A rare overcast morning in the normally stifling hot and hostile aridity of Turkana District. Under a collection of thorn trees, 200 people from three temporary villages of this nomadic pastoralist community are gathered around a mobile Amref Health Africa health unit.
As mothers congregate under one tree to have their children weighed and vaccinated, John Losikiriat walks among the rest of the group, holding up a set of pictures and explaining the symptoms of chronic illnesses like TB and cholera, and the importance of getting medical help as soon as possible.
John is an assistant chief, and though he speaks with authority, his friendly manner encourages his audience to ask questions.
When Amref Health Africa introduced its community-based health care programme in Lokichoggio in 1990, I became a member of the village health committee. We realised that if things were to change, we needed to get involved in improving the health of our people. The committee decided that each family would contribute one goat per year towards the programme to meet the cost of treatment.
In 2004, I became a Trainer of Trainers, creating more people like myself who are armed with information. I learnt about the diseases that affect our people, including diarrhoea, malaria, cholera, HIV/AIDS and the importance of immunisation. Twice a year, I get refresher training from Amref Health Africa.
Most of my effort goes into health education. Many Turkana are illiterate and do not know the basics of prevention and care. I talk to them about symptoms of diseases and emphasise the importance of going to a health facility for treatment as early as possible. I speak about the importance of immunisation and of proper ante-natal care. I also keep a look out for any signs of an outbreak of disease and report it to the nearest health centre.
I find it easy to combine my two roles. Giving health talks in the evening and during the day I perform my duties as assistant chief.
Insecurity is our biggest concern. We live under constant threat of attacks from neighbouring communities from Sudan, Uganda, Kenya and Ethiopia. They raid us and take our animals, which are our livelihood. This brings poverty and people are forced in to towns, engaging in activities like burning charcoal to make money.
Health is a big problem. Sixty per cent of Turkana are nomadic pastoralists; there are no hospitals in the areas, we move with our animals.
Before Amref Health Africa came to help us we had been forgotten. People died from preventable diseases like diarrhoea, polio and measles. Turkana is very dry and hot. Water is a rare commodity, so it is difficult to maintain hygiene standards such as bathing and keeping clothes clean. Water-borne diseases like diarrhoea and skin infections are very common.
With increased awareness of disease prevention, treatment and care, there has been a gradual but definite change of attitude and behaviour in the community. People are going to health centres when they suspect they are ill. Parents readily bring their children for immunisation whenever we have a clinic. Now we have fewer cases of polio and measles among children.
As far as they can, people are washing their utensils and trying to keep themselves clean, though this is very challenging considering there is barely enough water even to drink for most of the year. They are adopting healthier habits, for example, digging holes a distance from their homes when nature calls and covering it up in what we call the cat method. This way they do not risk contaminating water sources and causing diseases like cholera.
More and more people are buying and using insecticide-treated mosquito nets to prevent malaria. When they fall sick, they now go to the health centre instead of seeing a witchdoctor. People have developed confidence and trust in me. Many come to me for advice on health issues. I am called the doctor of the kraal.