A bicycle would today be considered in many African cities as a poor man’s means of transport yet in remote villages across the continent it could literally be the difference between life and death.
CooP-Kenya is local NGO that has operated in the Western Kenya region for about seven years now. The acronym stands for Cycling Out of Poverty Foundation Kenya and is part of a continent-wide foundation founded in the Netherlands by a Dutch couple Marike de Wild and Luuk Eickmans who fell in love with East Africa during an earlier visit.
In an effort to combat extreme poverty in villages across East and West Africa, the foundation started three programs targeting access to education (Bike2School), micro-enterprise (Bike4Work) and access to healthcare (Bike4Care).
Bike4Care is probably one of the most successful programs run by the Kenyan chapter of the foundation. In rural Kenya, the distance between populations and hospitals could at time be more than 20 kilometers. This makes it very difficult for them to access medical care leading to a lot of preventable deaths.
In 2007 the Government of Kenya in partnership with other donors developed what is now known as the Community Health Strategy that aimed at improving health indicators at the household levels to reduce occurrences of disease outbreaks, to improve maternal and neonatal health and to provide effective followups to HIV patients on antiretroviral therapy.
This strategy involved the recruitment and training of Community Health Volunteers to not only bridge the gap that exists due to distance but also provide a bit of reprieve to the under-staffed health sector by improving hygiene at the household levels thereby reducing occurrences of certain diseases.
This was however not going to be an easy task because the Community Health Volunteers (CHVs)are not paid salaries.
We found ourselves in a situation where a government policy that was meant to improve livelihoods of communities living in rural areas and urban slums lay on the hands of volunteers. Here were a group of women and men moving from house to house at times covering very long distances on foot. Our primary healthcare relied on goodwill from people who have challenges of their own. – Kennedy Obat, Country Director, CooP-Kenya.
The biggest challenge in rural Kenya was means of transport as some of the households covered by the CHVs were far apart.
Eunice Awino Ohana is a CHV reporting to Okana Dispensary, about 20 Kilometers East of Kisumu City. She has been a Community Health Volunteer for the past six years. Each month she visits an average of 110 households and doubles up as a supervisor to other CHVs.
This work has not been the easiest form of work for most of us but we do it because we had already volunteered. Many people who were excited about it quit within a few months because it involved a lot of sacrifices for our communities to live well.
At times the CHVs had to dig into their own resources from the businesses or farming activities they are involved in to help them meet their targets.
If you look around you notice that most people doing this job are either women or old men like myself. It’s very unattractive to men or anyone who has a responsibility of providing for their own families because there is nothing to be gained here other than the contentment that comes from serving your community. – Phanuel Litong’, 67.
Things however changed for the better when CooP-Kenya introduced the Bike4Care Project in 2011. The CHVs were provided with bicycles which they would then pay for in installments. This has gone a long way in improving the efficiency of the CHVs.
With this bicycle I can now do more than four times what I used to do walking on foot. Whenever I visit a household to give a health talk or monitor the various indicators we look for I can spend ample time as I am not in a rush. I also use the bicycle for my own errands and can now provide well for my family too. – Phanuel Litong’
When it rains these roads become impassable, no ambulance can come to pick a sick person from these villages. I remember one time I had to carry a lady who had had a miscarriage on my bicycle all the way to the dispensary 10 kilometers away. The impact is not just felt by us but by the people we serve too. – Eunice Awino Ohana.
The organization is currently giving out more than 2,000 bicycles each year. The impact has been tramendous.
When we look at the data captured by the ministry of health information system, there has been more than a three fold improvement in the specific areas we are operating in regarding capturing of data. We are seeing more women giving birth in hospitals as a result of the CHVs reaching more households with health talks. We are also witnessing increased referrals especially in rural areas. – Kennedy Obat
Florence Owiti is the Nurse in Charge of Komwaga Health Centre located about 15 kilometers South-East of Kisumu.
The CHVs are the linkages between us and the community. As medics we are usually stationed at one place but patients are coming from the community. We are not usually able to go there and bring them to the hospitals and that is why the CHVs are assigned specific villages. At times they need transport but we are not able to help them with that and that is why partnerships with non-governmental bodies such as this one is important.
The staff at CooP-Kenya working in various sectors understand the magnanimity of the work they do – right from the assemblers to the Project Coordinators.
I like my job because I know I am helping save lives across Kenya and Uganda. Even though it’s not me going to use the bikes in the field, I feel that I am part of them. – Jamal Kavenge Akhmed, Bicycle Assembler, CooP-Kenya.
My biggest motivation in this work is my desire to alleviate human suffering. I use my skills in making items like bicycle ambulances which are used in urban slums on roads that are inaccessible to conventional ambulances. – Christopher Oduor, Fabricator, CooP-Kenya.
While they are aware that they might not be able to fix all of Kenya’s primary healthcare challenges, the staff at CooP Kenya are focused on the little they can do, one bike at a time.