Kenya's 'backpack midwife' bringing healthcare for all

From BBC - January 22, 2018

Call the midwife in Nairobi, Kenya, and you may receive a visit from someone like Margaret Wairimu Maina.

She sets off on foot looking something like an astronaut, carrying a backpack stuffed full of hi-tech gadgets designed to monitor a baby's health.

The pack includes a wind-up foetal doppler used for measuring the baby's heartbeat, a portable ultrasound screen, a life-light with matching solar panel, in-ear thermometers, and a range of other medical instruments related to pregnancy.

The gear has become crucial for her voluntary job as a community health worker.

Although the backpack weighs just 5kg (11lb) it's still a heavy load as she does her rounds twice a week, says Margaret. She is responsible for more than 120 households in the local area and manages to see up to 20 a day when she visits between noon and 4pm.

"I have two sons, aged five and 11," she says. "Both of my pregnancies were very OK with no complications because I started my ante-natal care visits after only two months, and I had a skilled attendant around for delivery."

Many other women in the country are not so lucky.

In Kenya, unlike other African countries such as Ethiopia, primary health care is not paid for by the government or local authority.

Margaret works out of the Kiambu Community Life Centre north of Nairobi, where voluntary health workers are the first point of contact for those seeking medical help.

"In large parts of Africa, people like Margaret are unpaid volunteers who often lack formal training or even basic equipment to help them with their tasks," says Jasper Westerink, chief executive of Philips Africa, the firm that developed the backpack.

"For years, we have had strong focus on mother and child care in Africa."

Working with local government, Philips is developing a number of community life centres to support community health workers and midwives equipped with these hi-tech backpacks.

"Our ambition is to introduce this model throughout Africa to drastically improve access to primary care," says Mr Westerink.

Meanwhile, on the other side of Nairobi lies Kibera. It is the biggest slum in Africa and though officially home to 500,000 people, some estimate it might actually hold two million inhabitants.

Kibera is an open sewer with little or no sanitation - a random matrix of undulating roads and paths that ambulances cannot access.

In fact, the only thing close to an ambulance is an improvised wheelbarrow with a yellow siren attached to its handles. Patients are placed in the cart and the lucky ones are wheeled to the community health clinic.

But in the remote region of Mandera, on Kenya's north-eastern border between Somalia and Ethiopia, pregnant women do not even have the option of a wheelbarrow ambulance.

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