On April 30th, the Ochieng’s will present recent footage from the clinic and community as well as update supporters on what has taken place in their village since that night two years ago when the documentary’s premiere audience raised $230,000.

The event - Lwala: An Evening of Celebration - will take place at Langford Auditorium at Vanderbilt University on April 30th. In addition to the main program, the celebration will feature a multimedia village walk through experience and cultural musical events. Ticket sales will benefit the Lwala Community Alliance, which is now expanding its programs in Kenya to better address the maternal health and HIV needs in Lwala.

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This year, as a part of the Clinton Global Initiative, the Lwala Community Alliance publicly committed to expanding its Maternal Child Health programs by building and staffing a maternity facility and scaling its public health programming in the Nyanza Region of Kenya. This initiative is also supported by the World Children’s Fund, Real Medicine Foundation, Senator Bill Frist and the Segal Family Foundation.

To support the new maternity program,  DONATE NOW >

Listen to a Live Stream at:  on Friday, January 23 at 1:00 PM (EST).  In the top right corner, use the red LISTEN NOW category.

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If you miss it, check out the online archive after 4:00 PM.

a) It represents excellent growth in our relationship with the Ministry of Health, which hasn’t always been easy!

b) It gives voice to the things that set us apart, including quality patient care, low/no users fees, consistent drug supply, and a happy and engaged staff.

We work collaboratively with the Minstry of Health, and participate with them in health service planning at the district level. We work hard to keep them appraised of our work and provide them with lots of reports and updates on a host of diseases. They provide us with a small amount of drugs, including vaccines and some malaria medication. They also provide ongoing education opportunities for our staff.

This is not to say there haven’t been bumps in the road. If you’d like details, please get in touch! Suffice it to say here that the challenges of bureaucracy and corruption reach down to the local level.  However, through consistent friendliness and good will on our part (and the installation of a new district minister of health!) we’ve built a more constructive relationship over time, though we continue to face occasional bureaucratic roadblocks. We would still like a more in depth partnership and to receive more medication from them. However, in spite of the challenges our relationship has grown to a point where we feel we are appropriately situated and have some influence in the larger picture of public health and healthcare in our area. As the new minister of health, Dr. Gitau, said in his first visit to Lwala, “You are doing the work of the MOH in an area we aren’t reaching!”

This honor from the ministry of health is also an additional point of pride for our staff.  They have already expressed that they hold their head high in meetings with other facilities, since they work for a place where they have the resources they need and the community is so integrally involved. We expect this to provide them with even more reason to be proud of their work!

As the clinic began operating, and the size and complexity of the project increased, the needs for community oversight and leadership have changed.  To keep pace with these changes, the LCA board, executive director, founders, and LVDC executive committee redesigned a smaller, more skills-based LVDC to meet these needs.  The new committee will meet monthly to evaluate financial and operational reports from the clinic manager and accountant, and to provide assistance as needed to the clinic staff.

The new committee is comprised of 11 members, including representation from men, women, youth, people living with AIDS, the Church, and each of the 7 clans in the area.  It includes people with management experience, financial expertise, and other critical skills.  The new committee met for an orientation meeting last week, which included discussion of expectations and a detailed examination of the updated committee bylaws.

Our hope is that this updated committee will be able to more effectively provide leadership, assist the staff, and ensure financial accountability.  Welcome to the new members!

It was a great opportunity to celebrate, and we also took the opportunity to honor the original LVDC. This committee, which was elected to represent each of the clans in the area to the project, has worked hard for 3 years to make the clinic a reality. Each member received a clock and a certificate for their work.

John explaining HIV/AIDS to the kids at Lwala Primary School

We’re happy to announce the employment of a new clinical officer at the Lwala Community Health Center, John Badia. John is from Kisumu, and completed his training there, first at Kenya Medical Training College (KMTC), and then through an internship at Nyanza Provincial Hospital. Afterwards he worked at the Patient Support Center, a special clinic for people with HIV/AIDS run by the CDC and PEPFAR in Kisumu.

A clinical officer (CO) has a level of training roughly equivalent to that of a physician’s assistant. In Africa they train COs because nearly all of the doctors they train leave for greener pastures. COs are trained in symptomatic management, which means they’re trained to identify clusters of symptoms and apply decision making guidelines based on those symptoms. They do not have the extensive scientific background that physicians do, but in resource limited settings a CO can be a cost effective way of getting a lot of people treated for basic diseases. The standardization of treatments assures that the most common diseases are treated effectively, even if some of the more rare diseases are missed. In Kenya only the big city hospitals have doctors, and even there they’re in short supply. In the smaller towns and rural centers, COs are the highest level of clinical staff.

In Lwala John will lead our clinical staff of 3 nurses, a nurse’s aid, a pharmacist and a lab technician.

Prefect receives soccerball from Omondi and John

Asking a question about the pads

Girls with their new pads

Girls laughing with their new pads

Girls learning how to use the pads

Milton awarding question askers with biscuits

There has been a developing interest lately in the issue of sanitary pads for girls in Africa. The interest stems from the fact that many girls drop out of primary school when they get their period, because there are no toilet facilities at school and they don’t have access to sanitary pads. This is certainly true in Lwala. But in digging deeper we found the picture to be still darker; boys are offering to buy the girls pads in exchange for sex.

