2016 was a very exciting year. Our income grew by over 60% enabling us to expand our work in Kenya and to start our first project in Uganda. We have always wanted to expand our work into neighbouring countries, many of which have population growth rates higher than that of Kenya.
There are many excellent NGOs working to give people in Africa the chance to escape poverty, but not many acknowledge the link between poverty and access to family planning. We believe though that helping to meet the unmet demand for family planning is a positive way to give families a chance to escape poverty. With smaller families and longer gaps between births, everyone can be better nourished, access to education is improved, and the number of potentially dangerous, unskilled abortions is reduced. Smaller families require less food, water and firewood, reducing pressure on the environment. By allowing women to choose the number and spacing of their children, based on their economic and environmental conditions, the living standards and health of the whole family are improved. Can you imagine how difficult life would be with six children and an income of just a couple of pounds a day? This scenario is familiar to so many women in rural Africa. Enabling these women to choose how many children they want gives them hope and the chance to give their families a better life.
In 2016 CHASE gave 42,534 CYP of family planning…
In layman’s term this is equivalent to giving more than forty thousand women one year of family planning. It’s an effective and unified way of showing how the various different contraceptives (from the daily pill to a five year implant) we offer through our mobile clinics are reaching and impacting the communities that we serve.
Currently there seem to be more and more stories in the press about population. So long the elephant in the room, the subject is at last being more widely debated. Perhaps the demise of the real elephant is finally making people realise that if we are going to save this iconic species we have to protect areas where it can live. A burgeoning human population needs more land in which to live and grow food, and wild places all over Africa are being turned over to agriculture. Indeed, many developed countries did exactly this many centuries ago – it would be incredible if Africa could avoid the same mistakes. Preserving space for the elephant to roam free is just one element of conserving and protecting Africa’s astonishingly varied habitats and biodiversity – a goal worth striving for.
Many scientists have been grappling with defining the limits of a sustainable population for this finite planet – a population which would give us all a reasonable standard of living. The UNEP’s report “One Planet, How Many People?” suggests that we are now at the limit of a sustainable population. The report goes on to say that despite fertility rates falling around the world we’re projected to reach a population of at least 9.3 billion by the middle of the century. Although fertility rates in general are falling, in Africa they remain high. If African fertility rates stay at today’s level the population of Africa will be 3.2 billion by 2050 and 16 billion by 2100. The key to Africa’s future prosperity – giving its citizens a chance of a lifestyle we take for granted – is helping to meet the unmet demand for family planning over the next decade.
News from our Partners
Choosing the right partners is key to delivering our work on the ground. In addition to continuing to support our existing partners we were pleased to start projects with two new partners in 2016, Community Health Volunteers (CHV) in Kenya and Conservation through Public Health (CTPH) in Uganda. Both these partners have benefited from help and support given by our existing partners.
Community Health Africa Trust (CHAT)
Community Health Africa Trust mainly operates in the remote northern areas of Isiolo, Laikipia, Baringo and Samburu counties where many people are semi-nomadic pastoralists who have poor access to healthcare. CHAT uses a variety of methods to reach their clients. Sometimes it’s a back pack nurse travelling on a motorbike, but when travelling further from base the trusted Land Rover is used. When the terrain becomes too challenging for wheels, a team of camels is the preferred form of transport.
In April 2016 some of CHASE’s funding was used by CHAT to carry out a two week motor mobile clinic in the east of Baringo County. Two weeks before the Land Rover set out, community health mobilisers travelled through the area creating awareness of the different health related services the mobile clinic would be offering and giving dates and locations for the clinics. In these remote, rural areas there are still many myths and misconceptions about family planning, such as family planning “causing infertility” or “reducing sexual desire”, “damaging a woman’s womb” and other health scares. It is the role of the mobilisers to discreetly talk about these issues, allaying fears so that when the clinic arrives more women will be prepared to try using family planning. During the two weeks that the Land Rover was out, 903 women chose to come to the clinic to receive family planning.
Community Health Volunteers (CHV)
We were introduced to Community Health Volunteers by a tree planting partner of ours working in the Kakamega Forest. CHV runs a private clinic on the edge of Kakamega National Park and was started by Gabriel Msundi who originally trained at the Kenya Wildlife College to be a tour guide. He is passionate about the birds in Kakamega forest and also about the health issues of his local community.
