Orphans and Vulnerable Children Program

One of my most rewarding days here in Kenya presented itself through an opportunity to go into the field with Elizabeth Chester, the case manager for the Orphans and Vulnerable Children (OVC)Program last Friday (August 28th). **Note: I did not take any photos of this trip, because this was the most personal of the experiences I had in Kenya, where I was being allowed to enter the private homes of these families. Thus, I did not want to ostricize them by snapping pictures of their poverty.


The program began as a branch of AMPATH, for many children were being orphaned by parents who died from AIDS-related illnesses. The program does not, as the name seems to indicate, involve any orphanages, rather they strive to keep children with extended family in their communities. The OVC case workers at each of the 5 AMPATH outreach centers are closely in-tune with their district, and hear if children have been abandoned, orphaned, or are living in poor conditions. They investigate these claims and also regularly visit their juvenile clients and their caretakers at home to check-in.


I accompanied two case workers, Susan and Edna, along with Elizabeth to Mosoriot, an area about 30 minutes drive from Eldoret. We drove and hiked around the district all morning, on muddy roads, through fields, past grazing cattle and smoldering pits of wood being made into charcoal to the places these children live.


Most of the time, we would find two small buildings would comprise the homestead. One mud-walled, thatched roof hut was the kitchen, with a home-made clay stove in one corner. A shelf above that side of the room housed firewood, kept off the ground to remain dry and burnable. Often, Elizabeth told me, the woman (or women) of the household would sleep in this smoke-scented room because they would then be the closest to the area they worked the most in. Indeed, most of the stops we made had small blanket bundles in one corner which the female used for her bed.

The next building just normally a few feet away from the kitchen was the home, and most of these mud-walled, thatched- or metal-roofed buildings had 2 rooms. One room would either have a wood-framed bed with a mattress, if the family was better off, or simply blankets piled on the floor with or without a mosquito net. The other room would either have another bed, or would have chairs and serve as what we would call a family room. Elizabeth told me at the beginning of the trip to look for cushions on any chairs we might see at the houses - for whatever reason, she said, they indicate that the family is doing well. Other signs that the family is more financially stable include having a "store" on their property, which is a building raised off of the ground on stilts that houses grains or whatever the family harvests from crops. The bigger the "store" the more productive or large the family's crop. Also, if the family has any livestock, like chickens, goats, cattle, or sheep, this is also a sign that they at least have some capital.

Besides checking out the living conditions of the children, and reminding the families to use their mosquito netting appropriately and encourage them to have beds off of the dirt floor, we would talk to them about the current family members in the household. How many children were there in addition to the OVC clients? Who slept where? Who did what around the house/farm? How did they make their income? How much land did they own? We would check all of these things, Elizabeth said, because the program is designed to help the families help themselves. Their goal is to start the family off with the right tools, whether that be the skills to make crafts, fertilizer and seeds to cultivate crops on unused land, etc, so that the families do not become dependent on outside help and can survive on their own. I was really impressed with the OVC's approach to assisting these families, and their system seemed to be very effective. I was able to visit homes that were just having their initial consultation and also those that were works-in-progress and successes.

Besides the above support I mentioned, OVC clients are provided with school uniforms and have their school fees paid, but are required to show their report cards to the case workers to prove they have been achieving in school, and if not, to try and determine why the child is struggling. The last resort for OVC clients is admission to an orphanage, which in some circumstances, Elizabeth admitted, is the best option for some children. She works closely with many orphanages in the area to find the best place for each child.

I found myself feeling so sad for these children, living in such primitive conditions. Most of them were pretty dirty, in clothing that was either too large or too small and very well-worn. Most of the younger ones ran around bare-bottomed, I believe because diapers are impossibly expensive and they would soil whatever bottoms they might have, and had crusty noses. But they were all so happy and so interested in seeing a white person! They would run after our car as we would pull near the home and follow us around everywhere we went, bashfully peaking around trees and corners to get a good look at us. Once they'd given us a good once over, they would proudly come up and stick out there hand to shake ours. I couldn't figure out why, after shaking my hand, all the kids would look at their palms and then back at mine. "They're trying to see if your white rubs off on them, " she told me, and then she gestured to them by rubbing her hand in front of them, " See, it doesn't come off!" We both laughed.

I had brought a bag of candy with me, and handed out a piece to each child and adult, which they devoured instantly. I hoped in a small way I'd made their day a bit better, because seeing how happy they were despite such poverty certainly made me feel less sad.

After visiting 5 homes in the morning (a small number it may seem, but all of the off-roading and hiking we had to do to get to each home really added up on the minutes!), we headed back to Eldoret. I felt like I had finally seen the real Kenya, where my indigent patients on the wards at MTRH come from and why it may take them so long to present to the hospital.