The Beyond Zero Mobile Clinic project, offering essential services to thousands of Kenyans, faces numerous problems that are casting doubts on its sustainability.
Investigations by the Nation revealed that the clinics are struggling with inadequate health personnel, allowances, drugs and vehicle insurance.
The clinics need drivers, nurses, clinical officers, clerks and lab technicians who work in shifts.
“We have a minimum eight people going out with the mobile clinic and the main challenge is paying their allowances,” Laikipia Health Executive David Njoroge said.
Many counties are also struggling to fuel the clinics.
All of the country’s 47 counties received a mobile clinic.
There are wide disparities in funds allocated by counties to the clinics ranging from Sh2 million to Sh10 million a year.
County coordinators of the programme feel the funds are inadequate and some are now asking that the national government to help to run the clinics.
But despite the myriad of problems the project, started by First Lady Margaret Kenyatta, has ushered in a new dawn for Kenya’s far-flung villages where residents, especially pregnant women, had to walk long distances to health centres.
In Lamu, more than 4,000 patients have been attended to at the clinic, just three months after it started operating.
It offers HIV and Aids tests, cervical cancer tests, maternity services, laboratory services and treats various illnesses.
Mrs Mary Kachimbi of Sheemgambo Village in Hindi Division says the facility is a Godsend for those who could not afford transport and cost of treatment at Lamu County Hospital.
“One needs at least Sh1,500 for fare to and from the King Fahad Hospital. But now the services we used to seek at the general hospital are brought to us, saving us money, time and energy,” said Mrs Kachimbi.
But there are already fears about the sustainability of the project.
At Witu, villagers in Chalaluma, Katsaka Kairu, Maleli and Lumshi complained that the clinic had stopped coming.
“It came only once in September yet we had been promised it would visit our villages every month. We urge those involved in planning to ensure we have it even after every two weeks. We don’t have dispensaries here,” said Mr Yusuf Abdirahman, a resident of Chalaluma village.
Nurses running the clinic said they were unable to go to far flung areas because of lack of allowances.
“We are supposed to visit Witu and Mpeketoni every month but we have only been there once as there are no allowances. We have are forced to operate in Mokowe, Hindi, Bar’goni and other nearby villages,” a nurse who requested not to be named said.
The nurses also complained of poor roads and insecurity, especially in Hindi-Kiunga where Al-Shabaab is active.
Dr David Mulewa, the County Director for Health services, admitted that there had been delays in paying allowances.
“I am aware of delays in paying allowances but they have been paid,” said Dr Mulewa.
In Taita-Taveta, more than 8,000 residents have benefited from the services since the clinic was donated in July 2014.
The county was the first beneficiary of the programme due to the high rate of maternal deaths in the area.
The county was ranked 11th out of 14 regions with high rates of maternal deaths.
County Nursing Officer Eunice Masamo said more than 230 pregnant women had been attended to at the facility.
“More than 58 women have come for post-natal care and 3,177 children below five years have attended child welfare clinics since 2014,” she said.
Mrs Masamo said the bad terrain had resulted in frequent breakdowns of the van.
In Tana River County, which received its clinic in August, more than 200 children have been immunised against various diseases, including measles and tetanus.
Chief Health Officer Hussein Hassan said the children had earlier missed out on the countrywide jab.
“For instance in Konemahasa, which is 200 kilometres from the county headquarters, children had not been vaccinated. But when the clinic arrived we were able to reach them,” he said.
“Services offered at the mobile clinic are free. We have received positive feedback from residents who used to travel long distances to health centres. We have budgeted Sh10 million for drugs to ensure there are no shortages,” he said.
In Mombasa, county head of health programmes and Beyond Zero coordinator Isaac Jewa said the clinic had improved health services tremendously.
He said more than 700 women have been screened for cervical cancer. “Of these, 18 were confirmed to have cancer and were referred for further treatment,” Mr Jewa said.
Changamwe Sub-County Beyond Zero and HIV/Aids Coordinator George Kissinger says he has used the van more than 15 times to conduct health awareness and treatment programmes in the constituency.
“This mobile clinic has been a great help. When there was an outbreak of hepatitis A in Mombasa we used it to raise awareness,” he said.
However, he says, the problem has been a shortage of permanent staff, especially nurses, and payment of vehicle insurance and fuel.
He appealed to the government to register the van with GK number plates as paying its insurance was costly to the county.
Faith Chiguba, a clinical officer who coordinates malaria and child health in Jomvu and Changamwe, said she no longer has to worry about hiring tents when conducting health activities in her area.
In Kwale, Matuga Sub-County Public Health Officer Galole Dima said the clinic traverses Matuga, Msambweni, Kinango and Lunga Lunga.
Health Executive Athman Chiguzo said maintenance and fuelling of the van had been budgeted for.
He said the clinic had helped to reduce the rate of HIV infection from mother to child and general infections from 8 to 5.7 per cent.
“This clinic has enabled pregnant mothers to know their HIV status and those who are positive are guided on ways to raise their children,” he said.
Report by Kalume Kazungu, Lucy Mkanyika, Winnie Atieno, Rebecca Okwany and Farouk Mwabege.