Offering Kenyan women the means to control their fertility

At first glance, the mountain of bead necklaces on a cottage hospital table in a poverty stricken remote area of western Kenya look as though they are intended for a gift shop in a far-off city.

The stacks of coloured beads packed in cellophane bags carry detailed instructions, however, warning users that they don’t protect against HIV/Aids, nor are they a toy or a piece of jewellery.

“Keep them in a safe place,” their new owners are told.

Cycle Beads are 95 per cent effective if used correctly, claims the US charity which donated them in the latest natural family planning initiative to prevent unwanted pregnancies in Siaya, a needy rural district.

Early childbearing is the norm in this area, along with grinding poverty, unsafe illegal abortions and high maternal and infant mortality.

Dophil Nursing and Maternity home and Clinic on the side of a potholed road in Luanda, a hamlet of tin-roofed shanties, is grateful for the consignment of Cycle Beads, and the 6,000 condoms and 200 cycles of the pill which have just arrived.

Fifty women are trying out the Cycle Beads. The colours represent their menstrual cycle so they know the days they are most likely to get pregnant. Some women will wear them around their necks as a reminder of another unwanted pregnancy.

"Accessible family planning methods, preventing unwanted births, that's our biggest challenge," declares Manoah Okinda, deputy director at Dophil, where stocks of the pill and other forms of contraception deplete with lightning speed.

Family planning methods
We pause in front of an old display case containing examples of family planning methods and devices, from the pill to the coil, on a wall in a waiting room where voluntary counsellors provide information on available options and the need for safe sex.

Do many couples come in for family planning advice?

“Not enough of them. We encourage the husbands to come also. But usually only women come. The men rarely take any responsibility at all.”

Siobhán Learat Byrne of Adams & Butler, a successful Ireland-based tour operator (adams&butler.com), has a unique insight into Kenyan culture, one in which women are still shockingly vulnerable.

She and her Kenyan husband Kasao Learat, who is an elder of the Samburu people, set up the Nalepo Educational fund for Samburu East, one of the neediest parts of the country. Its objectives also include helping women with family planning in northern Kenya.

She has met women still in their 20s and 30s in Resim, her husband’s village, who are already widowed or were abandoned by their husbands.

“They have lots of children, usually with different fathers on purpose in the hope that these children will support them in their old age,” Learat Byrne explains, adding that they aim to shift such women away from multiple birthing through education and birth-control advice.

“Clinics in Samburu do not advise, they just dispense, and our intention is to make sure that the women know what is available and how it works,” she says.

If Kenya's population , standing at 41 million, continues to rise at current rates it could hit the 77 million mark by 2030, with catastrophic effects for natural resources, health and education needs and employment opportunities.

Range of services
Dophil may be modest in size and spartan by western standards. Yet this small hospital has made a real difference in helping the sick and injured (traffic accidents seem endemic around here) offering a wide range of services from antenatal care to dentistry.

The long-term aim is to be self-sufficient and patients who can afford to pay for treatment do so. However, most funding support still comes from Northern Ireland-based charity Moving Mountains.

Founded in Port Stewart by expedition leader and dedicated ex-Africa volunteer Gavin Bate, it runs and supports a range of health and educational infrastructural projects in Kenya and elsewhere, including an orphanage at nearby Ulamba.

A partner organisation, Adventure Alternative, sends volunteer medical elective students to Dophil to bring in new skills and relieve existing staff pressure. The operating theatre, funded and built in 2008 by Granaghan Community Outreach, Co Derry and Moving Mountains, is used for minor operations and emergencies. Previously, patients had to travel long distances on dirt track roads to the nearest big hospital.

The four-bed maternity ward is unoccupied during my visit, but a young mother, Esther, can stay there watching over her 11-month-old son who has malaria. Families of gravely ill patients are listlessly propped up against the walls outside keeping them company.

A young mother laden down with bundles and a baby strapped to her back has trudged for miles to get here to avoid another unwanted pregnancy by obtaining the pill.

“Sometimes they get here but supplies of the pill have run out, there are no condoms left or other contraception. So they leave again and another pregnancy follows. Some even believe that it is a sign from God to continue having children,” says Rosie Gathirimu of the Moving Mountains trust.

“But many cannot afford to feed these extra mouths. They have babies by chance and some children are abandoned because there is no means of caring for them.”

Aids and HIV treatment programmes used to stretch resources here at Dophil to the limit. Kenya is ranked third throughout Africa in terms of the numbers infected with HIV and there are more than one million Aids orphans.

Now malaria and pneumonia have overtaken HIV as the most commonly treated illness, evidence that Dophil’s community- based HIV support programme is working.

The Obama connection
A faded poster of President Barack Obama and Michelle Obama being tested for HIV has pride of place in the clinic. That image has special significance here: Obama's roots are in this community and the nearby village of Kogelo where family members live and where his father and grandfather are buried.

For information on medical electives at Dophil Nursing and Maternity Home and volunteer tourism in Kenya see movingmountainstrust.com and adventurealternative.com.