ENGAGING COMMUNITIES IN

WHOLISTIC HEALTH DEVELOPMENT:

THE ‘THV MODEL’

WARNING:This is a presentation made

to medical students and includes two graphic slides of human anatomy that is

not suitable for children or sensitive audiences.

SOME FEW HEALTH SECTOR INDICES FROM KENYA

• 5000 health facilities in Kenya• 4500 doctors; 1000 in public service. 50%

concentrated in Nairobi: Ratio 1 physician to 10,000 citizens (compared to 26:10,000 in US)

• 47,000 Nurses & other cadres of medical personnel (10:10,000)

• 4.6% GDP towards health financing ($29 USD per capita) far below the minimum $34 recommended for Africa by WHO. 40% of financing comes from Kenyan Government; 15% donors, rest by private sector

SOME FEW HEALTH SECTOR INDICES FROM KENYA

• 58% of health services run by private sector which caters to high income clientele

• 90% resources devoted to curative a service that only 10% of the population accesses.

• 90% of morbidity (and mortality) is caused by preventable infective diseases (and poverty)

Kenya HDI (Human Development Index) #147 (0.541)

(ranked out of 182 countries)Literacy Rate

(age 15 and over that can read and write) #107

73.6%

Infant Mortality Rate

(per 1,000 live births)

54.7 deaths/M

(2009 est.)

Life expectancy at birth

#152

53.6 years

Combined primary, secondary and tertiary gross enrollment ratio #138

59.6%

GDP per capita

#149

$1,542 USD Per Capita(2009 est.)

THE BURANGI PROJECT is a total health village (THV)

program

• It is a completely participatory strategy where communities analyze their situation, and plan a response strategy, and implement it using Community’s Own Resources/Persons and engaging External partners only in a facilitative role where they have no capacity in solving their own problems.

WHAT IS A THV?

POINT OF ENTRY THEMATIC AREAS FOR BURANGI THV

• HEALTH– Access to quality medical care through mobile and static

health clinics– Access to quality drinking water– Improved community, domestic and personal sanitation

• SUSTAINABLE DAILY LIVELIHOOD– Improved food security– Improved income generation

• Environmental preservation – Through tree planting and use of alternative renewable

sources of energy and others

RESOURCES ALLOCATION

THE 50 | 40 | 10® PRINCIPLE• 50% TOWARDS PROMOTION.

– INVEST IN PEOPLE

• 40% TOWARDS PREVENTION. – INVEST IN SYSTEMS/STRATEGIES

• 10% TOWARDS PROVISION:– INVEST IN CONSUMABLES

WHAT ABOUT SUSTAINABILITY?• Involve the people right from the beginning

– Teach them to ‘learn how to learn“– To ‘learn how to dream constructively”– Elevation of self esteem and self confidence– “Doing with” rather than “doing for”

• Weigh when to give what…don’t interfere with their strength.

• Support their vulnerabilities and their weakness. Don’t do what they do well.

• Emphasize transferable skills and locally sustainable technology

WHAT ABOUT SUSTAINABILITY?• Involve local leadership from the start• Involve women and school children who provide

great potential as change agents• Understand and respect their culture and social

values; handle what you might think is retrogressive culture with tact.

• Don’t aim to make them a mirror image of your self. Let them discover their inherent ability.

• Enthusiasm is the driver of sustainability.

WHAT ABOUT SUSTAINABILITY?• Think “small,” think real, build on what they

know/have. • Avoid ‘elephants with strange colors’• Personal Example

Essence of THV:

Breaking the vicious cycle that binds poverty, ill-health and

developmentthrough empowerment of

community members

The Principles of THV In ActionConstruction of an access road though high level

advocacy and community involvementAssisting in the medical camps

• Conducted Medical camps (April/August ’10/Feb ‘11)– 3800 people served with combination of US & Kenyan

medical professionals and community members

• Conducted a surgical camp in which 2 individuals with severe filarial morbidity

OPEN INVITATION

– Health care professionals– Students

ABUNDANT BLESSINGS

THANK YOU