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MSF in Kenya, 2009
Field Staff: 629
Reason for Intervention:
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In early 2009, as people fleeing the fighting in Somalia arrived in Kenya in their thousands, MSF teams re-started working in Dadaab refugee camp in Dagahaley in the northeast of the country after a five year absence. Teams also responded to numerous emergencies, including fuel tanker explosions and the return of a cholera epidemic, and treated people with kala azar, HIV/AIDS and tuberculosis (TB).
Assisting Somali refugees
Dagahaley is one of three camps in Dadaab that were set up in the early 1990s to house Somali refugees. By the end of 2009, camps that had originally been built to accommodate 90,000 people were struggling to cope with close to 300,000 people. MSF provides healthcare in the camp via a 100-bed hospital that carries out surgeries and offers medical care, and four other health centres that administer vaccinations and give antenatal and mental-health care. The medical needs are huge: the hospital provides around 10,000 patient consultations and admits 600 people every month. Between August and December last year, MSF cared for more than 67,000 patients, including more than 2,200 malnourished children.
Responding to emergencies
In January, more than 100 people died after a fuel tanker exploded in Molo town in Nakuru. Later in the same year, there was another tanker explosion in Kericho. Teams provided surgery, nursing, mental-health and palliative care to the survivors, many of whom suffered burns and other injuries.
After a 12-year absence, cholera returned to Kenya in late 2008. In 2009 MSF responded to several outbreaks around the country and treated approximately 5,000 people.
In the West Pokot District in western Kenya, teams cared for people infected with kala azar, a parasitic disease transmitted by the sand fly that is deadly if not treated. Every month teams cared for 40 to 50 people.
MSF is lobbying for treatment to be provided free of charge by the Ministry of Health and for rapid testing methods for the disease to be made readily available.
HIV/AIDS and TB
Since TB is the leading killer of people living with HIV, a focus of MSF’s work in Homa Bay is treating people with TB and multi-drug resistant TB (MDR-TB). In 2009, MSF constructed an eight-bed isolation ward for MDR-TB treatment in the district hospital for people living with the disease in Nairobi’s slums. Since MSF started providing care for this highly contagious killer disease in Kenya in 2006, 86 patients have received treatment.
In both Mathare and Kibera slums, MSF provides healthcare for around 7,000 people living with HIV, and antiretroviral therapy (ART) for more than 4,800 people. In 2009, consultations in MSF’s three clinics in Kibera increased from around 4,700 a month to more than 7,000. In Mathare, medical teams started providing counselling and testing in different locations around the slum in order to reach more people living with HIV. Specialised treatment for sexual violence, a huge problem in the city’s slums, is also provided and includes drugs that greatly reduce the risk of HIV infection, counselling and social support. In this slum alone, teams treat between 20 and 30 rape survivors every month, many of whom are children.
MSF runs an HIV/AIDS and TB programme in the western Nyanza province, where prevalence is among the highest in the country. In the hospital, MSF teams care for more than 9,400 people living with HIV, of whom 73 per cent receive ART.
Because of MSF’s intervention, this hospital was the first public facility in the country to offer free ART in 2001. However in this poor rural community, where transport is unreliable or expensive and stigma widespread, many patients seek help only if they are seriously ill with HIV. To try to encourage more people to receive treatment, MSF has focused on decentralising care in the district, and has been working to ensure that HIV care is available in clinics throughout the area.
In Nairobi, MSF handed over its activities in Mbagathi hospital to the Ministry of Health after 12 years of intervention. In Busia, in Western Province near the border of Uganda, MSF also handed over its activities in the main district hospital and the support of eight out of nine health centres throughout the year. The handover of the last health centre is planned for April 2010. In the ten years that MSF worked in Busia, good progress was made in treating people living with HIV. Working closely with the Ministry of Health and ensuring that care was decentralised and integrated into healthcare clinics around the district, teams provided care for more than 13,300 people living with the disease, and more than 4,300 of these received ART.
MSF has worked in Kenya since 1987.