In Kiangwe, a village in Lamu County at Kenya’s coast, Aisha Ahmed* stares at the ocean, wondering when her husband, who set sail to fish in the deep sea a week ago, will return.
How much longer it will take for her husband to return is critical — indeed, a matter of life and death.
Aisha is on the final trimester of her ninth pregnancy and she could go into labour anytime now. Which is dangerous, as medics say she is anaemic.
But she will not leave for Lamu Level 4 General Hospital, a two-and-half-hour journey on speedboat, without her husband’s permission. That is what her culture dictates. So she will wait, even though time is not on her side.
That is the scenario a team of medics from Safari Doctors, a medical non-governmental organisation founded by Umra Omar — now globally known, thanks to her nomination as a CNN Hero — are confronted with when they arrive in the village for their monthly clinic. They are alarmed. They check her and recommend immediate evacuation to a hospital.
Harrison Kalu, the nurse, upon examining her, says she could be having placenta previa, a condition in which the placenta partially or wholly blocks the neck of the uterus, preventing normal delivery.
“She needs to get to hospital now!” Mr Kalu says.
The Safari Doctors team has been the lifeline to the people of this far-flung area near the infamous Boni forest, which is believed to be a hideout for Al Shabaab militants.
About a thousand patients benefit from the monthly services.
The team of volunteers, who at times are accompanied by government doctors and nurses, has to go through a tortuous journey by sea and land to reach them. But when they do, they provide much-needed relief.
In the village, they use abandoned buildings such as school classrooms as treatment rooms or set up a makeshift clinic under a tree.
On this visit, we find three-year-old Baishe Abdi and his father Abdi Abdala eagerly waiting. It is seven days since he got burnt by hot water while playing with one of his brothers. His father could not afford Ksh1,000 ($10) for a boat ride to the nearest hospital, Tangawanda. So, for seven days, he has cleaned and treated the wound as he waits for the Safari Doctors.
“I have been using salty, warm water, honey and coconut oil to take care of the wound,” says the father of five.
At Kiangwe, as the team of four settles down, the tension around is palpable. The abandoned school is now occupied by the Kenya Defence Forces.
Armed General Service Unit men patrol the area and the team begins by seeing the soldiers.
Mr Kalu, the leader, is a former Navy soldier who retired and then trained as a nurse. He was posted to Mangani village in Lamu County but fled in 2014 after Al Shabaab raided Mpeketoni town and its surroundings and burnt the motorbike he used to visit the villages.
“The only thing that saved me when the terrorists raided the villages was that I had gone to Lamu town to see my family,” he says.
Few people visit the six villages of Kiangwe, Mangai, Basuba, Mararani, Kiwayu and Mtangawanda due to Al Shabaab threats.
Schools and health facilities in these areas have been abandoned, with most of them now serving as KDF camps.
Government workers have left the area for good.
“Before we set sail to any of these villages, we have to alert the officers in charge of the KDF on the ground of our intention so that they provide security and also advise us on whether it is safe to go there,” Mr Kalu says.
Access to health care and education has become a rarity for the communities living in these villages.
“A passenger boat to Lamu town passes here once a month. The only alternative means of transport is the farmers’ boat, which charges between Ksh1,500 ($15) and Ksh3,000 ($30),” says Bakari Afande, a community health worker in Kiangwe.
Despite the insecurity and remoteness of these villages, Umra Omar and her team keep going back and by so doing they have saved a few lives.
Ms Omar, who comes from Lamu, founded Safari Doctors two years ago to provide free basic medical services, including immunisation, maternal and child health care and treatment of infectious diseases like malaria and tuberculosis.
After studying in the United States where she trained as a psychologist, she returned home to start the organisation which is now credited with having saved many lives in this marginalised area.
Her decision to return to serve her community was cemented during a visit when she learnt of the closure of a medical aid project there because of security concerns.
“With a little research on the challenges and support from the closed medical aid project, I decided to start Safari Doctors,” says the 33-year-old mother of two.
It began with basic service by a nurse on a motorbike serving about 100 patients a month. Today, Safari Doctors travel by boat and offer outreach services by road using motorbikes, reaching about 1,000 patients monthly.
“Our emphasis is on primary health care. We all agree that prevention is better than cure. Therefore, our package includes reducing the prevalence of HIV/Aids, reducing environmental health-related diseases and taking care of mothers and children,” says Ms Omar.
To do this, she says it costs Ksh9,000 ($90) a month for the motorbike clinic and as much as Ksh400,000 ($4,000) for a full circuit round the islands.
She works with a team of three core staff: An office administrator, a nurse and herself.
“With two or three medical staff from the county and the boat crew, we are about a dozen people per outreach,” she says.
As for remuneration, she pays a stipend per outreach that is determined by the funds raised for the particular clinic.
But funding has been sporadic. Having started off through financial support offered by a local businessman, Safari Doctors’ source of funding today has become “pretty much like a giant puzzle” of well-wishers who, through crowd-sourcing and in-kind contributions have seen the team sail through their activities.
Ms Omar acknowledges the support from the county government, which provides vaccines, a doctor and nurses.
But they procure the essential medicines used in the outreach from the Mission for Essential Drugs & Supplies (MEDS), a local not-for-profit agency.
It has been hard but she says the outreach has touched many lives.
“We are not trying to substitute the government but supplement health services and that means working closely with those who are tasked to deliver that mandate,” she says.
Despite the challenges, her work has seen her get international recognition after being nominated as one of this year’s top 10 CNN Heroes.
She says one of her colleagues submitted the nomination that has now “materialised into something I never imagined!”
Each CNN Hero receives a $10,000 prize with the CNN Hero of the Year, who will be announced on December 11, receiving an additional $100,000 for a cause they support.
Their efforts will be highlighted on CNN Heroes: An All-Star Tribute, a global broadcast on Sunday, December 11.
Along the way, she has also had the best and the lowest moments.
“The absolute best moment was when a young woman walked up to me with her bundle of joy after two miscarriages. We facilitated her checkups during her last pregnancy, which saw her deliver a healthy baby called Yusuf,” she recalls.
Her lowest moment came in December last year, when the savings had run out with no funding in sight, threatening the existence of the project.
“We could not renew the contract for the nurse, and all sorts of doubt started creeping in. All the whys and hows of sustaining the initiative crept in. The fear of disappointing the communities that we frequent also haunted me.”
At 2pm the tide begins to rise and Kalu and the team wrap up their equipment and samples of sputum of patients suspected to be having TB. Children help them carry the equipment to the boat and they head out.
“Hearing the sail flapping as we head back to Lamu is exciting. From the trip, I draw a sense of relief, satisfaction and hope, knowing that we have made a difference,” says Ms Omar.