The Ekope family lives in one of the villages of Lodakach, in Turkana county (Kenya). Its members bear the weight of a triple burden: a measles outbreak that has hit the region again since last March —there was another in 2022— and has already claimed the lives of eight people, malaria and malnutrition. Only on the day that I am writing these lines, the team at Doctors Without Borders (MSF) He has carried out more than a hundred medical consultations in the town.
The mother, Hellen Adir, comes concerned to the Lodakach office where I am. With her are two of her three children, Ekidor Ekope, two years old, and Abenyo Ekope, 10, who have accompanied her to the doctor’s office. Abenyo looks frail as he goes through triage. The scorching sun makes his symptoms of fever and aches almost unbearable. The girl watches the MSF mobile clinic team while one of my colleagues asks her mother about the little girl’s condition.
“His joints, stomach and legs have started to ache. I’ve come to get medicine for her. I suspect it’s malaria,” says Hellen. “I have been without peace for two weeks. Children fall ill one after another. My five-year-old son Longem is home, also recovering from measles and malaria. I took him to the Lopur dispensary last week and he received treatment there,” he adds.
His joints, stomach and legs have started to ache. I suspect it is malaria
Hellen Adir, mother of the girl Abenyo Ekope, 10 years old
My colleague Nancy Gichiki, MSF’s clinical manager, checks Abenyo’s temperature and sees that it is very high, in line with what she has been seeing in children and adults in external medical activities. She also discovers some rashes around Abenyo’s ear and asks him to open his mouth to check for a sore throat. The symptoms confirm measles, which has probably reached Turkana, a community of herders who move from one place to another in search of pasture, after the return of some members from other areas of Kenya where there have been outbreaks of the disease. . The next step is to check if he has malaria, as he has also complained of body aches. The test is positive and treatment must be started immediately.
Abenyo is one of 451 measles patients and 1,475 malaria cases detected in West Turkana subcounty alone. These ailments have affected many people, from babies to the elderly. The suffocating sun has not deterred them from going to the doctor’s office. Some of them are sick and lie down in the shade to get out of the heat, waiting for medical attention. Most of the elderly complain of joint pain, but children under five years of age are the most affected.
The impact of the drought
But this is not the only struggle of this herding community that has not been spared by the drought. Its horrible impact is visible in the form of malnutrition among children, pregnant women, and lactating mothers. With livelihoods shattered by the death of livestock, many villagers struggle to find food to feed their families.
Hellen’s two-year-old son Ekidor has had a nutritional checkup and has just received a two-week therapeutic food supplement for severe acute malnutrition from Phinnah Botta, my nutritionist colleague. MSF medical teams have carried out nutritional tests on the most vulnerable – boys and girls aged nine months to five years, pregnant women and lactating mothers – both through mobile clinics and in health centres. We refer people affected by malnutrition to nearby centers where they are monitored and their evolution is checked.
The mobile clinic team continues to ask parents the following question: “Are there any children at home with symptoms of measles or malaria or malnutrition? Please bring it.” A distraught father responds. “I had no energy to carry my other son, he is too heavy and at the same time very weak. At least I have been able to transfer another son with the bicycle ”, he explains. The team listens to him and asks if he could guide the community health promoters to his house. Finally, they manage to reach the house and return with the child.
A stone’s throw away, the distribution of mosquito nets continues. 8,403 have been delivered to families with children under 15 years of age, pregnant and lactating mothers. Ekidor’s family has also received a mosquito net for the little boy and his convalescent brothers.
MSF has been working with the West Turkana sub-county team since June in a joint effort against the double threat of measles and malaria through mass vaccination, integrated case management, treatment in two health centers and teamwork essential mobile doctors at the community level. This is a race to leave no child unvaccinated against measles or treated for malaria
A total of 26,862 children have been immunized in the massive measles vaccination campaign in the vast sub-county, reaching villages more than 170 kilometers away. This is accompanied by a reinforcement of health promotion through community involvement, awareness and surveillance. Bringing vital medical services closer to Turkana villages has deep meaning for those who live far from healthcare facilities.
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