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Saving Nairobi’s Mothers and Babies

Earlier this year Rolex announced the five winners of the 2012 Rolex Awards for Enterprise, who are being honored in New Delhi, India,  on November 27. This profile looks at the work of Aggrey Otieno, founder of the grass-roots organization Pambazuko Mashinani and recipient of an award from the Clinton Global Initiative University and funding from the Ford Foundation Fellowships Program. An advocate of a variety of social causes for nearly a decade, Otieno was motivated to tackle the high rates of maternal and neonatal mortality in Nairobi’s slums when his sister developed serious obstetric problems while in labor at home at night.

Korogocho, Nairobi’s fourth-largest slum, is home to an estimated 200,000 people in an area of only 370 acres (1.5 square kilometers), which is troubled by widespread insecurity, substandard sanitation and deep poverty, says Rolex in a news release about Aggrey Otieno’s work. “An estimated 300 women experience post-partum hemorrhage and 200 newborn babies die there every year due to the lack of obstetric medical facilities and a means of getting to hospital, as well as the fact that the local birth attendants need assistance during emergencies.”

 

Aggrey Otieno in Safe Delivery Advocate (SDA) Grace Anyango’s clinic. Otieno’s NGO will train birth attendants to become SDAs, allowing them to be recognized by the government. Korogocho slum, Nairobi, Kenya, 2012. Photo: ©Rolex Awards/Tomas Bertelsen.

 

“In Korogocho, the maternal mortality ratio is roughly 700 women out of 100,000, compared with 13 out of 100,000 in the United States,” Rolex says in news materials about this week’s awards ceremony.

“After studying in the United States, Aggrey Otieno returned to the slum, his birthplace, to improve the health of his community by empowering its people. With his knowledge of the area, Otieno, who has gained a well-deserved reputation as a valiant champion of the poor and vulnerable residents of Korogocho, is well placed to drive forward his project to build a telemedicine centre with a 24-hour, on-call doctor and van, thereby helping to prevent many deaths.

“Under the auspices of the non-profit organization Pambazuko Mashinani – of which he is founder and executive director – Otieno will use his Rolex Award funds to train birth attendants to recognize when complications are occurring so that they can alert staff at the centre by text message when an emergency arises. These qualified workers and doctors will give instant medical advice and, if needed, dispatch a van to transport the woman to hospital.

“From his previous work in areas such as TB prevention, Otieno understands the need to develop a complementary, outreach component to raise awareness of maternal health issues, including hygiene, family planning and nutrition among thousands of local women.

“To accomplish this, he and his colleagues will create educational videos, which will be shown in hospital waiting rooms, and produce programmes, which will be disseminated through text messages and community radio. Otieno hopes to target 25,000 women with his campaign. His project not only has the potential of saving the lives of women and newborns, it should improve the health and well-being of all mothers and children in the slum.”

 

 

The Rolex Award will also be used to build the telemedicine centre. A doctor will be available at all times, with a roster of five medics needed to cover all the shifts. A driver will also be on hand to transport patients, particularly at night when travelling in the slum is not safe. The center along with the awareness-raising campaign, will take Otieno further in his implementation of Pambazuko Mashinani’s objective – to create a society where the poor are empowered to bring about transformative change in their own lives.

“Otieno’s intention is to replicate the project over five years to cover the other slums of Nairobi,” Rolex says. “This would allow the service to reach an estimated 2,200 women and 1,500 newborns requiring urgent care each year.”

 

Birth attendant Ann Mbala visits Caroline Achieng Odhiambo in her home. Women prefer to give birth at home or in a birth attendant’s clinic both because it is cheaper than hospital. Korogocho slum, Nairobi, Kenya, 2012. Photo: ©Rolex Awards/Tomas Bertelsen.

 

Children who grow up in Korogocho face tough conditions. Aggrey Otieno hopes to be able to transform their lives through his NGO, Pambazuko Mashinani. Korogocho slum, Nairobi, Kenya, 2012. Photo: ©Rolex Awards/Tomas Bertelsen.

 

Receipt of Rolex funds has permitted Aggrey Otieno to make huge progress with his plans to construct a telemedicine centre in Korogocho. He has finalized designs for the building and expects the centre to be opened on 2 March 2013. He has also bought five computers for five health centres surrounding Korogocho. “These computers will enhance connectivity between the hospitals, the telemedicine centre and our pool of volunteers,” Otieno says.

His only sister, who inspired Otieno to launch his project, has become its first beneficiary. “She became pregnant again. I had, together with my Mum and brothers, travelled to our rural village, and my sister remained in Nairobi with her husband. She started experiencing excruciating labour pains, and the community health workers were able to trigger response mechanisms after receiving a text message from her that she needed urgent health care. I was about 600 km away from Korogocho, and I was able to advise that she be taken to Kenyatta National Hospital where she gave birth to a bouncing baby boy whom she has named after me.”

In another development of which he is particularly proud, Otieno has strengthened security at Korogocho by persuading young men convicted of various crimes to join a soccer team. “The team now plays in Division 3 of the Kenyan league,” he says. “They are top of their league this year, and will be promoted to Division 2 next year. As a result, their energy is now focused on playing soccer, and by the time they are done with their matches or daily exercises, they are usually too tired to steal from anyone. Most of them have committed themselves to giving security to pregnant women in Korogocho.

“The Rolex Award has, furthermore, entirely changed how my peers look at me. I have had more media attention, people also appreciate the work I am doing in Korogocho… Many slum-dwellers have also sent delegations urging me to consider joining politics. However, I believe that I can still create a lot of impact and give leadership to my people even if I am not a politician,” Otieno says.