What is the role of an architect in a place where the profession doesn’t even exist? Jonathan Dessi-Olive explores this question as he shares his experience building a radio studio on a remote island in Lake Victoria with a team of architecture graduate students and local craftsmen. Working with them, he combined local practices with an academic research agenda to build a community structure.
The Ekialo Kiona Emergency Boat gets a new shade to protect patients from the intense sun and dangerous waves.
From the island itself, here is an update – written by Health Navigation Coordinator, Peres Okinyi, and EK Boat Captain, Walter Opiyo:
The HN program has greatly changed and improved the health logistics and coordination of good care to community members of Mfangano Island. All is well with our team, and with the Health Navigators (HNs) that represent the various villages around the island. Though we have been faced with challenges due to weather changes, with big waves, rains and strong winds, the E-boat transfers to mainland facilities have been successful with safe driving.
The communities and villages are very happy with the program and ready to support it fully. Many of our pregnant mothers are now well coordinated with facilities on Antenatal Care, and Birth plans are coordinated up to the day of delivery with facilities. Most of the birth complications within our mothers are now low, since our team of HNs are trained to identify such cases and call for help to hospital. A large majority of pregnant mothers in Mfangano East are planning for there birth, both financially and where to give birth.
Through our marketing efforts, visits to the facilities both in mainland and island, relationship building with facility staff and management, our work as Health Navigators comes easy during emergencies both day and night. There has been good coordination on care with our teams, both from USA and Kenya, and in future we hope that under good leadership and management things will continue to improve.
We really appreciate the team for the good work through supply donations, funds, health talks, and training. The whole Mfangano Island communities and facilities are so happy with the E – Boat transfers and the idea of constructing it to help people during day or night emergency transportation to mainland hospitals. Ero Kamano (thank you)!!
This past month, OHR has officially begun one of our biggest program expansions to date! Years in the making, our team on Mfangano has now begun identifying patients at local clinics who might benefit from additional support help stay on life-sustaining HIV treatment. Over the coming months, our team will help organize nearly 400 patients – and their self-identified social networks – into health teams called kanyaklas. In total, three to four thousand people will participate in a kanyakla (or microclinic) over the next two years on Mfangano and neighboring Ringiti and Remba islands.
Kanyakla groups will learn together about HIV and how they can collectively promote one another’s health. Groups will go through a series of structured discussion sessions, complete with role-plays and team building activities. These sessions will be led by local community health workers using beautiful new curriculum materials developed in conjunction with Mango Tree, a Ugandan design firm. After learning together, each group will take a collective leap of faith in the strength of their commitment to one another and will participate in a group HIV status disclosure session. By being fully transparent about one another’s HIV status, these groups will become a powerful platform for helping support those who are in need of HIV treatment.
The microclinic program was rigorously tested during a pilot study from 2011 to 2013 (see scientific publication of our results). During that evaluation, we determined that the intervention reduced drop out from HIV care by 50%. Simple interventions with this degree of effect have potential for tremendous impact in a region where up to one third of patients starting HIV therapy drop out of care within the first two years. We aim to leverage the powerful forces of social ties to make health ‘contagious’ across social networks, throughout communities, and across the wider region.
Applications are now open to receive a USAID Research & Innovation Fellowship through the Organic Health Response. This unique opportunity will allow an enthusiastic student to join our team and spend 6-12 months on Mfangano Island!
We offer a unique opportunity to participate in the evaluation and refinement of a nutrition intervention that uses a novel social network approach to treat whole social networks affected by maternal and child malnutrition. A fellow will participate in a case-control study on nutrition behaviors, nutrition knowledge assessment, and focus groups on pathways of effectiveness. Further, a fellow will contribute directly to the planned expansion of the intervention, providing recommendations for how best to scale, improve, and evaluate the program.
The Research on Environmental and Community Health (RECH) Study has worked with over 300 households and Mfangano’s 19 Beach Management Units over the last two years to study how environmental change affects household health. The RECH study visited families throughout all of Mfangano. This effort paved the way for the Kanyakala expansion, which extends EK services to the entire island.
EK Community Mobilizer shares study report in local Beach Management Unit near the lake shore
As the household survey portion of the RECH study winds to a close, we celebrated the success of the study with our research participants. As we thanked them for joining the research effort, we also shared individualized household data with each family. Each household received a report detailing their children’s growth, nutrition, and cognitive development over the past two years. And, children with faltering growth were referred to EK’s nutritional support program.
It was a pleasure to hear the ways our participant families appreciated the research study, and to see how big the participant children have become! We are tremendously grateful to our participant families, the BMU leaders who collect fishery data, and our wonderful EK staff for making this effort possible.
Organic Health Response is proud to have received a Nutrition Embedding Evaluation Program (NEEP) grant from PATH / DFID. The grant will allow us to evaluate our pilot kanyakala nutrition programming, which includes curriculum sessions and food security planning with the East kanyakala groups. Our evaluation will assess whether community members and Community Health Volunteers who participated in and led our nutrition kanyakala curriculum nutrition have more nutrition knowledge than people who did not participate. In addition, we will use data from the RECH research study to examine quantitative changes in nutrition behavior. Finally, we will use focus groups to understand the ways our program did and did not work and make improvements in our work on Mfangano.
Last week our work on fish-for-sex relationships and fish decline in Lake Victoria was published in the journal of World Development. A big thank you to Katie Fiorella, Dan Omollo and our entire community health research team for their hard work!
The Ekialo Kiona Community Health Nurse will be a full-time position that will assist in the management and provision of community health services to the Mfangano Island population. Primary responsibilities will include program development, administrative management, and participation in a local strategy for reproductive health, emergency response and regional advocacy for improved health.