya. 'Samburu'
is the region directly north of 'Laikipia'. This organisation
was established in 2003 as a sister organisation to
the Community Health Africa Trust that operates in
the Laikipia region.
Since
its inception this organisation has become well recognised
as one of the only providers of reliable health care
to the people of the Samburu region. Like its counterpart,
the Community Health Africa Trust, The NCT works in
close partnership with the Kenyan Ministry of Health.
The
Nomadic Communities Trust (NCT) currently operates
as an accountable, well established community based
organisation that provides reliable health, education
and counselling services to the underserved people
of the remote Samburu region in Northern Kenya.
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THE
SAMBURU REGION
This
region supports a population of 200.000 people extending across
an area of approximately 21.000 square kilometres. 'Samburu' is
more remote and less accessible than 'Laikipia'. For this reason
camel transport is central to the integrated mobile health service
that is provided to this community. Camel caravans provide a highly
effective means of transport for those areas that often have little
or no road infrastructure. The people of Samburu are largely nomadic
pastoralists. A strong reliance on grazing for livestock makes
these communities extremely vulnerable to seasonal variation and
drought. Other significant challenges include: HIV/AIDS, malaria,
upper respiratory tract infections, famine, lack of clean water,
and extreme poverty.
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NCT
PROVIDES THE FOLLOWING INTEGRATED SERVICES TO THE UNDERSERVED
COMMUNITIES OF THE SAMBURU REGION
The
health care services offered to the Samburu Region by the
NCT include: Reproductive Health and Family Planning advice,
HIV/AIDS awareness (including Counselling, Testing and the
provision of non-antiretroviral health services), basic
primary health care, immunization and information on Female
Genital Mutilation. The mobile team uses various forms of
transport to reach an average of 17 communities per month.
Statistics show that approximately 35.000 people attend
the NCT clinic annually. The Nomadic Communities Trust has
a field base in Maralal town (Samburu Region).
A
FOCUS ON SUSTAINABILTY
The
Community Health Africa Trust and its sister organisation
The Nomadic Communities Trust aim to create a sustainable
platform for health care in the Laikipia and Samburu Regions.
These organisations aim to initiate workable structures
for health management by mobilising and educating community
based health care workers, community leaders and individuals
to take ownership of these projects. Although ongoing assistance
is provided, the ultimate aim of these Community Based Organisations
is to facilitate independence and empowerment.
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The Community Health Africa Trust and The Nomadic
Communities Trust believe that childhood immunisation
is a basic right
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3.
ORGANIZATION HISTORY
THE
COMMUNITY HEALTH AFRICA TRUST AND THE NOMADIC COMMUNITIES TRUST:
HISTORY
The
Community Health Africa Trust has its home base on Mpala Ranch
in the Laikipia region. This Ranch is funded through the Mpala
Wildlife Foundation (MWF) and supports an internationally recognised
centre for ecological and social science education and research.
This research centre is administered through the Mpala Research
Trust in collaboration with Princeton University, the Smithsonian
Institution, the Kenya Wildlife Service and the National Museums
of Kenya. In 1999 Shanni Wreford-Smith approached the trustees
of The Mpala Wildlife Foundation with her vision to create mobile
clinic services to surrounding communities who were clearly
in need of urgent humanitarian assistance. The original owner
of the ranch, George Small agreed to purchase a vehicle and
allow the clinic to establish its home base on Mpala ranch.
The most significant contributors at this time were Marie Stopes,
Mr Brad Hall (from San Fransisco) and his partner Dierdre. In
1999 the Mpala Community Trust and its outreach arm, the Mpala
Mobile Clinic were established. The brainchild and initiator
of this organisation, Shanni Wreford-Smith, has since extended
this programme beyond Mpala Ranch into central and north Laikipia
and has subsequently re-visioned the activities of the Mpala
Community Trust (MCT) into the Community Health Africa Trust
(CHAT). In 2003 she established a sister organisation: The Nomadic
Communities Trust (NCT), which provides similar services to
communities in the neighbouring Samburu Region. Ms Wreford-Smith
continues to seek funding for the development of these community-based
organizations.