Gabriel built a simple clinic from two shipping containers in Virhembe Market in 2008 and now employs 27 staff who operate the clinic 24 hours a day, seven days a week.
In the latter part of 2015 Gabriel spent time with one of our other partners, Dandelion Africa, learning first-hand how they operate their mobile clinics. With the knowledge gained CHV carried out six mobile clinics in 2016. From a slow start things got busier, culminating with a clinic on Christmas Day which saw 210 women attending for family planning. Over the six clinics 1,319 women came for family planning and over 3,000 people attended for general healthcare issues.
2016 was a very busy year for Dandelion, who carried out 37 mobile clinics seeing 10,615 people for primary healthcare. 37,575 children received de-worming medication and 8,472 family planning options were provided.
As well as running the mobile clinic, Dandelion is well underway in building a clinic at Sarambei, which should be opening in July 2017. Once built, Dandelion will apply for an SC11 registration so that they have government recognition. The clinic will have a big impact on the community because women will have a safe place in which to discuss, learn about and access sexual and reproductive health services. Currently, the nearest hospital where women can have safe deliveries of babies is 20 kilometres away and the rates of HIV transmission between mother and child are high due to home deliveries. Giving birth in the new clinic will save the lives of many women and their babies.
With the help of Dandelion’s Wendo Aszed and CHASE supporter Steve Bown, we have been able to make a new video that follows the work of a day-long mobile clinic as it visits a rural community. You can watch the video by going to: https://youtu.be/CF8UHrN8N8o
New Project with the Big Life Foundation
At CHASE we are trying to focus our work in areas of high biodiversity. With this in mind we approached the Big Life Foundation who operate in the area around the Amboseli National Park to see if they would consider helping to implement a family planning project. Amboseli National Park in southern Kenya embodies many of the critical issues facing areas of high conservation value. With increasing human populations around the park there is an increasing amount of human/wildlife conflict. The staff at BLF were interested in finding out more about how a project would work. CHASE funded a visit from two of Dandelion’s staff to make a feasibility study on how a mobile clinic project could be established, and to spend two days training 20 Community Health Workers. One issue this trip identified was that the local MoH in Loitokitok had a severe shortage of family planning commodities. Generally, we get these for free and as this report goes to press we are trying to find a further source of free commodities.
The location of the proposed project is on the Imbirikani group of ranches where approximately 15,000 Maasai live. In this area FGM and polygamy are still common practice with very few women using family planning. The project is due to start in March 2017.
Conservation Through Public Health (CTPH)
Conservation Through Public Health is based in Uganda and conducts programmes to protect gorillas and other wildlife from catching diseases from humans and livestock. The mountain gorilla is a highly endangered species with about half of the world’s population, estimated at 650 individuals, found in Bwindi Impenetrable National Park. Gorillas and humans have a 98 per cent genetic resemblance, making transmission of diseases between the species highly probable. The human population around the park has risen dramatically over recent years and there has been an increasing amount of human/wildlife conflict. Humans enter the park for firewood and game meat while wildlife damages farmers’ crops. CTPH’s unique approach to biodiversity conservation led to Gladys Kalema Zikusoka, a practicing vet and one of the founders of CTPH, being invited to London in November 2016 to give the Tusk Conservation Lecture.
In a recent survey, the majority of the people in the villages around the park said that they realise that the gorillas attract tourists who bring wealth to the area. The survey also found that although most people had heard about family planning very few women had used it.
In November 2015 Stephen Rubunga, one of the co-founders of CTPH, spent time with Dandelion Africa to learn more about how to conduct mobile clinics. With the knowledge gained and funding from CHASE Africa, CTPH set about scaling up its family planning services with plans to conduct three mobile clinics around the Bwindi Impenetrable National Park in late 2016. In these remote areas most people do not have access to family planning. During our pilot mobile clinic nearly 100 people from Nyabaremura village in Rubuguri parish were provided with family planning counselling and commodities, as well as HIV testing.
Mount Kenya Trust (MKT)
Mount Kenya Trust works with national and local government divisions such as Kenya Forest Service and Kenya Wildlife Service to protect the national park around Africa’s second highest mountain. It is a constant battle to try and stop the poaching of wildlife and bush meat, logging of indigenous tree species, illegal grazing, crop cultivation and charcoal production, pressures which arise from the burgeoning human population.
