Community-Based Dispensary Initiative

            Beginning in 2004, Humanitarian Medical Outreach will begin a campaign to put dispensaries in small, rural villages throughout Kenya’s Western Province. These dispensaries will offer many of the same services as the clinic in Kabula—most importantly diagnosis and treatment for malaria, typhoid and tuberculosis—but on a smaller scale and in extremely rural locations. Each dispensary will be constructed with three rooms: an examination room, a laboratory and an administrative office. Each facility will be staffed by at least one health professional recruited from among the local population. Personnel who have already agreed to staff dispensaries are mostly clinical officers and nurses who had retired to their rural homes but recognize the dire health needs their home communities currently have.

The situations in these communities are dire because they have poor populations and are located at least 30 kilometers from existing health care facilities and far from major roads. The vast majority of these populations have no ability to access health care except in the most extreme situations. Despite the deadliness of diseases like malaria, typhoid and brucellosis, the frequency with which they afflict people makes it impossible for patients to seek proper diagnosis and treatment every time they experience a fever. By bringing basic health care to these rural populations, deaths from these diseases can be avoided.

Each dispensary is expected to receive at least six to twelve patients daily, based on observations made at similar facilities elsewhere, but the lack of other health care facilities near the HMO dispensaries may result in much higher patient volumes. The staff at the dispensaries will not receive a regular salary, but will instead be paid a portion of the fees assessed from each patient. Fees at the dispensaries will be slightly higher than those at the clinic in Kabula due to the extra costs associated with getting supplies and personnel in these extremely rural areas, deep in the interior, but costs to patients are still expected to be affordable.

Each dispensary will cost only $3,000 to establish, including construction of the facility and purchase of equipment. Communities that desire dispensaries are responsible for securing land and establishing an oversight committee. This committee will monitor the activities of the community dispensary and report regularly to Rev. Reuben Lubanga of Inter-Community Development Involvement, who will in turn report the status of all dispensaries to Humanitarian Medical Outreach. The first dispensary will be constructed in Pongola, where land has been secured and an oversight committee already established. The first phase of the Community-Based Dispensary Initiative will place one dispensary in each of the Bungoma District’s ten divisions.