Implementing Jali Watoto: Childcare in Lumumba Hospital

What had changed: Compared to our trip in the summer of 2023, Melat and I felt much more comfortable navigating Kisumu, Kenya. Sure, we were working in a different location, with new people, on a completely separate project, but the distinct uncertainty at every turn was nowhere to be found. It was a welcome shift.

What had not changed: The core reason for our visit. Mothers attending Lumumba Hospital still struggled with finding childcare while they attended healthcare appointments. This meant mothers arrived late, left early, or missed their appointments entirely. Alternatively, they brought their children to appointments which affected the quality of services when the children cried, held on to their mothers, ran around, or generally distracted both the mother and the healthcare provider. It was our hope that the childcare center we worked on over the year would ease the choice mothers often have to make between caring for themselves or their children. 

We were also grateful to find another constant from the previous summer: all our wonderful friends and community partners remembered us and more than that, they were excited for us to embark on our new project. 

“It was our hope that the childcare center we worked on over the year would ease the choice mothers often have to make between caring for themselves or their children.” 

The first two days of the project we spent reunited with Florence Mawere, our local lead who spurred us to think about this project in the first place. She also came up with the name for the childcare center: Jali Watoto, meaning “to care for children” in Swahili. The three of us went shopping for materials and toys that could not fit in our suitcases and thought through the administrative workflows and items we needed to produce before meeting with the Community Health Promoters (CHPs) who would help us run our program. Our team of three tripled in size when we met with medical superintendent Pamela Olilo, nurse in-charge Julie Omamo, head of administration Samuel Ochieng, and CHPs Millicent Gaya, Beatrice Jowi, Mwatumu Ahmed and Ruth Lugusa. We went to scope out the space we confirmed last year for the childcare center, and after some discussion, decided on an empty space at the entrance of the hospital that was safer, covered from the sun and rain, and bigger so the children had more room to run.

There was no time to rest because on the third day of our trip, we started the program. The first child came, and suddenly the nerves threw all our preparation into question. Do kids like toys? Do they like running around? What if kids don’t play anymore? These very rational thoughts were quickly quelled as soon as the child scooped up an armful of colorful blocks with a smile. We were similarly anxious when the first mother filled out an exit survey on her satisfaction with the program. Glancing at the page, we were thrilled to see she was very happy with the program and eager to use our services again.

The subsequent days fell into a routine. At 8am, the CHPs set up the play mats, toys, sign-in sheets, and exit surveys. A steady stream of mothers and their children began around 8:30 am and ended at 1:30pm. From the first two weeks we were there, children stayed for an average of 30 minutes and we saw roughly 20 children a day. As of this blog post, we’ve assisted over 450 parents with their childcare needs. 

“As of this blog post, we’ve assisted over 450 parents with their childcare needs.” 

Throughout this two-week implementation period, Melat and I bought refills of toys, cleaning supplies, more play mats, and other record keeping items that helped the center run smoothly. We developed photo release forms, child sign-in sheets for the security of the children, and exit surveys for mothers. We also conducted interviews with the mothers and CHPs to glean more detailed feedback to improve the program. Finally, we coordinated a management system with the Lumumba administration so we can run the program and respond to its needs while abroad. More than maintenance and program observation we planned for, we became very close with the CHPs Millicent, Beatrice, Mwatumu, and Ruth. Whether it was shared Fanta drinks and chapati, or Melat and I’s struggle to produce Swahili words, our team became very close. We also had the pleasure of meeting their administrator, Sallie Ojwando, who helped us furnish the center with play mats and look for various other items. We left the program with renewed confidence in the people and passion behind Jali Watoto.

We were also assured by the exit survey responses, which indicated that the childcare center was received positively by all its users. Of course, now that we are in the U.S., we are still keeping close tabs on the program to ensure its utility. In this next phase, we are considering larger investments and long-term planning with the help of our community partners and our support system at Duke. If we have learned anything, it’s that the best change comes from a team. There were many moments where we felt stuck, and it only took one person to help us see a new perspective or offer their abilities to move us along the way. Melat and I also became quite the team, maneuvering finicky locks, seemingly undying ants, and the same spicy ramen meal for almost every dinner. Through it all we learned more about each other, shared delirious laughs, and supported one another right up until the flight home. We are both not only committed, but very excited to continue this journey and hope to come to you with more updates on Jali Watoto!

From, Sydney and Melat

“If we have learned anything, it’s that the best change comes from a team.”

Thank you to Rosemary Odada, Bryan Jobita, Wicklife Abwao, Natalie Okello, and Felix Ombuoro for your friendship, support, and good times during our trip.

We would also like to express our thanks to everyone who believed in our project and donated to the Jali Watoto program. Your contributions were truly the lifeblood of our entire operation.

Finally, we would like to extend our sincerest thanks to Pamela Olilo, Florence Mawere, Sallie Ojwande, Millicent Gaya, Beatrice Jowi, Mwatumu Ahmed, Ruth Lugusa, Julie Omamo, Samuel Ochieng, Margaret Kathanje, Breandan Makhulo, Lysa Mackeen, Virginia Nguyen, Isabel Siebrecht, Evan Frazer, Adiesa Smith, Alicia Banks and Dr. Megan Huchko for their time, professional expertise, and invaluable insight.

Asante sana!

Pictured below: Millicent, Ruth, Mwatumu, and Beatrice at Lumumba Hospital caring for the children.