This is one manifestation of a widespread problem that public health types blithely call “transactional sex.” In settings of extreme poverty and gender inequality, sex is one of the few forms of capital available to women. But the stakes are high. For the girls, and for the boys as well, the risk of getting HIV and other STIs is huge. Though we don’t know the prevalence of HIV in Lwala for sure, we estimate it may be as high as 30% based on the data we have from Lwala and the surrounding areas. And youth ages 14-24 are often at significantly higher risk than other age groups. And of course for the girls, there’s the unintended risk of ending the problem of menstruation, however temporarily, by getting pregnant.

We wanted to address this issue of injustice at Lwala Primary School. However, we don’t feel that the wholesale importation of pads and tampons from American firms, which is in vogue right now, is either sustainable or environmentally friendly. So we partnered with a new non-profit in the states called Goods4Girls, which provides reusable fabric sanitary pads for girls in settings of poverty. In fact, we’re their very first implementing partner! Thanks to the coordination of Caitlin Reiner, the LCA education committee chair, and Deanna Duke, the founder of Goods4Girls, I was able to carry over a suitcase full of reusable pads sewn by women in the U.S.

On Thursday we took advantage of the opportunity afforded by the pads to do a sex ed and hygiene training day at Lwala Primary. We began with a lively participatory discussion with all the children from 4th through 8th grade, led by the clinic’s lab technician Michael Ondiek, with help from our new CO John Badia and other clinic staff members, about puberty and changing bodies, HIV/AIDS, and other STIs. Milton Ochieng’ gave out biscuits to kids who answered or asked questions, which made thing really lively. After about 2 hours of this (kids in Lwala have very long attention spans!) we split up into boys and girls. The boys wrote down their questions and put them into a special “anonymous question hat.” Then John and the other male clinic staff members and the male teachers led them in dialogue, role play, and even a little slam poetry. You could hear the laugter a mile away! At the end, since they didn’t receive any pads, they received two soccer balls donated by Eleuthero of Portland, Maine.

The girls gathered together with the female teachers and nurses Rose Adhiambo and Vine Adoyo to learn more about menstruation and how to use and wash the pads. There was some good laughter there too. 47 girls received kits, each of which included 4 or 5 pads and a carrying case. The girls who haven’t yet started menstruating each received a pencil, which made them very happy. We left 21 kits at the school for the teachers to give to girls as they come of age.

The school principal, Madam Damaris, was delighted. She deals with so many challenges in getting the girls through school safely, and this is one huge challenge met. In fact several of the teachers told us that even they learned some new things! One of them told Milton, “Even when you think you know it all, there are new things to learn.” Already the teachers are talking about inviting the clinic staff back for another sex ed day, and the clinic staff are encouraging the teachers to form a school health club.

Thank you Goods4Girls!

Erokamano Gige Nyiri!

I’ll let the girls thank you themselves, in English and in DhoLuo. Just click on the links to see the videos. In DhoLuo, “thank you goods for girls” is “erokamano gige nyiri.” On behalf of the LCA and Lwala Primary School, I’d like to express my appreciation to Goods4Girls, Deanna, Caitlin, and all those who donated pads to Goods4Girls. This will make a great difference in the life and education of the girls of Lwala. THANK YOU!

We’ve already heard from several people interested in getting involved. One way you can help is by sewing pads for Goods4Girls to distribute in other communities. Information about that is available at their website. Another way you can help is by donating to the LCA’s microfinance fund. We’re hoping to start a sewing business in Lwala so that women can make reusable pads right here in the village and sell them to other schools and villages, and maybe even some of the international NGOs providing disposable pads. All we need is a small building, a few treadle sewing machines, and some materials to get started. Thanks!

Kids hopping out of the back

In front of the clinic

Polishing the windows

Milton and I arrived in Nairobi on Thursday evening. Unbeknownst to us, until we saw one another leaving the plane, we were on the same flight from Heathrow. We spent Friday in Nairobi, taking care of a few meetings, and then caught the 6am shuttle from Nairobi to Kisii, the second nearest town to Lwala, though about the nearest hardly deserves the name. After an hour or so in the shade, Moi, Betha, and Michael picked us up in the new clinic ambulance! It’s an old but very rugged Toyota Landcruiser, which we will modify to fit a stretcher in the back. For Lwala, we weren’t looking for a fancy ambulance with life support equipment. We just needed a vehicle that could negotiate the “road” in all weather. This should do the trick. Having capable transportation means we can get people to Tabaka hospital, about 25km away, in an emergency. In the past we would call vehicles from town to come provide transport, but in rain or darkness they would refuse to come, which tells you something about the road. Now that we have reliable transportation, we’re more confident about establishing maternity services at the clinic. The ambulance has already taken several emergent cases to Tabaka. “It’s already saved lives!” Milton says. On behalf of the LCA, let me give a huge thank you to Martina Fuchs and Ian Swan at the Real Medicine Foundation for donating the funds for the new clinic ambulance!

After further consultation with Blood:Water Mission and several site visits to other clinics and hospitals in the region, we decided to install a large rainwater catchment system with enough capacity to tide us over during the dry seasons. We will gutter the entire clinic, install a below ground storage tank, and install an elevated tank. Water will flow from the gutters into the below ground tank, then will be pumped to the elevated tank using a small pump run on our existing solar power system, and then flow from the elevated tank into the clinic. You can see things are well underway!