How transfer brought junior pediatric nurse to limelight

In January 2019, Timothy Mwangangi, a pediatric nurse at Taveta Level Four Sub-County Hospital received a transfer letter.

The implications of the contents were devastating. “I was sent to Mata dispensary. I went into depression,” admits Mwangangi, 32, with a wry smile.

Having lived in Taveta town for two years, the transfer was a nightmare. Like all tiny health facilities located deep in remote regions, Mata dispensary had the odious tag of being inhospitable. It is saddled by a plethora of hardships that made it an extremely unattractive place.
This adverse reputation is somewhat merited. Established in 1972, Mata is one of the oldest facilities in Taita Taveta.

It is tucked in the heart of a harsh terrain along the Kenya-Tanzania border.
Locals say the foundation stone was laid by former Coast Region Provincial Commissioner Eliud Mahihu.

Geographically, Mata is the apotheosis of hardship areas. The rains trigger thundering flash floods that sweeps from Tsavo West National Park. The raging waters destroy roads, pipes, kill livestock and cause extensive flooding.

Drought comes with herds of marauding elephants that traipse across the villages wreaking havoc and destroying farms.

Villages in swampy areas near Lake Jipe report hippo menace. The phone network is erratic and the Internet connection is shaky at best. To Mwangangi, this transfer was punitive; perhaps a punishment for some unnamed crime. In this despair, his wife intervened. Being a nurse, she sensed his dilemma; the war raging within.

She reminded him of his professional oath. “Go. You might find people who need you more,” she said. Then added, “Besides, there is free accommodation at the staff quarters.”

Disturbing trend

The staff quarters were rundown houses that had not been lived in for ages. They had neither electricity nor running water.

Former staff were commuting daily from Taveta town, over 40 kilometres away. With his wife’s words fortifying his shaky confidence, he moved into the dilapidated house to start his work.

The decision marked the most significant shift in his young career. Two years later, Mwangangi has gone full circle. On December 4, he walked through the manicured lawns of State House, Nairobi and stood in the palatial tent under glittering lights next to First Lady Margaret Kenyatta and received Nurse Practitioner of the Year 2021 award during the National Beyond Zero Health Awards event.

“It is surreal. I never knew our work was that impactful,” he says.

At Mata, his initial resentment was eclipsed by his professional instincts. The call to serve was stronger. His nursing antennae picked a disturbing trend in mothers whose babies came in for immunisation.“60 per cent of the babies were not delivered in a health facility. They were delivered at home,” he says.

A more alarming discovery followed later. Over half of the babies had neonatal sepsis. This was from their mothers delivering in an unsterilised environment.“To eliminate neonatal sepsis, we needed mothers to deliver with us,” he explains.

The community is amongst the most marginalised groups in the country. The Pare, originally from Tanzania, exists on the fringes of most programmes.

Lack of documents like IDs keep away from places the documents might be required. There was also the Mata community that needed to be inspired to utilise the facility.

Working with Community Health Volunteers (CHVs) from 19 villages, they launched a public campaign. Word went round that there was a resident nurse and that the facility was open round-the-clock. The CHVs monitored pregnant women in homes and asked them to go to the facility.

“We assured residents there was a medic on standby even at night,” he adds.

Maina Fundi, chair of the dispensary committee, aptly captures their challenges. He cites unreliability of services and poor relations between villagers and medics as the cause for women keeping off the facility.

Already, the community does not want the young nurse transferred, as he has transformed the facility.

“It was an issue of trust. No one knew if they would find a nurse to assist them to deliver. This time, it is perfect,” he says.

Initially, villagers’ initial hesitation lingered. Accustomed to lacklustre services, women regarded the new medic with muted apprehension and uncertainty. To earn their trust, Mwangangi and the committee introduced an incentive programme to lure women to come.

Token programme

“We initiated a token programme where we offered caps, pampers, baby dresses and porridge to mothers who came. This was a small boost to start life for newborns,” he recalled.

The tide shifted. A facility that was recording zero to one delivery monthly saw the birth rate edge upwards to seven and eight. The highest recorded number of births is at 10 in a month.

“From zero to 10, this is good progress. It is a mark of trust,” he said.

The token system is so popular that some women demand their baby socks immediately they deliver. The purchases are from funds allocated back to the facility from the Linda Mama programme. When funds delay, he uses his personal cash to buy the awards to avoid disrupting the flow of goodies. “When our supplies run low, we promise mothers we will deliver later. We always do,” explains the nurse.

County Executive Committee Member for Health John Mwakima remains modest at the systems set in place to allow innovative ideas in the sector. He states that the county is committed to investing in facilities and staffing to ensure residents enjoy improved services.

“What is happening at Mata is a story of how we plan to ensure our people access the best of healthcare services,” says Mwakima.

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