Canadian nurse, Gigi Labrie, joins CHAT’s mobile clinic for a month.
This March I set off to Kenya for a change of scenery and a clear mind. I am a registered nurse working in a busy downtown emergency room in Toronto. Like many of my colleagues, I was feeling overworked, under-recognized, and on a straight track to burn out. I decided I needed some self-care and do something I always want to do: volunteer with an organization in Africa. I was fortunate enough to be put in contact with Sharon Wreford-Smith, the founder and director of CHAT (Communities Health Africa Trust) by one of my high school teachers, Rex Taylor. Through him, I learned about CHAT’s vital work providing integrated clinics and free family planning (FP) services to remote and forgotten communities in Kenya. They address population, health, and environmental issues with a strong emphasis on ecological sensitization. As a biology major before my nursing degree, I felt intrigued and wanted to help in any way I could.
Whilst still in Canada, I was hoping to participate in one of CHAT’s camel mobile clinics. I always have had an adventurous spirit. Traveling with camels while providing healthcare seemed so exciting to me. However, after communicating with Shanni, I learned that the clinic’s needs resided in administrative work. The camping and adventurous side of me was slightly disappointed but I gladly set out to Kenya on February 28th thinking I would be working at CHAT’s Nanyuki office for a month.
However, two days after arriving in Nanyuki, Shanni knocks on the door of the cottage I was renting on her property. She asked if I would like to participate in the camel mobile leaving the next day. An older gentleman was supposed to participate, but she felt it was unwise given he did not have any health insurance. I couldn’t believe it! Although this seemed slightly rushed, I gladly accepted and thanked my lucky stars.
My task were to be:
- Ensure the camels are healthy. Prevent pressure sores and administer the appropriate intramuscular camel drugs if needed. (I’m a human nurse, not a camel nurse – but sure!)
- Assist the nurse from CHAT on clinic days.
The next day I set out for Mpala Ranch, the camels’ place of residence. The first five days, I was to walk across West Laikipia with seven camel handlers in order to transport the camels to the first clinic site in Sokei. The rest of the team, community mobilizers (Pauline, Susan, and Agnes) and a nurse (Mercy), were to meet us there. With no Swahili phrasebook in hand and no clue how to take care of camels besides a three hour Google research the day before, this was going to be an interesting five days!
These days proved to be tougher than expected. I could handle the 6-8 hour walks, but the heat got to me. Two days before I was in -10 degrees Celsius shoveling snow! Another interesting challenge was my introduction to what is affectionately called Africa time. After walking six hours on Day 3, I asked a question one should never ask: “How much longer?” Andrew, one of the English speaking handlers, responded: “Just one more hour.” He responded one more hour three times until we arrived to our campsite. Even Armadeo, one of the camel mobile veterans, exclaimed: “TOO LONG SAFARI!” I will remember that day forever.
It was a wonderful safari across West Laikipia to a charming Kikuyu town. We walked by five schools with hundreds of children screaming GAMIA! (camels) and MZUNGU! (white person). Every day people were surprised to see a 5’3” blonde white girl traveling with 12 camels and seven Samburu men! I would too! My feet were on fire and I wrote in my diary; “AFRICA TIME IS !@#$%? Up!” We had walked 9.5 hours that day. In addition, besides sweet tea in the morning and snacks we didn’t eat a real meal until 8 pm. I suppose the guys wanted to power through the walk. It seems testosterone affects ALL men!
Once the actual clinics started, the dynamic of the group changed with the arrival of female energy on Day 6 in Sokei. Mercy, the CHAT nurse, and I got along really well. We are both in our late twenties and have similar views of our profession. The more I worked with her, the more I realized how nursing is universal. I also learned how the role of the mobilizers, Agnes, Pauline, and Susan, is vital to CHAT’s clinics.
