Elisabeth, 28, lives in Tupendane, a village two hours away from Isiolo, a small town in central Kenya. Until recently, she had never considered going to see a doctor.
"I thought that the normal thing was to wait for it to improve by itself,” she explained. A woman of faith, she believes that life is given and taken away by a higher power. “It is God's desire. He gives it to you, so if He takes it away, it's because He has his reasons.”
A mother of five, Elisabeth’s faith is unwavering – but she has changed her mind about seeking medical care for her children. Her second youngest child, a daughter, suffered from malnutrition and was the first in the family to go to a health center.
Her change of heart came as a result of the hard work of an army of volunteer health workers. Since 2006, the Kenyan government has supported a growing group of community health volunteers, people in villages across the country who can inform their neighbors about the fight against child mortality.
Community volunteers are selected to receive health training: how to spot common illnesses, when to refer someone for care at a health center, and how to prevent disease. Once equipped with knowledge, they go from house to house in their villages to meet with pregnant women and mothers with children under five to teach them optimal maternal and child health practices. Community volunteers check the mothers and their children, give advice, and explain how to get to the nearest health centers. They also explain the symptoms for common childhood diseases and teach mothers how to protect their children from malaria, pneumonia, diarrhea, and malnutrition.
“I was not aware of the risks I was running, when the volunteers explained it to me, I understood," Elisabeth says.
The goal is for these volunteers to serve as the first part in a national effort to fight against infant mortality and change the way people like Elisabeth think about health. It is necessary: in Kenya, 188,928 children under five die every year. Often, children are dying from preventable diseases, but are too far away from health centers or hospitals to receive treatment in time. Community health volunteers, who live in the communities where they work, make it possible for screening and treatment to happen closer to home.
In Elisabeth’s village, the community volunteers are part of a pilot project run by Action Against Hunger – one that empowers mothers to screen their own children for malnutrition. With a simplified version of the Middle-Upper Arm Circumference (MUAC) armband, mothers are taught to detect acute malnutrition in their children, allowing them to better understand malnutrition and its symptoms, participate in monitoring their children’s nutrition status, and increase the frequency of child screening at the community level.
Elisabeth keeps her MUAC band on a dresser in her living room. Once a week, she takes it out and, with her daughter sitting astride her knees, she wraps the tape around her mid-upper arm. Through bands of colors -- red (severe acute malnutrition), yellow (moderate acute malnutrition) or green (normal) -- she can see what state her daughter is in.
This particular afternoon, the tape stops in the yellow color. "With this, I can see that my daughter has come out of danger, but she is still sick, so she should continue the treatment until the tape stops in green," explains Elisabeth.
The pilot project is being implemented in six communities and five health centers in Isiolo County, targeting more than 3,000 mothers with children between 6 and 23 months. Now, it is the mothers themselves who have begun to spread the message.
Elisabeth recalls how a neighbor’s child fell sick with diarrhea and she took the MUAC tape and measured the baby: "It was in yellow (moderate acute malnutrition)," explains Elisabeth, "I advised her to go to the health center, because with diarrhea he can get worse and fall into danger."
Elisabeth is now a lead project volunteer in her community. "I like to help as others have helped me. I cannot read or write, but I have acquired some knowledge and I feel a duty to pass it on. When I explain something important to a woman who does not know it, I feel that I am doing something important for her life," she says with a satisfied smile.