Dadaab refugee camp, where MSF also provides healthcare to the host communities. Kenya, July 2019.

Kenya

In Kenya, Doctors Without Borders (MSF) provides care to refugees, drug users and victims of violence, and responds to public health challenges such as advanced HIV and noncommunicable diseases.

Kenya is MSF’s largest program outside a conflict zone or emergency crisis. In the sprawling slums of Nairobi and in the three-decade-old Dadaab refugee camp, for example, many people still struggle to obtain an effective diagnosis and care for life-threatening diseases.

Treating non-communicable diseases

Since 2017, we have been working in Embu to integrate the management of non-communicable diseases into general healthcare facilities. In that time, more than 4,000 patients with non-communicable diseases have enrolled for treatment. In August, the second cohort of 18 trainees taking part in our staff mentoring scheme graduated, having successfully completed their modules. They are now able to manage patients with non-communicable diseases independently.

We support the adult medical wards (90 beds) in Homa Bay county referral hospital. In 2019, 3,054 people were admitted, most with severe underlying chronic and non-communicable diseases. We assisted the hospital by improving the quality of care through early identification and monitoring of severe cases. We also opened an outpatient clinic for a closer follow-up of unstable/very sick patients after they are discharged from the inpatient wards.

Advanced HIV care

In Homa Bay, we continued to work on improving HIV care and reducing transmission and mortality rates. We finalized a study to assess the results of the new approaches implemented in our HIV activities in the Ndhiwa sub-county between 2014 and 2018. The program, aimed at reducing new infections through treatment as a prevention strategy, is based on the idea that an HIV-positive person whose viral load is suppressed by effective treatment is unable to transmit the virus to others. We tested as many people as possible to put all HIV-positive patients on treatment and worked on the quality and continuity of care to help them achieve viral suppression. 

The study was completed in early 2019 and showed promising results. The findings are due to be published in 2020.

In 2019, we supported HIV services in 30 government health facilities. We focused on improving the holistic management and follow-up of advanced HIV patients, paediatric and adolescent care, and management of patients on second- and third-line antiretroviral therapy (ARV), as well as ARV treatment failure.

Advanced HIV care in Homa Bay in Kenya.

MSF in Kenya in 2019

Mark Ouru Nyamae was diagnosed in 2003. According to him, there were no ARVs back then. He started taking ARVs later but he can't really remember when. He is currently under quimiotherapy for Karposis Sarcoma.

Care for people who use drugs

Many people who use drugs in Kiambu county had to travel to the capital, Nairobi, for opioid substitution treatment, as there were no medically assisted therapy clinics locally. They often had to visit several other facilities to obtain medical care and psychosocial support. 

In September, we opened a clinic in Kiambu, offering a one-stop service centre for drug users, comprising opioid substitution therapy, treatment for HIV, TB, hepatitis C and non-communicable diseases, wound care, mental health support and counselling, and sexual and reproductive healthcare.

Care for victims of violence

MSF runs a trauma room in Mathare, Nairobi, to treat victims of urban violence in the city’s Eastlands area. The clinic is supported through a 24-hour, toll-free call centre and an ambulance program that offers emergency care to patients and refers them for further treatment when necessary. 

We also run a clinic providing specialized care for victims of sexual and gender-based violence in Eastlands, in addition to supporting the Ministry of Health facilities. Services include medical consultations, treatment to prevent the transmission of HIV and sexually transmitted infections, pregnancy tests, swabs for legal purposes, psychological counseling, and referrals for social and legal support. In 2019, our teams treated over 260 patients each month.

Medical care for refugees

We continue to support a 100-bed hospital and two health posts in Dagahaley camp in Dadaab. Our health services benefit not only refugees, many of whom have been in the camp for close to 30 years, but also local communities. Our comprehensive general and specialist healthcare program in Dagahaley includes sexual and reproductive healthcare, emergency obstetric surgery, medical and psychological assistance to victims of sexual and gender-based violence, and psychosocial counseling. We also offer home-based insulin treatment, palliative care, and specialist referrals. In 2019, we conducted more than 210,000 outpatient consultations, admitted close to 10,000 patients for care, and assisted over 2,800 births. 

 

MSF’s palliative care programme in Dagahaley, part of Dadaab refugee camp. Kenya, November 2019.

MSFin Kenya in 2019

A patient with cancer of the esophagus is cared for through MSF’s palliative care program in Dagahaley, part of the Dadaab refugee camp. Kenya, November 2019.

Comprehensive obstetric care in Likoni

In Likoni sub-county, Mombasa, we support the Department of Health to provide comprehensive emergency obstetric and neonatal care in the fully renovated Mrima health centre. Our teams there assist an average of 6,000 births every year, perform lifesaving obstetric surgery, and support ante- and postnatal care, as well as screening for cervical cancer, HIV, and other sexually transmitted diseases.

Responding to medical emergencies

The high incidence of snakebites in Baringo county, northwestern Kenya, has been largely under-reported due to a lack of appropriate monitoring tools. For three months, an MSF team trained medical staff in prevention strategies and administering antivenoms and first aid to snakebite victims. We also donated antivenom vials to boost the county’s supplies.

In addition, we responded to malaria outbreaks in Baringo and neighboring Turkana county. In September, more than 45,000 people tested positive for malaria, in the worst outbreak in Turkana since 2017.

Heavy rains later in the year led to flooding and displacement in some parts of the country. In West Pokot county, when flooding and landslides forced many people to flee their homes, we donated medical supplies and treated mosquito nets. We also provided emergency relief items and food to the most affected refugees in Dagahaley camp.

No. staff in 2019: 823 | Expenditure in 2019: €26.7 million | Year MSF first worked in the country: 1987

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