OHR Takes Action Against COVID

Even the most remote regions of the world are not immune to the spread of COVID-19 and our team on Mfangano Island is responding to the threat.

Student interns with Organic Health Response, listed below, are helping with the  COVID-19 response on Mfangano Island.

  • Elias Owuor, Master of Public Health (MPH) student at Maseno University
  • Ananda Vigneswari Anebarassou and David Marshall, MPH students at the University of Minnesota
  • Naema Elsayed and Aimee Carlson, Master of Development Practice (MDP) students at the University of Minnesota. 


These students are collaborating with the OHR executive board (e.g. Dr. Lily Muldoon, Dr. Chas Salmen, Dr. Nick DesLauriers and Kelsi Hines) as well as Ekialo Kiona Center managers, Robinson Okeyo and Samwel Karan, to provide educational materials about COVID-19.

Our team provides weekly updates to the Mfangano community to increase awareness about changing risks and the response to COVID-19. The efforts include:

  • Dissemination of critical updates on self-protection and local regulations in the form of SMS text messages sent out to Health Navigators.
  • Circulation of visually attractive pamphlets to emphasize the importance of hand-washing, wearing a face mask, proper social distancing and more.
  • Up-to-date radio briefs aired daily on EK-FM 88.3 from the Ekialo Kiona Center.

More to come in the future…stay tuned!

Wan Kanyakla

MOMENTUM Study Publication

In March 2020, the first manuscript for the MOMENTUM study was published in Global Public Health! This paper describes the methods of the study, including our group’s approach to the challenge of measuring the “Three Delays” of obstetric emergencies in the rural setting of Mfangano, from beginning of symptom onset on Mfangano to final treatment on the mainland. The paper shows some of the novel tools we are using to capture timing of events throughout the day on Mfangano, such as a visual scale with locally-specific reference events. It also describes our group’s philosophy of participatory and inclusive research, and how we sought to enact this with a narrative-based design and a flexibility methodology to empower local research staff.

MOMENTuM Study staff at Ekialo Kiona Center before embarking on a field work.

MOMENTUM Study staff at Ekialo Kiona Center

Finally, the paper describes how the MOMENTUM study will be used to examine if the Health Navigation program results in reduction in these critical delays in care, and where the largest gaps in care remain. We are excited to share this publication with other researchers and program leaders within the global health community who are seeking to grapple with similar challenges in resource-limited settings! Building on this, future publications will show our results.

e-print link: The MOMENTUM study: Putting the ‘Three Delays’ to work to evaluate access to emergency obstetric and neonatal care in a remote island community in Western Kenya.

MOMENTUM Study COVID-19 Update

Due to the evolving COVID-19 pandemic in Kenya, and to prioritize the health of our staff and that of the community, in-person data collection for the MOMENTUM study has been suspended at this time in accordance with Kenyan and University of Minnesota guidelines.
OHR and Ekialo Kiona center will continue to monitor the situation including Kenyan and University of Minnesota guidelines as time moves forward, and return to in-person data collection only when deemed safe and appropriate. In the meantime, the study continues with remote work on data cleaning and preparation for analysis while the Health Navigation Department continues to serve the community in creating awareness in curbing the COVID-19 pandemic.

Student Spotlight: UMN students take deep dive into Health Navigation and MOMENTUM Study.

During the summer of 2019, a team of three interdisciplinary health science students from the University of Minnesota traveled to Mfangano Island, Kenya. Under the mentorship of Dr. Charles Salmen they assisted with OHR’s ongoing research projects including the Health Navigation Program and MOMENTUM Study (Monitoring Maternal Emergency Navigation and Triage on Mfangano).

The Health Navigation Program trains community health workers in the villages throughout the island to coordinate referrals and expedite emergency care transfers to the mainland, with an additional focus on minimizing obstetrical and neonatal complications through the establishment of birth plans with pregnant mothers. The MOMENTUM Study  is a 12-month study that screens for all obstetric and neonatal emergency cases in order to measure and evaluate delays in access to emergency maternal and neonatal care.

The summer Minnesota team consisted of Eileen Delehanty, a Masters in Public Health student, Katie Beck-Esmay, a second-year medical student, and Nyika Freeberg, a pre-medical student. The team jumped right into the Ekialo Kiona (EK) Center operations, attending Health Navigation meetings, responding to emergency activations alongside the emergency boat coxswain, Walter Opiyo, and accompanying Evance Ogola, a public health student from Kenya’s Maseno University. Additionally, the team worked closely with Violet Auma, the Health Navigation Data Clerk, and Peres Okinyi, the Health Navigation Coordinator, to improve the database for both data entry and extraction.

