For the people living in the rural areas of Western Kenya, there are major obstacles to access to health care. Although several government run hospitals do exist in the Western Province, they are not adequately equipped to handle the needs of the people. The two major problems are related to the shortage of health care professionals and the access to medications due to both availability and financial restrictions. By establishing a health clinic in Kabula, Kenya, we hope to alleviate some of these problems. From our first hand experiences we have seen unsuccessful development projects that failed due to the donor organizations unwillingness to work with the local people. Therefore, to promote sustainable development, we will assist the current infrastructure by working hand in hand with the local health care providers in a mutually beneficial exchange. By working in a non-imposing manner, the clinic will be maintained by the local health care providers even in the absence of members from the donor organization.

          In the United States, there exist 341 people per doctor, while in the West African nation of Burkina Faso, there are an astounding 57,310 people per doctor. The number of human beings per doctor can serve as a general indicator of access to health care in any given country. Therefore, by examining this figure, one can locate the countries in the world that are the most disadvantaged with respect to access to health care. It deserves mentioning that these figures are averages, meaning that in many rural areas throughout Africa and other developing countries there may be over 100,000 people per doctor. Please peruse the following table.

Country	Region	People per Physician
Burkino Faso	W Africa	57310
Ethiopia	E Africa	32500
Cambodia	SE Asia	27000
Tanzania	E Africa	24970
Nepal	NW Asia	16830
Kenya	E Africa	10150
Philippines	SE Asia	8120
Jamaica	C America	6159
India	NW Asia	2460
Honduras	C America	3090
Bolivia	S America	2124
United States	N America	341

Nearly 14 million children under five years of age still die annually in developing countries. Diarrhea, measles, tetanus, pertussis, pneumonia, and malnutrition are preventable and treatable and yet account for the majority of deaths (6). Infectious diarrhea is the most common infectious disease syndrome worldwide resulting in more than five million deaths annually, a higher rate than cancer and AIDS combined (7). According to the World Health Organization (WHO), every year more than three million children die in Africa from vaccine-preventable diseases. The results from 53 developing countries with nationally representative data on child weight-for-age indicate that 56% of child deaths were attributable to malnutrition's devastating effects, and 83% of these were attributable to mild-to-moderate as opposed to severe malnutrition (5). With the knowledge that 98% of all deaths in children younger than 15 years and that 83% of deaths in people between 15 and 59 are in developing countries, it is evident that some action must be taken (4).

      In Kenya, there is on average one doctor per 500 people in Nairobi, but only one per 160,000 in rural Turkana district (3). Health facilities are often located in urban areas, far away from rural populations most in need, or are not accessible to large numbers of the population via public transportation. Besides the issue of lack of access to health care, the people in rural areas also face the harsh reality they may be unable to afford the medications prescribed by the doctor. More than 900 million human beings worldwide make less than $1 a day (find UNAIDS source). In developing countries, corruption is often rampant and funding with good intentions never reaches the people at the grassroots that are in need. World Bank estimates that for every $100 spent by African governments on drugs, only $12 worth of medicines reaches patients (3).

      Why assist developing countries when there are still millions of Americans in need? With over 45 million citizens of the United States lacking health insurance, the question of “Why assist developing countries” arises. This figure definitely indicates that there exists a need for health care assistance in the United States. However, the barriers to health care in developing countries are much more numerous, greater and more complex than here in the United States.

The Clinic Our goal is to incorporate the services of a clinic, pharmacy and laboratory into one facility in the village of Kabula, Kenya. The clinic will be constructed of cement in the same fashion as the library that was built on the land during the summer of 2001. The facility will have rooms for examination, pharmacy, laboratory, storage and waiting/triage/education. More information concerning the details of the actual clinic may be found in the “Clinic Proposal” document.