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The community Health Worker of Tiaty, Treating Patients Under a Tree

The weather in Tiaty drains you by its sheer viciousness. There are scores of residents who seek healthcare but do not get timely services. Hungry, sick and often illiterate because schools are few and far between, it feels as if they are forsaken. A community health worker is now treating patients under a tree.

One man, 26 year old Reuben Rotich is not waiting for a miracle from somewhere. Or for the government to finally realise that perhaps, there is need to pay closer attention to this sparsely populated area.

He is doing something about the health crisis that has been ravaging his people. He is a community health worker who has come to fill a health gap that is as old as Kenya’s independence.

Insecurity Impedes Health Care Delivery
If he doesn’t and a patient is ill, they have to travel for tens of Kilometres to the nearest facility which is Chemolingot sub county hospital located approximately 30 kilometers from the village on a normal day. Currently, patients have to walk 80 Kilometres to access it because of tribal clashes between Turkana and Pokots. The shortest route is now impassable. They they are forced to use Kolowa-Chemolingot route, approximately 80 kilometers.
Patients wait to be attended to at Chesawach village

At other times, patients choose to stick with what they have always done traditionally. The use of herbs sometimes comes in handy. Other times they apply special clay known as ‘munyan’ which is reddish in colour. It is meant to prevent diseases. It is applied on the hair of newborns to ‘scare’ diseases and trap insects like sandflies and mosquitoes.

“Look at how weak these patients are and are expected to walk tens of kilometers to Chemolingot. This is what inspired me to be a voluntary community health worker ” He says confidently even as I acknowledge that the task ahead is mammoth.

When a Malaria outbreak hit parts of Kenya some three weeks ago, Akoret division in Tiaty was among the places worst hit and it is what gave rise to this makeshift ‘clinic’ in Chesawach village.

This is an expansive place, hilly and the roads are often impassable. The county government of Baringo Constructed Kapau dispensary but it has since closed for lack of professional medical personel.

I watch as Rotich, examines and treats patients suffering from various ailments.

The drips that he is using hang precariously on tree branches all connected to veins of emaciated children lying beneath. Some look up as if in prayer. There is a sense of immense hope amidst the pain.

“We have to improvise methods of providing health care to locals who are in dire need. Look at how weak these children are.’’ Rotich quips.

Patients were waiting anxiously for their turn. There were 30 patients waiting when this writer visited. Majority of them were suffering from malaria disease.

Chepsamai Loserkwan, a 20 year old woman who travelled from Kongor area was among those waiting.Her one year old baby girl had diarrhoea, fever, was vomiting and did not have appetite for food. She we also diagnosed with malaria and was too dehydrated.

” I tried to give her herbal medicine but she did not improve. She has been vomiting blood’’ The mother explains.

Rotich attends to the apprehensive mother and they are soon on their way.I easily understand why they call him ‘’Daktari’’ or Doctor. He trained as a community health worker at Eldoret Polytechnic and volunteered at Chemolingot sub-county hospital in Tiaty. While there, he was forced by circumstances to learn fast how to diagnose, prescribe and treat patients from the medics he worked with.

The Malaria outbreak called him to this current vocation. He purchases drugs from commercial chemists and when need be, refers his patients to Chemolingot.

Rotich travels with his motorcycle to the village and in case of any referrals, he picks the patients to Chemolingot.

“Most locals are not able to afford transport to Chemolingot. Most of the time, I carry them, because their condition has deteriorated. Sometimes the sick people die even before we get them to the hospital because we travel tens of kilometers,” said Rotich.

   Rotich Faces Challenges
Among challenges facing the volunteer is lack of proper referral mechanisms. When he gets children with anemia for example, he is forced to refer them to Chemolingot hospital for blood transfusion but majority cannot afford transport. Motorcycle operators charge locals between Sh10, 000 ($100) to Sh15,000 ($150) to Chemolingot from the village. The terrain is poor. When it rains, the bridges are impassable.

Chemolingot subcounty hospital is aware about his operations. Sometimes, he will call the facility to provide an ambulance but it takes too long because of the poor terrain.

He charges patients depending on type of ailment. His fee ranges between Sh300 ($3) to Sh50 for ailments like diarrhoea. Those who cannot afford to pay for services are treated all the same.
At times, Rotich commonly referred to as daktari by locals is also forced to prepare patients meals before treatment because majority are hungry and weak.

“Drugs cannot heal or release pain on an empty stomach. Patients need to eat but unfortunately many of them cannot afford a meal,”  He said.

Reuben Rotich cometimes cooks for his patients who are too hungry to be on medicaton

For a long term health solution in this area, Rotich urges the national and county governments to collaborate and establish hospitals and deploy medics to offer services.

“There are a lot of people who die before receiving health services because there are no hospitals in this area. The government should construct and employ qualified medics to cater for the needs of the locals here’’ he observed.

As I watched patients get attended to and leave, it became apparent rising up and filling the gap could be all that the people of the larger Tiaty need to heal the broken systems in this the area.

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