By Matthew Husband
Residents of the developed world rarely think about the lower levels of basic need found in Maslow’s Hierarchy. At its nadir, the hierarchy explains a requirement for things like water, food and shelter—physiological maintenance factors - that come easy in higher-income countries. Travel to East Africa, however, and you will see the daily energy expense of meeting these most basic of needs.
Kathleen White, Coordinator of Patient Family Education and a nurse at the Medical University of South Carolina (MUSC), was raised in Kenya and witnessed first-hand the difficulties of poorly developed systems. The result is limited access to food, water, education, healthcare and employment.
White saw the cause and effect of limited public health and medical infrastructure that lead to adverse health effects throughout the country.
She found her experience so captivating and life-altering that she chose to expose her family to her former homeland. Not only did she provide a similar experience for her kin, but also she began working with Real4Christ, a faith-based, non-profit organization founded in 2007 that provides water, food, education and medical care to communities near Mombasa, Kenya.
White grew up in Kenya, spending her childhood and teenage years in East Africa. She wanted to share the beauty of the country and people with her family as her parents did in her youth. But most importantly she wanted to show the less glamorous side of the country and the value of working in low-resource settings. White did this through Real4Chirst. She was impressed that Real4Christ took a bottom up approach to their mission by viewing individuals holistically – with physical, intellectual, emotional and spiritual needs.
“If people have to invest all their energy into meeting their basic needs they cannot have the best possible life,” White explained. “It is strikingly true in Kenya and provided a framework for me about what we were doing there.”
The team primarily went to support the teachers and over four hundred students from two Real4Christ schools. So dedicated to their cause, the twelve-member team brought fifty-one pieces of luggage filled with supplies from t-shirts to medical supplies to Mombasa. White worked diligently with MUSC to collect surplus medical equipment including hemostats, catheters, forceps, and purchase prescription medicine.
“You knew you were serving by infusing supplies, however that has a limited impact,” said White. “You have to look at sustainability. Something that I appreciated about the organization is that if the founders had to pack up and get out of there tomorrow, the programs would continue because they were embedded in the community. Started within an existing social structure of the church.”
At the outset, Real4Christ established a water supply by drilling a well, realizing how extensive the need was in Mombasa. Water—a need at the base of Maslow’s hierarchy—brings people together. Most people in Africa don’t have a tap in their own home, relying on water gathered in a gerry can from a nearby well or standing rainwater. Conditions are worse in sub-Saharan Africa. Only 40 percent of the nearly 800 million residents have access to an improved water source, whereas North Africa has coverage above 90 percent.
Real4Christ found that the children attending the school did not have sufficient food at home, they started a nutritious feeding program as part of school life. These programs are the cornerstone of sustainability, and will enable the schools to thrive in the future through ongoing parent/community support.
White witnessed a direct impact on the younger generation that was a part of the team. “We protect our kids so much in the United States and shelter them from the nitty gritty things of life,” remarked White.
While on this trip, they saw poverty, dirt, burns, and a severe lack of water. For youth, exposure is very valuable, but the reward goes both ways. Healthcare professional students sustain programs when they apply skills in the field; they receive life-changing experiences; and the people they impact are grateful. But you don’t have to go to the other side of the world to gain this exposure. Some students need a cultural primer on working in low-resource countries to mitigate shock they might experience. MUSC provides opportunities for students to participate in programs where patients with diverse backgrounds and varying levels of socioeconomic statuses can be seen.
The Community Aid Relief Education and Support (CARES) clinic is one of them. CARES is medical student-initiated and managed non-profit organization providing free medical care to the underserved, uninsured population in the Charleston area.
No matter where you travel, where there is despair there is also beauty and joy in serving. This is what White wants to impress on her family and students who may be traveling to work in the field for the first time.
White pointed out that there is an current initiative for the Real4Christ clinic to establish a niche in serving the broader community: birthing. With a brand new birthing suite on the way, it is important that the clinic is well staffed, well managed and well supplied to reach patients at greatest need. They have not delivered a baby there yet, but are gearing up to do so because maternal and infant morbidity/mortality is still high in Kenya.
“We have a legacy at MUSC with maternal and child health programs,” White said. “And we have practitioners and Physician Assistants who could benefit personally from clinical practice overseas, which would also benefit the people in Mombasa.”
Exposure to programs in low resource settings is important for students of the healthcare professions. It not only chips away at access issues, it better trains future practitioners pursuing work in areas with patients from diverse backgrounds. Simply teaching midwifery concepts to students or training nurses to recognize disease patterns in pediatric patients in developing countries is important to fulfill unmet healthcare needs.
“For years the focus in Africa has been malaria and HIV/AIDS; however, these are on the decline because of better management and increased awareness, which is good news,” said White. “[Providers] now also treat diseases like flu and pneumonia, and can invest in programs to reduce maternal and child health issues. People there deserve the opportunity to do more than just contend with meeting the needs of basic existence. We all have a desire to achieve higher levels of actualization – safety, love/belonging, esteem and mutual respect.”
Matthew Husband is a second year occupational therapy student in the College of Health Professions.