The Health Navigation Program and MOMENTUM Study were recently showcased at the Inaugural Emergency Medicine Conference in Uganda by Minnesota medical student Nick Deslauriers, research manager Gor Ouma, and study coordinator Evanace Ogola. 

These students are working through the Mfangano Community Health Field Station, a new collaboration with the University of Minnesota Center for Global Health & Social Responsibility.  

Eileen with some of her host family members.

Eileen Delehanty, a Masters in Public Health student, completed her required public health field experience (APEx) on Mfangano Island. Interested in better understanding the promotion of community health in resource limited settings, Eileen worked to streamline data collection and analysis, produced a training manual of standard operating procedures for the MOMENTUM study and assisted in grant writing for the Health Navigation project. As a community health promotion student, much of her time was spent translating information from community members and focus groups to data ready for analysis. Dubbed the “database queen,” she also provided training for local EK staff in database management and statistical analysis.

Katie with her host sister, Sonia.

Katie Beck-Esmay, a University of Minnesota medical student and Judd Fellow, arrived on the island eager to learn and work with EK staff and community leaders to expand experiential learning exchange opportunities for youth on the island and Minneapolis. While much of her time on Mfangano was spent assisting the Health Navigation Program, she also worked closely with EK staff and community members to develop ideas for a sustainable, community-led Emergency Fund that could serve to cover the costs of fuel and maintenance of the emergency boat and reduce the out-of-pocket costs of boat use. The goal is to pilot one of the Emergency Fund ideas in the near future.

Nyika in front of the old radio station building.

Nyika Friberg is a pre-medical student and recent graduate of the University of Minnesota. Having attended high school in central Kenya, he was able to provide unique perspective and motivation working with local communities. Nyika primarily supported staff on the MOMENTUM study, assisting with chart reviews at island and mainland facilities and with quantifying delays from patient surveys. The prolonged delays in receiving care seen in these surveys are a continual reminder of the value of and need for OHR’s work. Nyika will remain on Mfangano through the end of 2019, although the majority of his time is now spent in preparation for the upcoming National Geographic expedition!

OHR Announces Dr. Lily Muldoon as new Executive Director

The Organic Health Response (OHR) Board of Directors is excited to announce the start of our new Executive Director of OHR, Dr. Lily Muldoon!

Dr. Muldoon is a graduate of the University of California San Francisco (UCSF) School of Medicine, where she met OHR-EK Co-founder Dr. Chas Salmen in 2010. She also completed her Emergency Medicine residency at UCSF and obtained a specialized skill set through a Master of Public Health from the Harvard School of Public Health. 

Since 2006, Dr. Muldoon has been involved with health improvements in Kenya. Her partnership with OHR and the EK Center started with performing a needs assessment for the Health Navigation Program in 2013 and eventually facilitating the program launch. Dr. Muldoon has served on the OHR Board of Directors for the past 5 years, operating as a Health Advisor and the Chair of the Development Committee.

She will be working closely with Richard Magerenge, OHR-EK Co-Founder and EK Executive Director to advance the mission of OHR-EK to further promote health and well-being, cultural resilience and environmental sustainability. 

Thank you to Kelsi Hines for her leadership, passion and perseverance in the role of Executive Director from June 2016 – June 2019. We are thrilled to have her join us on the Board of Directors.

We are confident that Dr. Muldoon will lead OHR-EK into a new era of advanced research, powerful partnerships and expanded vision.  Please join us in welcoming Dr. Lily Muldoon to her new position as Executive Director of Organic Health Response!


Rethinking our Rigor Mortis – A new publication!

As global health researchers, we have long embraced the conviction that the answers to complex problems of poverty and disease will reveal themselves if only we apply enough scientific rigor. Yet, at the community level, our group of American and Kenyan investigators has begun to question whether our veneration of rigor is itself contributing to the intractability of certain types of global health problems.

