Breakthrough Patient Recruitment

: How a Vacation to Kenya Shed New Light on Health Care Disparities

How a Vacation to Kenya Shed New Light on Health Care Disparities

Managing Editor

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 stories.


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 births.


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 the population.


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 Issue


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 days.


Asante Sana Kenya!



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