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The Lwala Community Clinic Project is the brainchild of Milton Oludhe Ochieng', a 3rd year Vanderbilt medical student and his brother Frederick Otieno Ochieng', a 1st year medical student at Vanderbilt Medical School class of 2010 with inspiration from their late father, Erastus Ochieng’ who helped write the proposal for the clinic but himself passed away one month before the groundbreaking ceremony in June 2005.
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In the months before their death, Ochieng’s parents brought the community together to establish a village health committee, with the goal of creating a health clinic that would serve others like them who lacked access to basic health care. A committee of 21 people comprising 3 from each of the 7 clans was elected. The committee was charged with building and operating a clinic in Lwala that would serve the 4,000 residents of Kameji sub-location.
The clinic seeks to improve access to primary healthcare in a rural village in western Kenya. Milton and Fred have enlisted the help of numerous organizations in Kenya and in America, American college professors and administrators, college student groups, high school and middle school students to build a community clinic in Lwala, the rural village in Western Kenya where they grew up. Milton’s and Fred’s efforts represent a unique addition to the attempts by many individuals and international organizations in pursuing the UN Millenium Goals for African countries. However, Milton and Fred have the rare advantage of having first hand knowledge of the Kenyan community in which they will be putting to good use some of the western education acquired from the American institutions they attended.
Lwala is in Nyanza province, which borders Lake Victoria. Nyanza has perhaps the highest prevalence of HIV in Kenya. Kenya’s overall adult (15-49) HIV prevalence, according to The Joint United Nations Programme on HIV/AIDS, was 6.7% as at the end of 2003. In Homa Bay, a town in Nyanza province, prevalence was estimated at 33%. Many factors contribute to the spread of HIV in this area, including poverty, migration associated with the lake, polygamy, wife inheritance, untreated STIs, and lack of circumcision. The problem of HIV/AIDS overlays a host of normal health problems in Lwala: Malaria, tuberculosis, pneumonia, cold/ flu, pharyngitis, tonsillitis, typhoid, diarrheal diseases and worms, among many others.
Poor infrastructure makes accessing health care in surrounding towns and cities very difficult. The primary modes of transportation in Lwala are bicycle taxis. In emergency situations, people carry the sick in wheelbarrows, or even in their beds. There is one health center 3km away (Minyenya), that provides some outpatient care and family planning, but for further care residents go to Rongo Subdistrict Hospital (10 kilometers away). Yet even Rongo, a hospital that serves over 60,000 people, is only served by a clinical officer, not a doctor, and cannot perform an emergency delivery by c-section for example. Rongo Sub-district hospital takes care of simple outpatient problems but stabilizes and transfers any surgical and complicated cases to the district hospitals that have doctors. The nearest district hospitals are Kisii District Hospital 33km away, Migori District Hospital 40km away and Homabay 41km away. Patients from the Rongo area stand to benefit from receiving ARVs in Lwala Clinic.
The idea for this project was inspired from a two-week Dartmouth Cross Cultural winter service trip in which Milton Ochieng’ participated during his sophomore year. Working hand in hand with the Nicaraguans, the Dartmouth group built a Women’s and Children’s Health Clinic in Siuna Nicaragua. The trip served as an eye-opener for Milton, who saw a lot of similarities in the healthcare situation in Nicaragua versus that of the rural village where he had grown up in Kenya. He was also struck by the impact that young college students could make by volunteering some of their time, effort and resources in service activities. On his return to the USA, Milton vowed that he too would lead a team in constructing a clinic in his rural village in Kenya whenever the opportunity would present itself. That opportunity presented itself when Milton joined Vanderbilt University School of Medicine in August 2004. Through the new Vanderbilt Emphasis Program, the first year medical students could choose one of 8 areas ranging from clinical research, lab research to international health in which to focus their efforts in the summer between the first and second year.
Vanderbilt Medical School would provide each of the students with a stipend for the summer. Milton chose to focus on international health and was lucky to find a willing advisor in Dr Peter Wright, the Shedd Professor of Pediatric Infectious Disease at Vanderbilt University Medical Center. With the help of his late father, Milton put together a proposal that they started using in soliciting money. Milton and Fred reached out to Dartmouth college groups, local middle schools and high schools in Hanover, NH and student soccer groups in the Upper Valley Region. With key support from the Dartmouth chapter of the Navigators, the Dartmouth Soccer Program , and Thetford Academy, Milton and Fred were able to raise the initial money needed to start the foundation.
Fundraising for the project was launched in January 2005. Milton asked his brother Fred, then a senior at Dartmouth College, to think of fundraising ideas. At a Northeast Navigators Conference on January 27th 2005, Fred gave a presentation about the project and people raised $9,500 for the Lwala Clinic that weekend. Dartmouth Men’s Soccer Coach, Jeff Cook, organized an interview for Fred with a local newspaper, The Valley News and support came pouring in. Children emptied their piggy banks. The ford Academy students donated part of the money from their community service, Operation Day's Work, to the "Freddy clinic." The initial budget estimated that it would take approx US $25,000 to erect the 30.2m by 6m clinic building.
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