I recently took a trip to Kenya. It was my first trip to Africa.
A few months before the trip, I received vaccines for hepatitis A
and typhoid, a tetanus booster, and prescriptions for a malaria
medication. I also got a prescription for ciprofloxacin, commonly
known as cipro. Cipro is a common antibiotic that fights bacterial
infections. My doctor said I should take it with me in case I got
sick. And then he said if I didn't use it, I could leave it with my
guide to provide to one of the local clinics, because an antibiotic
in rural Kenya is like gold.
So when I arrived in Kenya, I asked our guide about it.
Our guide, Joseph, is a 20-year veteran of safari drives, and
there's not much he hasn't seen. He's spent countless hours talking
to people, imparting his knowledge and love of Kenya-a country that
is full of breathtaking beauty and people with heartbreaking
Specifically, I asked Joseph if something that's as easily
accessible as an antibiotic to many of us might be hard to get in
Kenya. His answer? Absolutely. Because you see, I didn't have to
wait in line starting at 4:00 a.m. for the mere chance of getting
an antibiotic. And I wasn't turned away at the door because the
clinic ran out. And my insurance covered 100 percent of all but one
of the medications I took to prepare for my trip.
Disparities, Poverty, and Solutions
Kenya is one of the 50 poorest nations, with 46 percent of the
approximately 40 million people in the country living in absolute
poverty (meaning they earn less than $1 per day), including 9
million children. Kenya faces a high rate of tropical diseases,
like malaria and tuberculosis, and it is stymied by high rates of
HIV/AIDS infection. In addition, the country has poor maternal
health with a
maternal mortality rate of 1,000 per 100,000 births and an
under-five child mortality rate of approximately 142 per 1,000 live
But accessing even basic health care in Kenya is difficult. There is no free
or subsidized medical care-no matter how poor one is, and
getting health care is expensive-more expensive than in most
countries when you consider average gross income. A combination of
user fees and out-of-pocket expenses at health facilities make
proper health care difficult to attain for a significant portion of
That's why organizations like Imbako Public
Health are so important. Imbako Public Health is a non-profit
organization based in the United States and Kenya that aims to
address health care and educational disparities in rural Kenya.
Imbako has partnered with several organizations to implement health
and education programs, focusing on innovative solutions to ease
disparities. For example, Imbako
conducts clinics for women and teenage girls to educate them on the
benefits of pre- and post-natal care and partners with local
hospitals and clinics to educate women about the availability of
these and health care services.
Health Care Disparities Aren't a "Developing" Countries
The World Health Organization reports that 1.2 billion people in the
world live in extreme poverty. Even in the United States, 20
percent of the population lives in poverty, and here in Maryland,
where the median income is nearly 17 percent higher than the
average for the United States, 16
percent of our residents live in poverty. And where
poverty levels are high, access to care and the ability to pay for
care is often a struggle.
But there are also efforts in place to address care disparities
here at home. For instance, a
four-year, $16 million pilot project to create five "health
enterprise zones" recently launched in Baltimore. The program will
incentivize care providers and community organizations-through tax
breaks and other incentives-to provide health care services to
underserved neighborhoods in Baltimore.
Care disparities are a global concern, and as progress continues
to be made on many fronts, we need to continue efforts to close
gaps in access to and quality of care for all patients around the
world. Here at home, the Patient Protection and Affordable Care Act
(ACA) will seek to address some of these issues, but we've got a
lot of ground to cover.
P.S. Thank you Joseph for helping me to put names and faces to
some of the statistics I'd heard in passing. And thank you Kenya
for so graciously sharing your country with me and my group for 10
Asante Sana Kenya!