After our first clinic in Sokei, we descended a valley to Wasegas. Wasegas and its surrounding towns are very isolated and difficult to access by motor vehicle hence the need for camel mobile clinics. In addition, the residents of all of these towns including Sokei belong to the Kalenjin tribe. Kalenjin speak a dialect named “Kale”. Mercy was the only CHAT team member that could speak Kale. As a result, CHAT decided to hire two Kalenjin handlers from Sokei. The goal was for them to attract villagers to our clinic and act as mobilizers themselves.
As stated earlier, one of CHAT’s main goals is to address population, health and environment issues (PHE) through free family planning. Our other health services including basic curatives, reproductive health, and HIV/AIDS services acted as entry points for FP services. In any culture, FP, sexual health and contraception are difficult topics to approach. In rural Wasegas, the issues seemed even more stigmatized. When it came to family planning, many women seemed uneducated and believed many myths and misconceptions. They were fearful of stigma from their peers and afraid their husbands would find out. As a result, despite our mobilization efforts, many women were afraid to visit our health tent. On our third clinic day, I finally felt comfortable inserting contraceptive implants. (Implants are surprisingly unpopular in Canada, I had never inserted them before.) Mercy and I decided to split up. I would stay at our health tent in Wasegas with Susan and Mercy would travel with a backpack filled with FP commodities with Pauline. (Agnes, our third mobilizer, left us for 2 weeks in order to care for her baby.) That first day Mercy reached 38 family planning clients and I only reached one. Mercy’s ability to communicate in Kale with women in the privacy of their home was an extremely successful approach. We continued to follow this approach at every consecutive clinic day. Two nurses for the win!
One particular clinic day touched me immensely in a town named Keon. That morning, Mercy had left with the FP backpack with Agnes. I was left at the health tent with Pauline and Susan. We were having a slow day and I was feeling fairly defeated. Why were women not visiting our tent? Was the stigma this high? Just when I was thinking these thoughts, 15-20 women came walking down the road. I ran up to them greeting them in Kale ‘Chamgay!’ and urged Pauline and Susan to come over. It turned out that they were heading for a one year old’s birthday celebration. I decided to fill my own personal back pack with FP commodities and the three of us headed to the party. At the party, they fed all three of us and allowed Pauline and Susan to provide them with an FP education session. Several of these women were already using implants and encouraged their peers to utilize them. One of these women, the leader of the group, nicknamed Mrs. Masa (not her real name) was my favourite. Mrs. Masa had an interesting sense of humour and was very open about FP. She disclosed to the group in a laughing way that her parents were very poor and alcoholics. She never finished grade school and wanted her four children to have an education. This is why she first started taking the birth control pill. However the pill made her “Want to have sex with everybody!” This made the group laugh. Due to these side effects she chose an implant and is very happy with it. I don’t think we could have advertised our services in a better way! The whole group followed us after the party. Four women were tested for HIV and another three received implants. Mrs. Masa, however, was the real hero in this story. She was able to influence her peers in such a positive way. Even if some women did not receive implants she still influenced them for future camel mobile trips. I was really moved by these women’s generosity and resilience that day. I wish I could have taken Mrs. Masa to Canada on a camel like she wanted me to!
I would like to share another story regarding education and bursting FP myths and misconceptions. In Ngarie, the town after Keon, I inserted a 40 year old woman with an implant. Before the insertion, she was talking with Susan, one of our mobilizers. She always wanted an implant but had heard that they give children birth defects. She thought all of her children would be born without limbs and have large heads. As a consequence she had 12 children! According to Susan, these misconceptions are extremely common. My hope is that the more clinics are held, less cases like these will exist.
So many different stories occurred over my 24 days with the clinic. This little report took me so long to write. My experience is so difficult to summarize into a short essay. I hope that the last two stories paint a picture of the importance of family planning education and the role CHAT plays in mitigating this issue. CHAT truly follows their mission to promote healthy, empowered and sustainable communities. As a young woman I felt empowered. CHAT is all kinds of incredible. March is women’s month. I can’t think of a better way to have honoured it. I can’t thank the team enough for this amazing experience.
I will be back. Asante sana sana!