Girl's Health Day!

“According to UNICEF, 1 in 10 school-age African girls, ‘do not attend school during menstruation, or drop out at puberty because of the lack of clean and private sanitation facilities in schools’.”

“In Kenya, 65% of girls 18 years old and younger have dropped out of school.”-ZanaAfrica

As an educated American woman, it is hard to imagine dropping out of school because I have missed so much of it purely due to the fact that I was menstruating.  These statistics are overwhelming, but they are completely true, especially in rural areas of poor developing countries, such as my small village here in Chebukaka. It is a United Nations Millennium Development Goal to help reduce these staggering numbers, but how can I as a Peace Corps Volunteer help?

A program that many health (and education) volunteers have undertaken here in Kenya is one of reusable sanitary pads. These easily constructed and inexpensive items are a direct way to decrease the amount of school that a girl misses each month. The reusable sanitary pad costs approximately 0.50 cents to create, which equivocates to about 40-50 Kenyan shillings. However, if the girl would have to purchase the Always brand pads (which is pretty much the only thing available here) it would cost around 80 shillings. This figure multiplied by the 12 months of the year comes about to be 960 Ksh per year. When girls come from families where the average income is 300 shillings per month, as it is in my area, this figure is nearly impossible to come up with. If a girl were to make 2 or even 3 reusable sanitary pads, this would cost her only about 120 shillings, and they could last several months. They may not even cost as much if the items necessary were already owned such as scraps of fabric or a sewing needle.

A woman receiving a full education links directly to her health status. A girl who is better educated has the knowledge to take care of herself and her family, and it usually results in having fewer and healthier children. So I decided to do a project that would help the girls in my area on the path to become fully educated women.

Earlier in the year, I applied for a small grant to receive funds for a gender related activity through the volunteer run Gender and Development Committee (GAD) that we have in country. I proposed having a one-day event specifically for girls, which would teach them how to create these sanitary pads, as well as delve into other issues of sanitation and hygiene, and continue with lessons on HIV/AIDS and family planning. I was fortunate enough to receive the grant funds within a very competitive cycle, and at the end of June, I had a Girl’s Health Day at the local primary school, Chebukaka Girl’s Primary School.

As is typical here in Kenya, and anywhere else for that matter, there were hiccups along the way to having the event. Most importantly was the issue of ‘will there be any students?’ because the teacher’s strike was in full force at the time and students were not attending classes. However, thanks to the help of the teachers and headmistress of the school, almost all the students who were invited to attend showed up. (not all on time, but that’s to be expected haha!)

The day ran smoothly with the reusable sanitary pads being our first session of the day! I invited volunteers who are in my area to assist me, and it would not have been the great success it was without them. Breezie and Lori took charge on teaching exactly how to make the pad, and myself, Brittnee, Joy and Andrea all came in and helped different groups create their pads.

 Myself with one of the groups and their finished products!

 Working hard!

We moved on to a lesson in water treatment, which is extremely important, because diarrheal diseases and typhoid are severe, but common health threats in the area. This was followed by a session on hand washing and hygiene, and everyone lined up to wash their hands before having lunch!

 Britt, myself and a few student volunteers going over proper handwashing!

 

Britt discussing how and why you should treat your drinking water!

 Breezie and Targes helping out with handwashing before lunch!

After the meal, Joy facilitated a lesson on HIV/AIDS, specifically discussing the myths and facts, and then we were all able to answer any questions they had in regards to the disease as a group. We discussed family planning, and then had a short talk on the importance of staying in school and how education will empower them as females. 

 

HIV/AIDS Myths and Facts exercise!  

 Discussing family planning and women's empowerment with the girls!

At the end of the day, the students graciously thanked us for being there and teaching, and we were invited to return whenever possible by the administration of the school. The girl’s were then off to play football and enjoy the rest of their Saturday! 

 Myself with the girls, some teachers and a few CHW's!

 My fellow volunteers with the crew! Thanks guys!

I think that the day was a great success and could not have wished it to go any smoother than it had. I am so thankful to the GAD Committee who’s grant gave me the funds to purchase the materials necessary to create the sanitary pads for fifty girls, and to all those who helped me put on the day, ASANTE SANA!

Women should have the same chance at an education and a future as men. By creating a sanitary and inexpensive way to deal with menstruation, hopefully we will have helped at least some girls remain in school.

“Education is the most powerful weapon which you can use to change the world.”- Nelson Mandela

As always, I leave you with a little love and sunshine from Kenya =) 

Why try to treat Jiggers?

