James Nardella is the executive director of Lwala Community Alliance, a rural health and development program in Migori County, Kenya. In this piece, James helps us see the benefits of electricity through the eyes of a pregnant woman.
The Lwala Community Hospital in rural Kenya. Photo credit: James Nardella
Eight years ago, we set out to design, build and open a health facility in Lwala, Kenya. Now, thanks to support from partners like Blood:Water Mission, the clinic – which has caught the attention of Apple for using iPad apps in their health work – sees 2,800 patients a month and distributes antiretrovirals to more than 1,000 people. However, bringing health care to a low-resource setting in a rural place takes more than one grant, one building or medicine. Providing nearly 35,000 patient visits a year is dependent upon other resources such as electrical power, water and roads. Here’s a story to help illustrate.
Imagine you are Nancy Atieno, a woman living with HIV in Lwala, Kenya. You come to the Lwala Community Hospital for care. When you arrive at the hospital, you cannot get your blood test to monitor your HIV. You go to the pharmacy to get your drugs, but they have no electronic record of your regimen.
Worse, you are pregnant and have arrived at night because you are in labor. The hospital is dark except for kerosene lanterns. Water has to be carried by the bucketful from a local river.
You struggled to get here, calling for the ambulance several times on your hour-long walk through the rain, but the hospital’s phone was out of juice. Even if you had gotten through, it is hard to know whether the ambulance could make it down your muddy path.
In Lwala, this was a reality for every patient.
Women in Lwala, Kenya, bringing their babies to the health facility for immunization. Photo credit: James Nardella
Then, in April 2011, after six years of lobbying the local government, electricity arrived for the first time in Lwala’s history.
As Nancy, it is so obvious to you that electricity and water are core components to safety and health. With these resources, you can now monitor your HIV; pharmacists have your records on hand; ambulances can reach you in emergencies; clean water can be pumped, piped and heated; medical tools can be sterilized; and you can safely deliver your baby.
More infrastructure development is needed, to be sure. The electricity in Lwala experiences rolling brownouts and frequent blackouts. Storms and other complications on the line can darken the hospital for days.
The power reaches very few private households, because setting up a meter is beyond the financial means of most. Many villagers are left with the choice between no power or pirating power by illegally attaching a low-gauge wire to the line. Since 2011, the skies of Lwala have become a spider web of illegal lines.
These Macgyver tricks show the resourcefulness of local people but can have dangerous consequences. More than once, electrocution has led to death in our small community. Children have been most susceptible to shocks.
Clean water access is also limited to those at schools and hospitals. Despite years of lobbying the government, the roads are still a patchwork of muddy paths, impassable for months at a time.
But we take solace in the slowly growing progress we have seen. This year, more than 800 women like Nancy will deliver in the safety of a hospital in Lwala with the lights on and water running. Computers and phones are operating. Community health workers are using iPads and iPad apps to reach 1,000 households with health education lessons.
Watch this mini-documentary from Apple to see how the Lwala Community Hospital is using technology to improve health care for the rural community. This would not be possible without reliable electricity:
Not every rural place like Lwala has the benefit of external connections to organizations like Blood:Water Mission, ONE and Apple. Most communities are still waiting for their governments to respond.
From wherever you are reading this, you can hasten the powerful change we have seen in Lwala. President Obama has promised US support for electricity in Africa. Will you make sure he and Congress follow through?