September 19, 2006 – Wajir, Kenya - Merlin

     I saw much in Wajir and Western Somalia.  Many are things I can’t tell you about yet – partially for personal security and partially I just need some time to process.  In the meantime – this was the “good news”.

      The residents of Wajir are extremely poor.  This has been by far the greatest area of need I have seen so far.  On the “Hunger Assessment” scale, these kids are mostly between 6 and 8, compared to 1’s or 2’s across Tanzania and the rest of Kenya.  In addition to being witness to the greatest need, I have also witnessed some very well managed relief.  I have spent most of my time here with an organization called Merlin.  Merlin is an acronym for “Medical Emergency Relief International” and they have programs like this in several countries.  Projects are “need specific”, sometimes water, sometimes nutrition, sometimes pandemic disease and usually a combination of all.  The program here in Wajir is primarily nutrition and health.  They employ 12 teams that spend Monday through Friday making the rounds of villages in their respective regions.  Community volunteers within each village first communicate through village leaders or churches who they are, and set-up mass nutritional screenings for children.  Children who are determined to be malnourished are referred to one of three levels of care:

-                          SFP (Supplemental Feeding Program):  This is for children in the least degree of malnutrition.  The children are given a 2-week supply of CSB (Corn-Soy blend  - corn flour, soy, sugar and vegetable oil), and the team follows up on this child every 2 weeks.  If the child is not gaining weight he may be referred to one of the other programs.

-                          OTP (Outpatient Therapeutic Program):  This is designed for children with greater nutritional needs.  The children are examined weekly, and given a food supplement called “Plumpy-nut”.  This is a “ready to eat” product that requires no preparation.  It has the taste and consistency of peanut butter – but has all of the vitamins, minerals, fat and protein these kids need.  Children eat 3 to 5 packages per day, and usually gain weight very quickly.  If weekly examination shows they are not gaining weight, they either have other medical complications, or someone else is getting the food.

-                          Stabilization Center:  This is an “in-patient” program located in “Wajir Town” near the district hospital.  Children referred to this program are usually severely malnourished as well as having medical complications.  The medical complications may include diarrhea, vomiting, measles, anemia, TB, HIV/AIDS and Kal-azar.  Children and a care-giver are housed at the Stabilization Center – treated for malnutrition and for other specific medical complications.  Often care-givers are ill as well – they also receive food water and medical care.

     The best part of all of this is that it is free of cost to the patients.  Merlin absorbs all cost for food supplements, medical treatment – they even provide transportation to and from the Stabilization Center.  Sad, but a reality for this part of the world – the families of the children that die are given 1000Ksh to help cover burial expenses.  So how does Merlin do it?  They have amazing staff – and are backed by some “heavy hitters” in the NGO world.  Here is some of the help they receive:

-                          OXFAM:  Provides funds for hygiene and sanitation programs as well as providing transportation for the food – which in this region is enormous.

-                          ECHO (European Community Health Organization):  Also provide funds for hygiene and sanitation programs.  Theses programs are vital to educate adults on causes of illness and disease, and emphasize prevention.

-                          UNICEF:  Drugs (Mebendazole (de-wormer), Vitamin A, vaccines), food supplements (Plumpy-nut, F75 & F100) and mosquito nets.

-                          WFP (World Food Program):  Corn-Soy blend.

-                          DFID (Department for International Development):  Funds salaries and vehicle expenses.

     Merlin also has the ability to refer certain medical conditions such as tuberculosis to the Wajir District Hospital, where children under the age of 5 are treated free of charge.  Parents are encouraged to bring children to the screenings as every child, regardless of condition is sent home with 4kg (about 20 meals) of the Corn-Soy blend.

     I think the most amazing feature of Merlin is their reach.  They are able to systematically access every child in the region – which is a monumental task when you consider most of the population is nomadic.  Most of the other NGOs I have seen provide help to a relatively small area – usually close to the comforts of a larger town.  Merlin is the first organization I have seen that actually provides for the entire region.

     Now that health and feeding programs are well established in this region – they are beginning to work on water supply issues.  They currently truck water into remote areas, and are installing pipe and pumps in several villages to supply water to their dispensaries.  One of the biggest health issues is clean water.  With water in such scarce supply, people and animals often share the same water source – and the animal waste contaminates the water for humans – so Merlin works to educate villagers and help provide separate water sources.

     The program is effective.  Last year at this time there were 670 children in the OTP program.  Currently there are about 200 – a drastic improvement.  About 90% of the children admitted to Stabilization Center are discharged – healthy - to an OTP in their village.   The survival rate of these children without the Merlin programs would be less than 10%.  Other programs currently running in Kenya include an HIV/AIDS and TB program in Kisumu, and a program very similar to Wajir operating in Turkana (northwest Kenya).  They also have operations near Darfur in Southern Sudan.  I will be meeting with the Country Director in Nairobi next week, and hope to get the opportunity to see more of their operations.

     Many thanks to Madoline – the Wajir Project Manager, Sebit (nursing supervisor) and all of the Merlin staff for their hospitality and willingness to share data.  These people are all well educated and very talented.  They could be making a lot more money in a much more comfortable environment, but they choose, often at great personal sacrifice, to serve God’s most needy here in Wajir.  May God bless them, their families and all those they serve.  Although they are not a religious organization – they certainly shine the light and love into the darkest regions of Africa.

Shine!