Babies were crying. Mothers were patting them on the back. Names were being called for appointments. “With all this information, what will you do about it?” Florence Mawere, a research technician with the Center for Global Reproductive Health, was taking us on a tour of the Lumumba Sub-County hospital in Kisumu, Kenya and specifically demonstrating her work testing samples for HPV in the lab. She asked us that question at the end of the day, referring to a different project we were working on. At that moment, though, we had a different idea.

 

Isabel, Melat, and I (Sydney) spent two months in Kisumu working on launching the pilot study of a mobile health app that facilitates HPV screening for cervical cancer prevention. Part of our work was to understand how Florence processes samples at her lab, hence our presence at Lumumba. In our conversations with her, she explained the barriers to reproductive health and mentioned how the lack of childcare sometimes affected mothers’ ability to attend appointments. In Kenya, Florence explained, childcare is a job strictly for women in the village. If a mother needs to leave her child for a moment, she must find another woman to help. When a mother has a health appointment and can’t find someone else, she sometimes comes late, leaves early, misses the appointment, or brings the child to the appointment. This is especially the case when Lumumba is a considerable distance from the mother’s home.

 

 

“With all this information, what will you do about it?” Sitting on a bench near the waiting room, we thought about what it would take to provide childcare so women could more easily attend their visits. From one question came more. Where would the childcare be? How much would it cost? When would we set it up? But most imminently, was a childcare program even needed? All of us had studied global health enough to know that the consideration should always be for the community’s needs, and solutions should be driven by members of that community.

 

We started by seeking ideas from  staff at the Duke Center for Global Reproductive Health in Kisumu. Each staff member we talked to, Breandan, Mercy, Belinda, and Florence, was intrigued by the idea and encouraged us to ask some of the hospital workers for their thoughts. Florence made the initial introduction to Dr. Wicklife Abwao, the Comprehensive Care Coordinator whose unit we would start the daycare at first. He was equally enthused about the project and initiated the subsequent chain of introductions with HPV specialists, nurses in the pediatric center, the medical superintendent and other healthcare workers with valuable insights. The feedback was all positive.

We went home that day brimming with excitement and plans. First on our task list was to understand child care in a Kisumu-specific context. After doing our own research, we also serendipitously stumbled upon the opportunity to visit the Garden of Hope kindergarten after befriending Rosemary, the founder, at a restaurant. The day we spent at the kindergarten was invaluable for the kindergarten staff’s insights about how the program was run and the impact it had on the children and their families. Our next visit to Lumumba we scouted the hospital for available space and found a few feasible locations. We began talking to our project advisor, brainstorming a list of fundraising ideas, and reaching out to other Duke faculty that could help. 

 

Since then, we’ve stayed in close contact with Wicklife and Florence by providing updates on our progress and checking in with any major changes on site. We also occasionally chat with Rosemary, who sends us pictures of the children we met. At Duke, we’re focused entirely on logistics in preparation for returning in the summer of 2024. When we return, we hope to talk to the volunteers who would help us run the program, set up the toys and cots, and collaborate with local partners like Rosemary who can help us understand how to run a childcare program in Kisumu. This project is unlike anything any of us have undertaken before, but we will post updates to the website and social media as they come in! We have high hopes that we can implement real change at Lumumba Hospital for all mothers seeking healthcare.

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