The Republic of Kenya conducted a historic general election on March 4, 2013, the first election held under a new constitution passed in August 2010 that provides for the devolution of government to 47 counties. The last general election in 2007 resulted in violence across the country that led to loss of over 1,000 lives, displacement of thousands of people and destruction of property worth millions of shillings. As a result, beneficiaries of critical health service were unable to access treatment and care as the violence escalated and spilled over into 2008. Bearing on lessons learnt from that experience, AMREF has put in place contingency measures to ensure continuity of services to beneficiaries. Kibera informal settlement in the capital, Nairobi, was at the centre of the post-election violence. Inter-ethnic fighting left dozens of people dead in the slum. Hundreds were injured in rampant incidents of beatings and rape, while thousands were displaced as houses were burnt and businesses destroyed. Though AMREF’s health facility in Kibera was closed during this period for security reasons, AMREF provided critical health and counselling services to the community through mobile clinics. In the build up to the 2013 elections, the Government of Kenya identified Kibera as a hotspot for potential violence and many feared a repeat of past events. Nevertheless, AMREF put measures in place to ensure that the Kibera facility remained open and accessible to the community, particularly those in need of maternity services.
On election day, AMREF Programme Officer Lydia Kuria was on her way to work at the Kibera Community Health Centre. As she crossed the railway line that runs through the slum, she saw a crowd of people thronging around a woman who was writhing on the ground. On seeing Lydia, members of the public told her that the woman was having a baby. Lydia quickly got to work and there, by the side of the railway line, she helped the woman deliver a healthy 3.1kg baby girl. Lydia then took mother and baby to the clinic for post-delivery care and recuperation. The mother’s name was Betty Masamba. She had gone into labour early that morning and decided to make her way to hospital for the delivery. But as she crossed the railway line, the pain intensified and she was unable to go on. She was in the process of having her baby when Lydia arrived. Betty and her newborn are expected back at the health facility next week for post-natal care and vaccination.
Besides maternity services, the Kibera Clinic manages patients living with HIV and Tuberculosis, and also provides outpatient, ante-natal, child welfare and family planning services. On a regular day, the facility receives an average of 360 patients. However, the number has greatly reduced during the election period, receiving one patient on Monday 4th, 76 patients on Tuesday and 73 on Wednesday. The reduced numbers can partly be explained by the fact that, as part of contingency measures put in place by the Ministry of Public Health and Sanitation, HIV and TB patients had been given buffer stocks of treatment to last three months for HIV patients and one month for Tuberculosis patients. As Kenyans await results of the elections an uneasy calm reigns over Kibera, and many service providers in the slum have closed shop. Despite the anxiety, AMREF and its dedicated staff at the Health Centre are committed to ensuring that the community has continued access to health services.