Rukanga Community — The small Myaribo dispensary in the Rukanga community, lying about 30 kilometers from the city of Nyeri, has only four rooms. But here, where for so long there was nothing, these rooms represent much.
Before the dispensary was built, the sick or injured would sometimes have to walk to the nearest town—Kikaajo, about nine kilometers away—for help. "Sometimes they would pass out," said Ifad coordinator Peter Wachira who had brought me here. And such walks, on mostly unpaved roads, also meant there was a good chance that small wounds would become dangerously infected.
Now the dispensary is here and its hallway is crowded with women holding babies, children with sniffles and people with cuts and bruises. Maybe there are 30 or so people; not a big urban medical center for sure but one offering them what they never had before two years ago.
Small as the dispensary is, it has taken years to get where it is now. The community group responsible for it formed in 1969 but didn't begin building until 2003 when the municipality gave them five acres of land. And it's been erected gradually—literally room by room—and was only officially opened February 16, 2006.
There is a small laboratory, a small store for medicines and staff housing, and the facility offers maternal and child family planning services. It has also trained 28 children's health workers.
Ifad, the Belgian Survival Fund and the Central Kenya Dry Areas Project—three agencies that often cooperate in Kenya—have provided about U.S. $78,000—a little money that over a few years has gone a very long way.
But there is also strong local commitment to this effort. There have been significant contributions through "harambee," says Charity K. Miriti, a local primary health care "implementer" in the area. (She is using the Kenyan term, meaning "pull together," which describes the practice of collective effort which took root during Kenya's independence struggle.)
The community group has contributed about $2,500 over the years. That's a lot in a land where few earn more than $1 a day. And the fenced land on which the clinic sits is worth about $7,000.
The Rukanga community might be only 30 kilometers from Nyeri—where the slopes of Mount Kenya attract many foreign tourists—but the distance has to be measured in more than miles or kilometers.
Life is hard here. The land is rocky and parched; the region is subject to drought. Services, health and otherwise, are few. Life expectancy is about 47 years.
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A 1999 report estimated that in Kenya as a whole, there were 0.1 physicians and 1.6 hospital beds per 1,000 people. This dispensary, with one doctor, was built to serve about 5,700 people but it actually helps double that number, says Pauline, one of the facility's two nurses.
"The doctor sees many more than he expected," she says. "People come from out of the coverage area and they have to be attended to."
The doctor—Simon Mugambi—is young, still in his twenties, and from the city. How is it living in this rural community where there are no bright lights, only a solar-powered generator for the dispensary?
It is a challenge, Dr. Mugambi acknowledges without elaborating, surrounded as he was by dispensary staff, villagers and government officials. Laughing, he adds, "Well, being young, as I am, I had to face the challenges."
He can treat illness, he says, but solving the problems which cause illness will take more than his efforts. A "proper and clean water supply," for example, could reduce worms, skin diseases and other ailments brought by dirty water.
Nevertheless, he says everyone he has dealt with "was cooperative," and there is no reason to doubt that. The dispensary has had success with primary health education.
And, looking into the future, he finds every reason for optimism despite the uncertainties of money and the pressures of poverty: "Maybe we can do a great thing."
