The Beyond Zero Mobile Clinic project is offering essential services to thousands of patients across the country but is facing many challenges that put its sustainability in doubt.
Investigations by the Nation reveal that the clinics are struggling with inadequate health personnel, allowances, drugs and lack of insurance.
The clinics need drivers, nurses, clinical officers, clerks and lab technicians who work in shifts.
“On a minimum we have eight personnel in the mobile clinic and the main challenge is the high cost of paying their allowances,” Laikipia health executive David Njoroge said.
The same goes for other counties which are struggling to employ medics, pay their allowances and at the same time fuel the trucks.
There are wide disparities in allocated amounts ranging from the lowest — Sh1 million — to the highest — Sh10 million a year.
Many coordinators of the programme feel the amounts are inadequate. Some are now asking that the national government helps to run the clinics.
In Tharaka Nithi County, services have ground to a halt due to lack of fuel, drugs and allowances for nurses.
The truck was recently moved from Chuka County Referral Hospital where it had been parked to an unknown location after the Nation reported about it.
Nurses who were offering services said they used to spend several nights in the bush for lack of fuel before work stopped and they were recalled back to their former stations.
The medics said they never received their allowances and were not given food during the few months that they worked in the truck. “We were sometimes forced to carry food from home because we were never paid our allowances despite working in a harsh environment,” said the nurse.
Tharaka-Nithi health chief officer Walter Mugambi said the truck needed to be serviced before resuming operations but denied that it had stalled.
Ms Mary Kageni, a resident of Kathangacini area said many pregnant women used to get prenatal care in the mobile clinic before it was withdrawn.
But despite the challenges, the project, started by First Lady Magaret Kenyatta, has largely ushered in a new dawn in some of Kenya’s far-flung villages where residents, especially pregnant women, have had to walk long distances to access basic health care. All of the country’s 47 counties received a mobile clinic.
In Embu, at least 10,000 people have accessed services in remote areas in the past one year, health executive Pauline Njagi has said.
The facility has been visiting far-flung areas especially Mbeere.
Ms Njagi said Embu government has set aside Sh1 million for use in ensuring the smooth running of the mobile clinic.
She said the programme requires Sh5 million to ensure it reaches all corners of the county and were borrowing from other votes.
“The mobile clinic is manned by a clinical officer and offers ante-natal care, family planning services, laboratory services and cancer screening,” she said.
Embu Governor Martin Wambora’s wife Teresa has undertaken the role of monitoring how the mobile clinic is being utilised and usually visits sites where the clinic visits.
Ms Lydiah Gicuku said the mobile clinic had served her in Siakago when she was pregnant. “It is a good initiative and it should continue reaching out to women in remote areas,” she said.
In Isiolo, the clinic has registered success in its two years of operation, with 16 babies being born in the truck.
County director for health Mollu Huka said the clinic had reduced maternal deaths and cases of mother to child HIV infections.
The maternal mortality rate in the county stands at 700 deaths out of 100,000 live births while the HIV prevalence rate is at 4.2 per cent.
“Due to the vastness of the region, the health department has liaised with Kenya Red Cross Society to integrate parallel outreaches in the region to supplement the clinic which is overwhelmed,” he said.
Issues of budgetary allocation was a problem when the truck was donated in 2014 but the Health director said Sh8 million has been allocated in the 2016-2017 financial year for maintenance and services.
Ms Nuria Adan, a resident of Kinna said the clinic has helped pregnant women in the area.
In Marsabit, the clinic was grounded for seven months this year before Governor Ukur Yatani’s wife intervened.
There were no services from March to October 2016 due to lack of funds.
Before it stalled, county clinical psychologist and Beyond Zero services coordinator Sarah Lalafa said two deliveries had been conducted in Shur, North Horr .
Dr Gumato Yatani wrote to the Marsabit county assembly which approved a budget of Sh10 million for the operations of the truck.
Ms Lalafa said due to vastness of the region, they require at least two trucks.
She also pleaded for more staff to run the van as well as have the truck re-designed to suit the rough terrain in the county.
Maternal mortality rate ratio in Marsabit stands at 1,127 per 100,000 live births, the fourth highest in the country after Mandera, Wajir and Turkana.
In Makueni, more than 25,000 residents have been served by the clinic, according to the county health executive Andrew Mulwa.
Data on the services of the mobile clinic made available to Nation shows a majority of the cases are cervical cancer screening services.
“Out of the 28,447 cases at the Beyond Zero medical camps from last year when to date, 3,526 are cervical cancer screening services,” Dr Mulwa told Nation.
Among the 3, 526 residents screened for cervical cancer in the mobile clinic, 43 patients were positive, according to the data from the health department.
Other services offered include counseling, laboratory services, pharmacy, HIV testing and counseling, minor surgeries, nutrition, deworming, family planning as well as general outpatient and antenatal care services.
On board the truck are medical officers, clinical officers, nurses, a records officer, laboratory and pharmacy staff, he added.
Reports by Alex Njeru, Vivian Jebet, Ken Bett, Charles Wanyoro, Pius Maundu and George Munene.