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4.
SUSTAINABILITY
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The
Community Health Africa Trust and the Nomadic Communities
Trust have created a unique model of sustainability that
has proven to be highly effective in the remote areas of
Laikipia and Samburu. This project model entails engaging
the assistance of local people and relevant government ministries
to provide health care to previously underserved communities
using integrated transport options such as vehicle, bicycle,
foot and camel transport. By training local community members
in key roles to facilitate service delivery, and by mobilising
support from community leaders this model has the potential
to empower communities towards establishing their own systems
of basic healthcare. It is hoped that this will in turn
lead to the expansion of economic opportunity and increased
wellbeing for people in poor remote communities
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The effectiveness of this model in the Laikipia and Samburu regions
of Kenya raises the possibility that such a model can be re-produced
in other parts of Kenya and Africa for similar communities that
have received little or no intervention due to their remote location.
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THE MODEL OF SUSTAINABILITY USED
BY CHAT/NCT
Enter
into previously underserved regions that have requested
assistance for clinic services
Engage
local communities using integrated mobile clinic options
such as: vehicle, camel, foot and bicycle delivery
Educate
indigenous community based counsellors and Health care
workers
Empower
communities towards self-sustainable health care
Enhance
the well being of previously marginalized and disadvantaged
communities
Exit
once a framework of strong human and institutional capacity
is in place with good management and leadership capability.
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5.
LAIKIPIA AND SAMBURU: THE
REGIONS, THE PEOPLE & AREA MAP
THE
LAIKIPIA REGION AND ITS PEOPLE
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The
Laikipia region supports a mixture of well-watered areas
in the south to the more semi-arid areas of the north. This
region is located on the Equator in the northern part of
Kenya. Laikipia is home to a diverse population of ethnic
communities: The Kikuyu people make up about 60% of the
population, with the remainder comprising other ethnic groups
such as Maasai, Samburu, Meru, Borana, Kelenjin, Somali,
Turkana and Pokot. This region, which is similar in size
to Wales, covers an area of 9,500 sq kms and supports a
population of approximately 420,000 people. Whilst tourism
and agriculture play a role in the economy, the vast majority
of people (80 percent) live in rural areas and subsist as
pastoralists and cultivators with some nomadic groups in
the north. The life of the average person in this region
is largely shaped by the search for water and grazing land
for their animals. Parts of Laikipia are harsh and inhospitable,
with poor road infrastructure, making travel between urban
centres and outlying areas extremely difficult. The Mpala
Community Trust began operating mobile health clinics in
this region in 2000.
THE SAMBURU REGION
AND ITS PEOPLE
The Samburu region is a semi-arid area situated north of
the Laikipia region.
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This region is characterised by low grass plains interspersed
with rocky outcrops and high mountain ranges. This remote region
is home to the Samburu ethnic group as well as smaller groups
such as Turkana, Somali and Rendille communities.
Samburu,
which is similar in size to Israel, covers an area of approximately
21,000 square kilometres, and supports a population of approximately
180,000 people. Only 3 percent of the land in Samburu is cultivated
for crops. The Samburu Tribes are generally termed "nomadic
pastoralists" relying on goats, sheep, cattle and camel ownership
for their livelihood. The men move livestock seasonally to fresh
pastures while women and children are becoming more sedentary,
living close to a small number of schools, clinics and development
projects that have been established in the region. The Samburu
people share some customs that are similar to the Maasai.
Due
to their severe isolation, the population of this region has received
minimal access to health care and education. In 2005 the Nomadic
Communities Trust (NCT) began providing services to the people
of this area using camel caravans as part of an integrated mobile
health system.
