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Why can't you stay?

As the end of August approaches so too does the end of fellowship here in Nairobi, Kenya. A recurring question posed to me over the past week by colleagues, staff at my apartment complex and the drivers who bring me to work has been ‘Why can’t you stay?’ My simple response is I have to return to my job back home. The Global Health fellows program has allowed me to experience both work and life in Kenya for the past four months and I consider myself extremely lucky to have had this fantastic opportunity. 

At the outset of the program I had two goals I wanted to achieve from this experience. The first was to gain an understanding the challenges facing health service delivery in developing countries and the second was to enhance my project skills. I can definitely say both have been achieved. The main focus of my work has been in the area of human resources for health (HRH) and I have seen how complex and intertwined many of the issues are.  An obvious statement but without health workers service delivery would not be possible. Therefore understanding the composition of this workforce is vital. It becomes even more important when you consider the amount of impending change in Kenya. In addition to elections in March 2013, constitutional changes that came about in 2010 are paving the way for a devolved system of power at county level next year also. Undoubtedly this will impact the health sector. I am glad to have been able assist two hospitals implement the human resources management system, iHRIS, to enable them track their respective health workforces. Paper based records are not a viable long term solution when operating health facilities employing in the range of 400 to 600 staff. Admittedly a small step but continuity planning is underway to expand this footprint beyond these pilot sites. This will facilitate the Christian Health Association of Kenya (CHAK) present an accurate snapshot of the health workforce and how it is dispersed among its faith based facilities. I will definitely be keeping in touch with colleagues here and keep updated on how this and other projects progress. During my time here I have also been fortunate to be able to travel to different parts of Kenya, both on field trips with work or at weekends and I have met some great people. Returning from one recent field trip to Kijabe hospital, a one hour drive from Nairobi, I found myself taking in all the sights and watching people go about their daily lives. Some people live in such remote areas with minimal infrastructure and amenities. It really does put things in perspective and teach to really appreciate what you have. A saying I came across recently while taking some Kiswahili lessons was, ‘Hapana marefu yasio na mwisho‘, (There is no distance that has no end). Well that is the case now as I say goodbye and I hope that the end to the hard times for so many Kenyans is not too far ahead. On that note I say goodbye Kenya, see you again! (Kwaheri Kenya, tutaonana tena!)

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