Africa Medical and Research Foundation (AMREF) Kenya is a leading medical rescue health organization that works closely with the ministry of Health in Kenya – driven by the belief that the power to transform Kenya lies within its communities. AMREF’s vision is for lasting health change in Kenya created by partnering, empowering and strengthening health systems within communities. They work to accomplish this vision by supporting five programmatic approaches – Reproductive health, Maternal health, Child Health, fighting diseases (HIV/AIDS, TB, Malaria), water and sanitation.
Community Health Workers (CHWs) at Malaha Clinic are trained to strengthen primary health care in Kenya through Community Units. To date, AMREF Kenya has empowered CHWs with 330 Buffalo bicycles to enhance access to healthcare for all. Another 400 bicycles have also been distributed as a pilot project between Amref and Women Fighting Aids in Kenya (WOFAK), in Kwale County with a commitment to supply CHWs in two more counties, Homabay and Vihiga, in the near future.
“We are linking the community,” says Malaha Clinic General Manager, Bernard Ochanda. Bernard goes on to describe the Community Health Worker program at Malaha Clinic; “each volunteer has 100 households they serve with Household Mapping Registration. They visit people, assess their health situation and get them to their local clinic for registration. The CHWs do malaria investigation in order to ensure their client’s health and provide treatment. Especially in pregnant mothers.”
“The CHWs are now able to collect more information to keep Mother and Child healthy by visiting 2-4 new babies per week,” Bernard explains. The bicycle is invaluable to the CHW. They use it to reach households and inform mothers how and when to reach the nearest clinic. Many times, “the bicycle is used in getting the mothers into the clinic for delivery,” says Bernard. “Compared to home deliveries, delivery at the clinic is far more safe. Traveling by bicycle is far less expensive than hiring a vehicle.”
“Cheap is expensive!!” Bernard clarifies. “The mechanics can bring low-priced parts that will last three months or these expensive parts that last more than two years.”
When we visited Malaha Clinic, there were four local field mechanics servicing bicycles for CHW’s – Clement, Benedict, Joseph and Evans. These trained mechanics service bicycles in their community provided to CHWs as well as students in the region and anyone else who has purchased Buffalo Bicycles for their business.
Merinzia Anzoka is a community health worker. Today, she is having her bike serviced by local field mechanic Clement. Merinza has had her bike since 2015. “It is helpful!” She says, “I carry my patients to health centers. Especially the pregnant ones.”
“Do you carry the pregnant women to the clinic as well?” asks Clement, somewhat surprised.
“Yes! Even people living with HIV/Aids and children with Malaria,” Merinzia answers. “I meet them at their homes. Every week I visit about 5 patients, one or two per day. My husband is a doctor at Mbugasi Masanda Hospital. I also have three boys and one girl. When not using the bicycle for helping clients, I do things like selling sausages and vegetables at the market.”
While field mechanic Benedict Ontage works on their bicycles, Fatuma (66 yrs) and her grandson, Francis (31 yrs) share about their roles as CHWs. ”When we go from house to house we get many questions,” says Fatuma. “The community wants to know more about health, how they can improve their lives, about finance. We encourage them to go to the clinic if they are ill.”
“We use the bicycle for meetings, for healthcare workshop gatherings, as before we were walking. The power of the bicycle is hearty and a motivation to us as Community Healthcare Workers. We reach our patients very easy. Thank you very much. Plus we are able to multitask. We go for food stuffs, water, milling.”
Francis shares, “After community work, I transport veggies to the market for my grandmother and fetch water from the river. The Buffalo is strong. It can carry 100-150kgs (220-285 lbs). It is soft, easy to ride.”
Joseph Wabuti is a field mechanic trained to service bicycles purchased by AMREF Kenya for their health programs. He also owns his own small repairs shop which has been servicing Buffalo Bicycles since 2015.
We asked Joseph about the importance of bicycles for the community he services. His answer illuminates one of the many values for expecting mothers.
Joseph shares that all families should have a Mother and Child Health Booklet for each household member. This booklet, provided at birth, serves as an important record for the health of a child. If a mother is not able to make it to the clinic for delivery, they do not receive this formal document tracking the baby’s birth. With bicycles, Community Health Workers are able to transport expecting mothers to the clinic for birth, meaning more babies have this record of health.
Additionally, CHWs carry with them a Service Delivery Log Book. This log helps in monitoring, as it is directly linked to the National Health Information System – generating reliable data on the performance of community health. The booklet includes records of the client’s name, age, condition and sex of the baby. These Service Logs are tools for teaching HIV/AIDS prevention, dosage tracking, and malaria tracking.
Evans services bicycles for Community health Workers and also for students in the community who have received Buffalo Bicycles through World Bicycle Relief’s Bicycles for Educational Empowerment Program (BEEP). Evans was trained as a field mechanic during one of WBR’s training sessions in Kisumu, Kenya.
“I didn’t know I would get this far. The certificate, toolkit, and work is all reducing our challenges. Special thanks to Mr. Joel for being my instructor.” Joel Ogambi is World Bicycle Relief’s lead Field Mechanic Trainer.
About his work servicing bicycles for students, Evans shares, “The students get to school earlier, then come back home and help their parents. The bicycle helps them take farm products to the market to sell. Before they used their heads to carry their goods.”
“Also, people are saying that an alarming amount of girls were getting pregnant by the boda-boda (motorbike) drivers. If they have a bicycle, they will not have these problems. The story was quite alarming and now we have the record, four schools are bringing down such numbers.” Evans says, “I feel happy to help bring down such numbers.”
Between the students and healthcare workers in his community, Evans helps maintain bicycles for 168 households. “It is not easy,” he says, “but I do take time and ride to church.”