WHY DO THE PEOPLE OF LAIKIPIA
AND SAMBURU NEED ASSISTANCE?
Many of the inhabitants of both Laikipia and Samburu live in abject
poverty and have little or no access to professional health care
and other essential services. The World Bank states that people
who live on less than $1 per day are in extreme poverty. Extreme
poverty correlates with hunger, lack of shelter, illiteracy, child
mortality, joblessness, political powerlessness, and poor or non-existent
healthcare.
The Mpala Community Trust (established, 1999) and the Nomadic
Communities Trust (established, 2003) evolved out of a recognition
that many people in Laikipia and Samburu were in dire need of
humanitarian assistance and qualified as 'living in extreme poverty'.
For the most part, these regions were not receiving adequate health
care from government and non-governmental agencies. This was largely
due to inaccessibility, remoteness and poor road infrastructure.
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The
Laikipia and Samburu regions face increasing pressure from
a lack of basic health care, family planning education and
exposure to the HIV/AIDS pandemic. Challenges include the
cultural practice of male domination, gender inequality
and female genital mutilation. Other challenges are illiteracy
(75-80 percent), unemployment, land degradation, drought/famine,
rapid population growth, a lack of education opportunities
and local insecurity. A lack of clean drinking water and
poor sanitation makes these communities vulnerable to infectious
and preventable diseases such as Trachoma. Effective intervention
is hampered by access and a lack of education. Illiteracy
presents ongoing challenges for communication and education
strategies.
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Conflict
in the Laikipia and Samburu regions between various groups of
pastoralists and cultivators is frequent. This is generally related
to competition for essential resources such as grazing for livestock
and water, especially in times of drought. Livestock theft and
subsequent raids to recover livestock is another a source of conflict.
These incidences of group conflict can be violent and often fatal.
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6. TRUSTEES AND PERSONNEL
COMMUNITY
HEALTH AFRICA TRUST (BOARD OF TRUSTEES)
Mr Michael Shaw (Registered Attorney: Kenya, Nairobi)
Mr Jeff Gonya (Representative/Mpala Wildlife Foundation. Registered
Attorney: Baltimore, USA)
Dr John Tole (Registered paediatrician and administrator of the
Aga Khan Hospital: Nairobi, Kenya)
Ms Shanni Wreford-Smith
Mr Ken Wreford-Smith
NOMADIC COMMUNITIES TRUST (BOARD
OF TRUSTEES)
Dr Duncan Blaikie
Mr Charles Hewett-Stubbs
Mr Toby Aykroyd (Population Sustainability Network)
Dr Patrick Ochieng
Ms Shanni Wreford-Smith
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CHAT
PERSONNEL
Ms Shanni-Wreford Smith (Initiator and Programme Director)
Ms Demoriah Kililiku (Financial Officer)
Ms Lucy Kananu (Data clerk and Procurement Officer)
Dr Lynne Elson (Consultant/Resource Manager: Nairobi)
Ms Pauline Nunu (Clinical Nursing Manager)
Mr Titus Kirimi (Nurse)
Ms Mercy Mwari (Community Health Worker/CT Counsellor)
Ms Beata Muli (Field and Support
Group Co-ordinator)
Mr Peter Obino (Driver)
Mr Patrick Kimanzi (IT/Admin Manager)
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NCT
PERSONNEL
Ms Shanni-Wreford
Smith (Initiator and Programme Director)
Ms Demoriah Kililiku (Financial Officer)
Ms Lucy Kananu (Data clerk and Procurement Officer)
Dr Lynne Elson (Consultant/Resource Manager: Nairobi)
Ms Christine Lesadala (Nurse)
Mr Josephat Ngasike (Community Health Worker/CT Counsellor)
Mr Toshi Singh (Driver)
Ms Beata Muli (Field and Support Group Co-ordinator)
Ms Lois Lesoto (Nurse)
Mr Patrick Kimanzi (IT/Admin Manager)
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