MKT has been very successful in engaging the local community with their conservation projects and the community health project launched with CHASE in 2014 has changed the lives of thousands of families. 21,000 family planning treatments (equivalent to 30,000 women each receiving one year of contraceptive cover) have been provided free of charge, with many women opting for the three year implant. Giving women the chance to choose when they want their next child gives them an opportunity to earn an income and help themselves to escape poverty. The project has also helped over 13,000 people receive primary healthcare.
The Kenyan Government is committed to reducing the total fertility rate and one of the best ways to make this happen is to enable girls to go to secondary school. On average, women who only went to primary school have 5.4 children whilst those who finish secondary have 2.9. As secondary school is so expensive in Kenya girls born into a poor family with lots of children often miss out on secondary school.
It will still take many years, but the success of the family panning project run by MKT will mean in the future more girls will get the chance to go to school.
Friends of the Mau Watershed (FOMAWA)
Kenya faces an increasingly severe shortage of “tree products”, firewood, poles for power, and timber which all come from the higher areas where the climate and soils are suitable for growing trees. We continue to fund the planting of trees at schools, and many of the first schools to plant are now generating useful income from selling their timber with the help of FOMAWA.
In addition, many local people are seeing how the schools are benefiting and are planting trees themselves as a future source of income. With FOMAWA’s influence and guidance they are now looking upon trees as a potentially valuable crop and are giving them the husbandry required so that they grow well. Making money is the biggest incentive, but there is also the knock-on effect of the benefit to the environment.
In 2016 CHASE funded the purchase of 2,000 avocado seedlings. Most of these have been given to pupils who have shown real interest in environmental matters at schools covered by our tree growing projects. They have taken them home and planted them there.
Avocados are easy to propagate from the pip of an eaten fruit and will produce fruit from the fifth year, and will continue to do so for another fifty years. In Kenya the tree will fruit rather haphazardly all year, so if there are many trees within a neighbourhood there will be fruit available nearly all year round. Any fruit that is not needed can be sold in the market.
One Tree Per Child Project (OTPC)
In November 2016 OTPC held an event in St Stephen Walbrook church in London, hosted by John Dee and Kevin McCloud. At the event, CHASE presented a report on the OTPC project we had initiated with Mount Kenya Trust. The aim of the project was to plant 500 trees at each of three schools, improving the school environment and teaching children how to grow and look after trees. A highlight of the project was a visit by the UN Mountain Ambassador, a Tibetan monk, in October 2016 on the day the children planted their trees.
In 2012 world leaders gathered in London for a summit on Family Planning. Out of this summit FP2020 was born, which set the objective of offering 120 million additional women family planning options by 2020. FP2020 is hosted by the United Nations Foundation, which builds public-private partnerships to address the world’s most pressing problems. It is supported by philanthropic, corporate, government and individual donors.
In 2016 CHASE made a pledge to reach 100,000 additional women by 2020. This pledge appears on the FP2020 website.
The family planning and basic healthcare service will be provided by mobile clinics operated by our partner organisations, with the support of the county Ministry of Health. We have already been supporting our partners to do this for nearly five years and want to expand our work to meet the high demand for family planning among those who are not yet using it.
CHASE Africa looks forward to being part of a larger effort to ensure that the Global Strategy for women’s, children’s and adolescents’ health is achieved.
FP2020 runs a programme called the Rapid Response Mechanism giving grants which will help meet the target of reaching 120 million more women. In 2016 with help from CHASE, one of our partners, Dandelion Africa, applied and was given a grant to run more mobile clinics. We will be encouraging our other partners to apply, and we received a small grant for helping with the monitoring and evaluation.
New technology is helping to meet the unmet demand for Family Planning
Many women use Depo-Provera as their preferred method of contraception, but this means having to visit a clinic every three months to receive an injection. For those living in remote areas this can mean a long trip to the clinic. It would be so much easier if they could self-administer this form of contraception. A new product called Sayana Press does just this. Sayana Press is small, light, easy to use, and requires minimal training, making it especially suitable for community-based distribution—and for women to administer themselves through self-injection.
Sayana Press has now been recommended by WHO in contexts where women have information, training, and support. Throughout 2017, PATH, a leader in global health innovation, is conducting research on self-injection of Sayana Press in collaboration with ministries of health in Senegal and Uganda, and learning how to support women in these settings to self-inject safely and effectively. With lessons learnt from this research it is hoped that Sayana Press will soon be available in Kenya, allowing women to use it in the safety of their home.
Our financial year
Income = £165,376
Expenditure = £156,854