Author Archives: Karen Pitts

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Contraception: Is it cultural barriers or is it lack of supplies?

It is so often claimed that shortage of supplies is not the real reason for low contraception usage, but here is a case where the shortage is indeed the problem. In 2015, lack of information about family planning may have been the reason, but we have solved that problem with family planning training of a few women and the development of a family planning video in the Maasai language. Consequently, in August, when Marie Stopes showed up with their mobile clinic at a nearby health clinic in the small town of Nainokanoka, 28 women walked 4 miles to get family planning implants.

Now, when more women are showing interest, Marie Stopes has cancelled their mobile clinic, at least until next year. This means that the women who wanted to get a method can’t get one, and that women who were having undesirable side effects from the hormones in the implant can’t easily get it removed and can’t get a new method. It has been shown that women who reject a method that does not work for them are at a large risk of rejecting modern contraception altogether.

We had been hoping that the doctor at the small, woefully inadequate, government health clinic at Nainokanoka could be talked into providing family planning services there. Finally our Maasai team members have become acquainted with the facility and the staff and have convinced the doctor to provide family planning services. This doctor even suggested a mobile clinic to make monthly rounds to serve all the people in the area.

But, gosh, I had really underestimated the sad state of affairs at a government-funded clinic.

This like peeling an onion.

So now I am looking for an NGO who can supply the clinic with the needed contraceptive methods. And then there is all the other equipment needed.

Below is his letter, listing all that is needed.
Dear Karen,
Greetings,
Thank you for your response.
I have impressed on what you have started on Family Planning issues.
I thought that,your plan would be sustainable if we can equip Nainokanoka HC (health clinic) with enough instruments and supplies to facilitate services for the entire population and the nearby.
At our Centre we are providing the following methods of Family Planning:
1.Short term methods-Pills; Combined Oral pills and Progesterone only pills, Male and Female Condom, Calender method.
2.Long term FP methods -Implanon 3 years and Jadedly 5 years.
Permanent FP methods – Bilateral Tubal Ligation(BTL) and Vasectomy meanwhile not practicable as we do not have theatre,.
 
There are 3 Health Care Workers who trained to provide these services.
It is therefore, they are able to put and remove implants without dought.
Giving them a refresher course will be an advantage.
 
The following items will facilitate to run Family Planing services at our Centre:
=A supply of Oral Pills and Implants, Lignocane, Surgical blades, Surgical gloves, Iodine solution, Syringes 5cc and 2cc,Cotton wool, Gauze and Antiseptics.
 
=Instruments needed -Cheatle forceps, Artery forceps, Dissecting forceps, Speculum(cusco), Kidney dishes 5, Gall pots 5 ,Sphygmomanometer (Blood pressure machine), Sterilizer,Examination bed, Examination light and Weighing  scale Adult.
 
Diesel engine Generator is needed for sterilization of Instruments.
 
=Mobile outreach clinics to the community will increase the number of Clients but not Family Planning alone in separate, other services like Vaccination to Children, Health education, Antenatal services will be rendered if fuel and Allowance for driver and 4 Staff will be available. 

Progress Report

We are still finding pieces of the solution of the water system.We still think that conservation by means of water tanks is a good part of the solution.

The Emburbul primary school children have started going to boarding school in Nainokanoka.  We have provided 28 girls’ uniforms and 20 boys’ uniforms as an incentive to the kids and parents. This will be a big help towards the goal of getting girls into school and keeping them out of child marriages.

There are two hitches in this plan:

1) Children can’t start at the boarding school until age 9 unless they can learn to wash their own clothing. This leaves a gap between nursery school (ages 5-7), which is at the village, and the time they can go to primary boarding school. So if they are to start primary school at age 8, they must walk 4 miles each way, every day, to school.

Possible solutions: a. teach the younger children to wash their own clothing. b. enlarge the scope of the nursery school at the village.

2) About 50% of children fail the Leaving Primary School exam, which means they cannot go to secondary (high) school.

Fortunately we have found a girls high school that takes failed girls: Emanyata in Loliondo, 135 km away. The school wants only $500 per girl per year, plus there are personal expenses of about $100. We have promoted a Facebook ad and we are soliciting donations to send several girls to Emanyata. See more here.

The three girls who are attending Shepherd School (English Boarding School), came home for their holiday this week. One of them, Nopenyi, had a rash and was sick. The doctor said she had brucellosis, a disease common among pastorals, contracted from eating unboiled meat and milk. If untreated, it can affect the organs of the body. The rash is a symptom of the disease. Except for the rash, the school staff did not seem to notice she was sick. I noticed that she rarely smiled although the other two girls did. Fortunately, Nopenyi has now been treated and her rash is gone. She is on a 28 day treatment plan.

We were hoping to have Marie Stopes come back this month to supply more contraception to the Emburbul women. We had finished our family planning video and Samwel has gone around and talked to the women about family planning, and at least one woman (maybe more) is interested. Plus there may be women who had unwanted side effects from the hormonal implant and needed to have it removed. But Marie Stopes said they were not coming back until next year – they were short-staffed. However, we now have reason to believe that the clinic in Nainokanoka may start family planning services. See more on this.