As protests continue throughout Kenya, Médecins Sans Frontières (MSF) teams are responding to the additional needs created by the violence of recent weeks. In Nairobi, where MSF has provided HIV/AIDS and TB care in the slums for more than 10 years, medical teams have set up extra clinics and first aid posts in order to assist any people wounded during the protests. MSF teams in Busia and Homa Bay are continuing to provide HIV/AIDS care and are assisting displaced people. In other parts of western Kenya, MSF emergency teams that arrived in the country to help deal with the increased needs continue to provide assistance to the thousands of people who have been affected by the violence. One of the main challenges will now be to continue to respond to indirect consequences of violence on the most vulnerable displaced people, who will probably remain displaced for months.

Nairobi slums

MSF has set up two first aid posts in Mathare slum. Over the course of three days (Wed. Jan. 16 to Fri. Jan. 18), 32 victims of recent violence were treated in these facilities. Several of them, including a young child, had bullet wounds and were referred to a nearby hospital. Seven of them had been so severely beaten that they also needed hospitalization. MSF is working with a Kenyan ambulance service to ensure any casualties can be transported to its clinics. On Friday, the MSF team in Kibera slum received two children — one 13 years old the other even younger — who had received a bullet in the leg. In preparation for three days of rallies announced in Nairobi, MSF had opened two of its three clinics in Kibera (Kibera South Health Centre and Gatwekera clinic) in order to treat a potential influx of wounded people. The MSF team was also able to carry out HIV consultations as usual at these two clinics and in the nearby Mbagathi hospital. However, the violence and ongoing insecurity has prevented some regular patients from attending MSF’s clinics in both Kibera and Mathare. Between Dec. 31 and Jan. 14, for example, 290 patients missed their appointments at MSF’s health facilities in Kibera and in Mbagathi hospital. This is an issue of great concern for MSF. If HIV/AIDS and TB patients do not regularly take their medicines their health will deteriorate and there is a risk of resistance developing. If TB patients do not take their medicines there is also an increased risk of infection for those around them. MSF has set up a free phone hotline for both MSF patients and patients followed in other health structures which are currently closed, so all of these patients can get their treatment. As of Jan. 21, MSF patients throughout Kenya who have not been able to attend their appointments and may have been displaced by the insecurity will be able to call for guidance on how to get their medicines and advice on their closest health centre.

Western Kenya

Emergency medical and logistical staff are working in several large sites in western Kenya, where thousands of displaced people have gathered. The situation is fluid and the needs varied. In some areas MSF teams are working in large sites where thousands of people have settled, providing primary healthcare, distributing urgently needed items, supplying clean water and installing sanitation facilities. In others, teams are finding smaller groups of displaced people who have not yet received any assistance. As a result, MSF staff are constantly evaluating the needs and providing ad hoc responses, both for the displaced families and the local population. In Kisii, for example, the hospital needed medical materials after the arrival of many patients, and displaced families helped by the local population needed basic items such as sheeting and cooking pots. Around Londiani mobile MSF teams met the need for medical consultations. In Nakuru and Molo, extra staff have been sent to help run mobile clinics that visit different sites on rotation, providing medical care to displaced people. As the situation is changing in Eldoret, which saw a large influx of people in late December, and many people have now left the city, the MSF team has refocused its activities. The four-person team will now work on providing clean water and sanitation to three displaced people’s camps around the city and will remain on standby to respond to any emergency needs that arise in the coming days. Distribution of jerry cans, blankets and other basic items is taking place in two settlements, Timboroa and Muge Secondary School, in Koibatek district. Assistance to the 7,000 displaced people in Cherangani is ongoing. MSF has set up hundreds of tents and latrines, and distributed 7,000 litres of water in the camp. An MSF team organized a vaccination campaign for 1,000 children against measles and polio and plans to help supervise a rapid nutritional assessment carried out by the Ministry of Health. In Kitale and Webuye MSF staff are supporting two hospitals. Following fierce clashes on Jan. 16 between communities in Endebes, seven people died during their transfer to Kitale hospital and five wounded were treated by the Ministry of Health surgical team with assistance from MSF. In Endebes itself MSF has started distributing plastic sheeting and material to build latrines in several settlements where people had received little or no aid. On Friday a truck and a cargo plane loaded with a total of 70 tonnes of medical and logistical material was sent from Nairobi to western Kenya. As more agencies start working in cities like Eldoret, Nakuru, and Kitale, MSF will hand over its activities and increasingly focus on assessing and responding to the needs in smaller, rural areas where pockets of displaced people are reported to be living with little or no assistance. In the coming days, MSF will start providing aid to displaced people in Kiminini, Kesogon and Kapcherop. Long-running HIV/AIDS projects in Busia and Homa Bay had resumed normal activities. However, on Thursday medical staff weren’t able to get to the hospital in Busia because the roads were blocked. In addition to providing HIV/AIDS care, teams in Busia are also assisting displaced people who have sought shelter near the police station in the town.

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