Sunday, June 3, 2012

ACCT International: Eldoret

AMPATH Hospital

On Thursday, 24 May we went to Eldoret to visit AMPATH. We set out at 8 am with the goal of being there by 10:00 am...we finally pulled into the Imani Workshop (our first stop) at 11:30 am. It took a little longer to get there than we anticipated.

"AMPATH is Moi University, Moi Teaching and Referral Hospital, and a consortium of North American academic health centers led by Indiana University working in partnership with the Government of Kenya." AMPATH has a long and interesting history. It originally began as a partnership and exchange program between Indiana University and Moi University in an effort to create a medical school at Moi. According to one partner university's handbook:

The Indiana University-Moi University partnership was formally established in 1989. At its inception, the partnership focused on exchange of manpower and ideas, with the expectation that cooperation, mutual understanding, and the collective creative energy of the participants would grow the institutional partnership and enable it to achieve its mission. The initial goal of the partnership was to develop the systems of medical training and primary care delivery at Moi University and its affiliated delivery sites, with the expectation that these systems would establish a strong foundation upon which to build a robust and sustainable research collaboration.

However, in the late 1990s and early 2000s, the founders of the partnership noticed a dramatic change at their facilities. The hospital beds were full, the mortality rates were skyrocketing, and Moi medical students were dying. HIV/AIDS had found Kenya. In response to this, AMPATH was created. At its inception, AMPATH stood for "Academic Model for the Prevention and Treatment of HIV/AIDS" with three "vital components":
  1. Care programs that foster HIV treatment and prevention, and are capable of hosting research and training missions
  2. Research programs that enable the development and evolution of “best-practice” strategies for prevention and treatment
  3. Teaching programs where a wide range of health professionals and outreach workers can learn to implement these strategies
As the consortium worked to address the issue of HIV/AIDS, it began to understand the importance addressing health and economic needs beyond just HIV/AIDS.  Today AMPATH stands for "Academic Model Providing Access to Healthcare" and incorporates a wide range of programs from primary healthcare, to nutrition, to income-generating activities.

For more information on AMPATH, try the links above and here and here.

When we first arrived, we went to the Imani Workshops, which is a income-generating project of the AMPATH program. Imani trains HIV positive craftspeople and produced a wide range of products available at Global Gifts in the U.S.

Imani Workshops was established in 2005 as a branch of the Family Preservation Initiative (FIP) under the IU-Kenya Partnership’s AMPATH program...FPI provides avenues for HIV positive patients and their families to achieve sustainable economic security by increasing their skills, knowledge and productivity and improving the quality of their life. Imani Workshops is a revenue-generating social enterprise focused on producing high quality crafts by HIV+ artisans in western Kenya. Due to stigma associated with HIV/AIDS, many AMPATH patients have a hard time securing a job or accessing credit for a business loan. Imani employees all earn a living by producing high quality handmade goods. Imani workshops aims to expand its reach to the vulnerable individuals in other sites in Kenya by providing capacity building and markets to other HIV positive artisan groups. It is laying foundation for an Imani Training Institute and testing a “work from home” Model called Kazi Nyumbani to develop contract manufacturing relationships, incorporate those with disabilities and provide business ownership opportunities. Imani Workshops is currently comprised of 30 full-time employees and 220-100 part-time employees...100% of the income earned through sales is reinvested in the Workshop through which artisans benefit from employment, skills training and other forms of empowerment.

I actually missed the Imani tour because I was with Dr. W at the bank exchanging USD for Ksh. We caught up with the group in time for me to pursue the gift shop and find a couple of presents.

After the workshop, Bornice Biomndo, head of AMPATH Communications and Public Relations, give us a tour of the hospital and explained its operations. She then took us out to see a demonstration garden, which is one of many AMPATH farms.

AMPATH Demonstration Farm

Following our tour of the AMPATH facilities, we found ourselves at IU House, which is a guesthouse compound for visiting doctors, students, researchers, etc. We were lucky enough to be visiting AMPATH during a time when both AMPATH Director, Dr. Bob Einterz, and Founder and Field Director, Dr. Joe Mamlin, were on site. I was lucky enough to see Dr. Einterz and Dr. Mamlin's wife, Sarah Ellen Mamlin, present at the Women's Philanthropy Conference I helped organize as part of my summer internship with the IU Foundation last summer. Ms. Biomndo and Dr. Einterz arranged for us to meet with Dr. Mamlin in his home after dinner. It was a great honor to speak with him.

Dr. Joe Mamlin's House at AMPATH

Listening to Dr. Mamlin speak was inspirational. He has lived an amazing life. His family was part of the original Peace Corps and they were posted in Afghanistan, where he helped start a medical school as well. He was extremely confident in AMPATH's eventual ability to eliminate HIV/AIDS as a threat. Several interesting points:

  • They are treating HIV/AIDS like any other chronic illness
  • They are working on a new concept, FLTR, which stands for Find them, Link them, Treat them, Retain them. FLTR focuses on community-level interventions, which means getting away from hospitals, clinics, and even medicine.
  • They are in fact in the process of shutting down all of the AMPATH run farms. Instead they will be supporting rural subsistance farmers to produce their own food, the food for their communities, and surplus that the World Food Programme will buy and then donate to AMPATH (WPF current donates food to AMAPTH, but it is not purchased from local growers).
  • AMPATH is weaning itself off donors. PEPFAR is coming to an end. For this last 4.5-year grant, Moi (not IU) is the main signature of the grant. AMPATH is working closely with the Kenyan government as well. According to Dr. Mamlin, "The only disease more frightening than HIV is dependency."
  • Dr. Mamlin stressed the importance of doing, "The most important thing in development is to get busy doing it."
The next morning we were up early for breakfast. Peter Park, co-director of the Family Preservation Initiative, joined us for breakfast to share his story and answer students' questions. Then we met up with Peace Corps Volunteer Hannah Gulliford who is a health educator outside of Turbo. We were supposed to go to her town to see her do a health presentation and see a table banking activity. However, after a long shopping excursion and lunch, there wasn't enough time. Instead, we dropped Hannah and another PCV, Cassidy, at Hannah's house on the way home to Mumias.

One of the places we stopped on our shopping trip was Rivatex, which is a money-generating activity of Moi University that trains students in textile arts and tailoring. We all came home with a lot of fabrics.

Rivatex Fabric Factory in Eldoret

I am only a week behind on blogging now. More details to come soon.

— Sara

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