****Note: Some pictures may be graphic and unpleasant, they have been placed at the end of the post***

       As many of you know, I live in Western Kenya, in a rural village called Chebukaka. When I first arrived here, one of our tasks as a Peace Corps Volunteer in the Health Education sector was to complete a Community Needs Assessment (CNA). This activity allowed me to get acquainted with what was going to me new home for these two years. A major piece of this assignment was prioritizing the health needs of the community. Through meeting with community health workers, medical staff at my dispensary, and doing extensive field visits and interviews throughout my sublocation, the disease that always came out on the top of the list was jiggers. Well, like most people, I first had to figure out what exactly were jiggers, and how they came about and how could we try to help with this problem. Luckily, my fellow volunteer Joy Storm, who lived within the same location as myself was already working on this problem with her community, and I was able to receive a great deal of assistance and information from her. I discovered that jiggers are a small flea that burrows into the skin, and proceeds to lay its eggs and feed off of a person’s blood. They can cause severe itching and pain, and need to be removed or treated in order for them to go away. Physical removal, if there is several on a person’s body (which is usually the case), can create several open wounds that often lead to other infections. However, the proper treatment, using potassium permanganate to soak the infected areas is extremely expensive for a Kenyan living in my rural village area. The disease is known to be one evolves from being unhygienic, but this lack of hygiene is caused by extreme poverty. In the process of completely my CNA I discovered that the average household income for a family, which often times included up to 12 people, was about 300 Kenyan shillings per month. That roughly equivocates to be around 4 USD. A bar of soap found at any small shop in the village will sell on average for about 60 Kenyan shillings. Doing that math, means that about one fifth of that families monthly income is going towards the purchase of one bar of soap. Unfortunately, this product we usually call a necessity becomes a luxury, and its purchase takes a back burner to things such as food, shelter and clothing for the family.

            Once a family and their household is infected with jiggers, it becomes a cycle, because even if the jiggers are removed from the person’s body, they will most likely be re-infected from the fleas that have taken up residence in their homes. The flea thrives in dry, dusty areas, which is the exact make up of many villages dwellings which are made of a dirt and mud mixture, not the concrete structure I am blessed to be living in. This is why a complete treatment, not only of the person but also of their homes is important to eradicate jiggers. It is necessary to educate the people on what a jigger is, how they can prevent them and how to properly treat them. This is what I hope to do with the outreach I am planning. I want to educate those who are infected, as well as community health workers and medical personnel on the proper way to treat and prevent, and then go about doing so with 200 participants. We will treat their homesteads so that they may not be re-infected from their own homes and as a final prevention step after the full two-week treatment is completed provide the participants with shoes. Through research done by my colleague and friend, Joy, wearing close-toed shoes has a great effect on the prevention of contracting jiggers. The disease can cause extreme pain and discomfort, deter children from reaching their full potential in school, and prevent adults from being able to work and provide for their families.

Below I have put the link to the grant I am trying to get funded for this project and have placed the small summary here as well.  Please consider donating to the community if you can, any little bit helps! 

https://donate.peacecorps.gov/index.cfm?shell=donate.contribute.projDetail&projdesc=13-615-114

“Tungiasis is a neglected tropical disease that is commonly referred to as "jiggers." It is a disease that is endemic in Latin America, the Caribbean, and Sub Saharan Africa. Jiggers is caused by the female sand flea (Tunga Penetrans) which penetrates the skin causing severe inflammation and other morbidities such as necrosis, auto amputation, difficulty walking, tetanus and can even result in death. In Kenya, it is estimated that 2.6 million people are infected with jiggers. Unfortunately, even though it has such a high prevalence in the country it has not been a priority in the public health sector. With this project I am hoping to bring awareness of the disease as well as motivate the community in the fight against the disease. In my area, jiggers not only causes severe health complications but also impacts work and school attendance because of the inability to walk or concentrate. There is also a large stigma associated with the disease that creates further isolation for those infected. The project will take a systematic approach to the prevention and treatment of jiggers. We will treat 200 people in the community for jiggers. Before, as well as during and after the treatment, participants and facilitators will receive education on prevention of the disease. Also the home compounds of those treated will be fumigated to rid the homes of the pest. The recommended way to treat jigges is to soak the area affected three times a day for a two week period in a solution, or to extract the fleas using a sterile procedure. The latter is not the preferred method in those severely affected with the disease because it can often lead to secondary infections. Unlike many other neglected tropical diseases, treatment of jiggers can be costly. The soaking solution, potassium permaganate, costs about $30 per person, and with all the other required materials for treatment, the cost rises to be about $50 per person to treat. Although the amount seems small, here in Kenya this could be over a half of years salary for someone in the village. We are asking for partners to provide funds to help cover the costs of the fumigation and oil needed for the treatment, as well as some of the secondary materials for treatment of each individual. The community will be providing for the rest of the campaign. The community health workers have partnered both with the district medical offices and Kenya's national anti-jigger campaign to make the project a success. "

 

 This is what jigger infested feet and hands look like, the infected areas are painful and can itch, and the tissue can become necrotic. Without proper treatment and continued infections, the areas, often times toes can auto amputate. 

 

 This is an example of the medication used to treat the jiggers. You add the medication to water to allow the infected areas to soak for 15 minutes, which you do three times a day for two weeks. This noninvasive way of treating the jiggers is not painful.

 Above shows a community health worker putting oil (Vaseline) on the affected areas after treatment, which is done because the medication dries out the skin.

 Demonstration of the proper way to treat the ailment, first you must wash affected areas.

 Showing how you use Sevin Dust to treat the homes, which kills the fleas and any eggs they have laid.

All of the above photos are courtesy of Joy Storm, who has done a similar project in her community and found a great deal of success in this course of treatment!

So if you have gotten this far, I just want to say thank you for checking out the project, and seeing what kind of illnesses affect those who live with so little. While HIV/AIDS, malaria and TB receive a great deal of attention, there are other diseases such as jiggers having just as great of an impact on many communities in the area. 

I hope you are all staying well!

With love and sunshine,

Lindsey Rae