Community Health Work in Kawangware

For a week, I had the opportunity to work with Jane. Jane is a volunteer community health worker (CHW). She works on average 60 hours per week, and it's all volunteer. She works with a group of other CHWs, mostly women, in Kawangware slum. It's the second largest slum in Nairobi. Jane is responsible for checking in on 150 families each month. She mostly checks in with the women in the family. She goes and talks to them about nutrition, sanitation, water, parenting, and managing chronic conditions. She looks for signs of public health concerns including disease outbreaks. During the recent cholera outbreak in Nairobi, the CHWs were the people documenting cases and reporting back to the government.

She and the other CHWs attend regular trainings from the government and various public health NGOs. During the week, we also met many of the other CHWs in Kawangware. They are all such inspiring, dedicated individuals. They care about their community and want to see the quality of life improve for all of their friends and neighbors.

Kawangware is a slum area west of the city center. It's a long walk or a short piki piki (motorbike) ride from where I am staying in Satellite. Similar to my experience walking through Kibera, walking through Kawangware is a full body sensory experience. I don't know how someone can adapt smells and the texture of the ground. Jane shared her frustration with the trash and lack of sanitation and clean water in the area. In the area, garbage collection costs 20 Kenyan shillings per week (about 20 U.S. cents). Most people in the area, cannot afford this so the just dump their trash. Walking down the road, you see used baby diapers, food trash, plastic, and other waste lining the roads. There are also tons of goats and sheep wandering in the area. The sewer lines are all open. Fortunately, unlike in Kibera, I didn't see anyone collecting water from clearly contaminated water. Unfortunately, the pipes that supply the "drinking water" run through the sewers and often end up contaminated. One of the major responsibilities of the CHWs is educating people and continually reminding them to boil or treat their water every time.

Another responsibility of the CHWs is to visit schools and teach health education lessons to the students. Jane teaches hygiene, puberty, and healthy relationships. This week, she had me teach the lessons. We talked through the lessons that I typically teach back home, and made very slight adjustments to make sure they were culturally sensitive for our classes. 

I got to teach puberty to 5-8 grade students and healthy relationships to the secondary students. It was so much fun. Every time I visit a school in Kenya, I am reminded that the kids and adolescents are so similar to my students at home. Their fears and concerns about adolescence are pretty much the same. The students I worked with in Kawangware have to worry about other health issues and have bigger hurdles to overcome in dealing with poverty, but their fears about fitting in, being normal, and dating and relationships are so similar to the fears students tell me at home. I think the most striking difference was when we were discussing overcoming barriers to dreams for the future. In the U.S., I find that my students tell me about external solutions including money or the assistance and support of others. Consistently in the classes in Kawangware, the students focused on internal solutions and self improvement. They very much believe that their ability to be successful is determined by their own strength and determination.