This morning I’m zooming off out of Nairobi (well as much as you can ever zoom out of Nairobi) in the direction of Nunguni, a small town up in the mountains. I’m with the Marie Stopes Kenya outreach team who are going to be providing family planning services there for the day and they’ve invited me to join them.
The journey to Nunguni is going to take us just over 3 hours, but it certainly isn’t tedious. A combination of amazing scenery, the chance to spot some game and the driving ‘style’ are keeping me very much alert! I’m travelling with Anne, the Outreach Team leader. Anne’s a nurse and she’s worked for Marie Stopes Kenya for many years so I’m going to use this opportunity to pick her brains.
In the car ahead are the rest of the team; Fred (the doctor), Julia (another nurse), Peter (the clinical officer) and Lucas (driver, surgical assistant and comedian).
As we finally escape the heavy traffic we start to climb up and up a mountainside, through the switch-backing road, up and up there, eventually, ahead of us is the sub hospital of Nunguni.
As we pull up, Fred, Julia, Peter and Lucas are already beavering away, setting up the procedure room, scrubbing up and preparing instrument sets. News of the outreach team’s arrival has been publicised well in advance throughout the villages surrounding Nunguni and a group of about 40 people have turned up.
Peter gathers the group around him and starts to deliver a health education talk, focussing on family planning choices. The talk will enable the women (and men) to decide which option best suits their needs be it, bilateral tubal ligation (female sterilisaton), contraceptive implants or an IUCD (interuterine contraceptive device). As well as these options the team is also able to offer Voluntary Counselling and Testing for HIV as well.
Everything is really well organised, and not a moment is wasted. That way, the team is able to see as many clients as possible. By the end of the day, a total of 26 women have had a bilateral tubal ligation. I talked to a number of the women as they were waiting and many had already had 4, 8 or more children and were extremely happy to be able to receive this service which is provided free of charge. The procedure takes approximately 7-10 minutes, and then the woman is given some paracetamol, a sugary drink, and rests for half an hour and before heading off home. I watch in amazement as these women simply picked up their bags and headed off back up the hills to where they live to carry on with whatever chores were awaiting them at home or in the fields.
The team work through the clients without a break and with good spirits and humour, even though they must be exhausted. They’ve been on their feet for almost 5 hours and there’s still over a 3 hour journey to get back to Nairobi through the crazy traffic again. On the way back the roads are extremely congested coming into the city and the police were on every corner. The President of Iran is paying a visit. One way of traffic calming (as I discovered) is simply to close the roads until the VIP has arrived in town from the airport. Then, it’s every man for himself. One team member explained to me that ‘People in Nairobi just drive to move’; hard shoulders, roads closed for resurfacing, petrol station forecourts and imaginary spaces between cars are all used to their maximum potential. You just gotta keep on moving in Nairobi.