Already early in the morning it is hot as we pack up in the desert. Also, the strong wind is no big help for us. Rather, it constantly blows the fine desert sand in our faces, while we load our supplies into the off-road vehicle. And it will stay like this for the whole day. For the inhabitants of this area, however, this is one of the least of their problems. We are in North Horr, a very remote place in Northern Kenya, where the nomadic pastoralists have been particularly hard hit by the historic drought that has plagued the region for years. Five consecutive seasons have brought far too little rain for man and their animals. People have to watch their animals die because they cannot find enough water or grass to survive. And for the people this also means hunger, because they live on what the animals give them. The nomads depend on the rain, but it has been absent for a long time. And it is very questionable whether it will ever return in sufficient quantity.
“Medair’s emergency response has come at a time when the people are in dire need of assistance. Every morning, more than 50 % of women and children must walk more than 2 kilometers to access the nearest water source,” shares Maureen.
Maureen, Medair WASH project Manager, pulls a bucket out of a well during a visit of boreholes and water points that need rehabilitation or repairs together with local community members. ©Medair/Stefan Kewitz
As WASH project manager, she has been tirelessly traveling in Marsabit County for months. In close communication with local communities and authorities, she has found ways to help local people in this difficult situation. “Surface water dries up quickly after the rains,” Maureen continued. “Ground water is the main source of drinking water. Most water pumps installed to pump groundwater are broken here. Many boreholes have collapsed during the drought, mostly due to lack of maintenance, and have been abandoned. These circumstances have led people to look for alternative sources such as unprotected wells, which are not safe. We distribute water treatment chemicals to treat water in households. We are also currently planning to repair damaged water points and train water user associations to manage them.”
Local community members show WASH Project Manager Maureen and Caroline, Head of Country Program, how the water point used to work before it was destroyed by the wind in the desert. ©Medair/Stefan Kewitz
Most families in North Horr are pastoral nomads and travel around the desert. Grass and water drive them from place to place. Reaching migratory nomads with targeted assistance is therefore not easy. When our vehicle is fully loaded, we set out to meet them. With a mobile clinic on four wheels, we bring nutrition services in the vast desert to those who urgently need this help and hardly manage to take the long and expensive journey to visit one of the few clinics or hospitals in the region.
Nomad pastoralists in North Horr mostly rely on their animals. The search for water and grass gets harder and harder during the severe drought that is happening now in Northern Kenya. ©Medair/Stefan Kewitz
“The problem for people here is the long distances they have to travel to get help,” Stephanie explains as she sets up her desk at one of the eleven sites where Medair is stationed with the mobile clinic. She is a nurse in North Horr and part of our emergency response team.
“To be a nurse is a call from god, it is not a career. My faith is to be grateful to my patients. They are all equal in front of god to me.” Nurse Stephanie works tireless to serve her people in North Horr as part of Medair’s outreach team. Here, she distributes therapeutic food and hygiene articles to a family in the nutrition program. ©Medair/Stefan Kewitz
“Imagine somebody cannot come to a health facility when he or she is sick, when the child is sick. Whenever we go to outreach, we look at the mothers, the children, the pregnant and they do not have to walk far but we come and treat them at their place, at their homes. With the outreach, we are improving the situation on the ground a lot. If you have an outreach, you can look after the people and the children. Without an outreach, children often will not get help because their parents are illiterate and will not bring them to a health facility. With the outreach, we can go and see who needs our help.”
Fatuma is a mother of four and needs help with her sick daughter today. Like most here, her family makes a living from animals, but almost all of her livestock fell victim to the drought. “We used to sell animals to have money to reach the hospital by motorbike. But due to the severe drought the animals passed away and therefore we have no money to get to the health facilities. As my child was sick and I wanted to take her to the clinic, I was informed that due to the crisis, fuel prices increased and the ride with the motorbike became even more expensive. That makes it harder for me to get help for my children.”
Her daughter will be admitted to Medair’s nutrition programme to receive treatment for her malnutrition. For the next weeks, Fatuma will receive therapeutic food for her and can feed her at home. Every two weeks, the mobile clinic will stop close to Fatuma’s home to treat patients and to monitor the progress of her daughter until she is well enough to be discharged.
Fatuma (in the middle of the picture) is one of many patients today at Medair’s nutrition outreach site. Mothers come with their children to seek nutrition services at this place where Medair stops biweekly to delivers services for nomad pastoral communities. ©Medair/Stefan Kewitz
If there are no additional medical complications among the patients in the nutrition programme and the families follow the medical advice, patients usually recover quickly even from severe active malnutrition.
Boru’s son Ibrahim is now almost completely cured. The treatment has worked very well for him, and the little boy loves the sweet high-calorie therapy food, which tastes almost like peanut butter and contains many important nutrients. His mother is delighted that she came to Medair’s clinic when the mobile clinic team first visited her. “Since my child is in your nutrition programme, I can see constant progress. The situation is improving, and he is gaining weight gradually. I am glad to see my child gaining weight again. When I see the progress, I am so happy about that”, she says gratefully with a relieved smile on her face.
Mother Boru is happy to see her son Ibrahim recover from severe malnutrition. In Medair’s nutrition program, the young boy receives weekly supplies of therapeutic food and is able to gain weight constantly. ©Medair/Stefan Kewitz
If sufficient rain ever falls again for the nomads of Marsabit, it will be a tough road ahead for families in the remote desert of Northern Kenya. Medair’s mobile nutrition clinics provide vital access to basic nutrition services for the people. In an inclusive approach to outreach, Medair works closely with local health authorities, whose staff participate in Medair’s programme, while also providing health services such as child immunisations or health training to volunteers and the community. By joining forces, Medair is able to bring a broader range of services to people for whom any other help would otherwise seem almost inaccessibly far away.
Community Health Assistant William explains five critical handwashing times and proper use of latrines and toilets to Community Health Volunteers (CHVs) and mothers and children of a nomad pastoral community using Maternal Infant and Young Child Nutrition (MIYCN) counselling card. ©Medair/Stefan Kewitz
Little girl of a nomad pastoral community receives routine Vitamin A and dewormer Albendazole during Medair’s integrated nutrition emergency outreach in North Horr on 13 July 2023. Medair support to MOH Health and Nutrition outreaches enables children to access routine immunizations. ©Medair/Stefan Kewitz
This content was produced with resources gathered by Medair field and headquarters staff. The views expressed herein are those solely of Medair and should not be taken, in any way, to reflect the official opinion of any other organization.