This recent publication, Rethinking our Rigor Mortis: Creating space for more adaptive and inclusive truth-seeking in community-based global health research in Kenya, illustrates examples from our experience among the remote island communities of Lake Victoria, Kenya, and join a chorus of emerging voices, to examine how our culture of control as global health scientists may marginalise truth-seekers and change-makers within communities we seek to serve. More broadly, we seek to acknowledge the limitations of control over truth that rigorous academic research affords. We suggest that by relinquishing this pervasive illusion of control, we can more fully appreciate complementary modes of answering important questions that rely upon the intrinsic resourcefulness and creativity of community-based enterprises taking place across sub-Saharan Africa. While such inquiries may never solve all problems facing the diverse populations of the continent, we advocate for a deeper appreciation of the inherent capacity of adaptive, locally contextualised investigations to identify meaningful and enduring solutions.

The Mfangano Community Health Field Station is a collaborative partnership blooming on the shores of Mfangano in Lake Victoria. For the past year, health practitioners from OHR, Maseno University in Kisumu and University of Minnesota have been working to expand and define how best we can apply knowledge and lessons learning to building resilience among this remote population.


Student Spotlight: Investigating How Health Navigation Improves Maternal Mortality on Mfangano Island

This year, we are grateful to have University of Minnesota Med Student, Nick DesLauriers, with us as a Doris Duke International Clinical Research Fellow! Nick is currently working alongside our team on Mfangano to develop and implement the MOMENTUM Study on Mfangano. Check out the recent Student Spotlight article – Nick shares is first hand experience working on Mfangano!

“In July 2018, Nick DesLauriers arrived on the island as a Doris Duke International Clinical Research Fellow. He is working with Charles (Chas) Salmen, UMN Department of Family Medicine assistant professor, on a project funded by a UMN Center for Global Health and Social Responsibility (CGHSR) seed grant. The research team is studying whether the “Health Navigator” program, through which trained community health volunteers (CHVs)—first responders—in the village, can effectively coordinate and expedite emergency care transfers to the mainland. The project uses an emergency boat, available 24-hours a day, with a captain and a nurse.”Read more!

OHR Co-Founder Joel Oguta Speaks at University of Minnesota

During the month of September, OHR Co-Founder Joel Oguta is in Minnesota on a Visiting Scholar Award sponsored by the University of Minnesota Center for Global Health and Social Responsibility. After hosting hundreds of volunteers and visitors in his home on Mfangano Island, this is Joel’s first trip to the United States!

During his time in Minnesota, Joel will be helping to launch the “Mfangano Island Community Health Field Station,” a new partnership between the University of Minnesota and Organic Health Response. The vision for the field station is to cultivate community-based research, bilateral training opportunities, and foster long-term resilience among the communities of Lake Victoria. Through an adaptive “Community Health Ecosystem” model, we hope to grow transcultural friendships to better understand deep problems and cultivate creative, enduring solutions.

On Tuesday, September 11th, Joel gave a Community Health & Activism Talk (CHAT) called “Living Off the Land: A day in the life of a subsistence farmer on remote Mfangano Island in Kenya.” This was held at the University of Minnesota Urban Research and Outreach-Engagement Center. CHAT is a monthly series of talks around matters that are important in health and healthcare delivery. 

$100,000 CAD Stars in Global Health Award to Improve Maternal Health

We are excited to announce the receipt of a $100,000 CAD Stars in Global Health Award to expand our Health Navigation model, funded by Grand Challenges Canada! This 18-month project will strengthen the emergency referral system for mothers and newborns on the remote island of Mfangano by establishing a durable pathway for healthy pregnancies, safe deliveries, and effective referrals. Beginning in April, this project will support community education for mothers, male partners and traditional birth attendants and will help us train 30 Community Health Volunteers (CHVs) to serve as “Health Navigators” during critical emergencies. Over the course of this project, we seek to improve maternal and newborn health, demonstrated by:
  • Increase in number of pregnancies with at least 4 ANC visits from 27% at baseline to 70% 
  • Increase in skilled birth attendance from 36% at baseline to 70% 
  • Improved access to emergency obstetric care, indicated by an average time of 120 minutes to reach care from the time symptoms present 
  • 70% births having a follow-up visit within 3 days 
  • Qualitative decrease in patient’s financial concerns caused by obstetric emergencies 
We are thankful for all of you who supported the pilot phase of this project, such as our Rotarian partners in Colorado and the Roaring Fork Valley community, and look forward to the next 18-months of community implementation!
To learn more about Grand Challenges Canada and the Stars in Global Health Program, click here.