Bill & Melinda Gates Foundation

Stories From the Field: My Trip to Nigeria and Kenya

February 15, 2013

One of the most rewarding parts of my job is getting out into the field to meet the individuals who benefit from the foundation’s work and learn directly from our partners.

Late last year, I traveled with my wife Tricia and a team of colleagues to Nigeria and Kenya, where I caught a glimpse of some great progress we’re making  to end polio,  give smallholder farmers the tools they need to earn more income, and increase access to family planning. We spent part of the week in government meetings to align our interests in global health and development with the interests of ministers, governors, and other key country figures.  It’s never far from my mind that without these important partnerships, our work would not have the impact we want and never reach millions of kids and adults in some of the poorest parts of the world.  Maintaining good working relationships and understanding our partners’ and grantees’ points of view is critical to our success.

 


Jeff Raikes (far left) and Aliko Dangote (seated, in blue) sign the immunization MOU with Nigerian government officials in Kano.

The most significant meeting we had was to sign a landmark Memorandum of Understanding (MOU) with the State of Kano in Northern Nigeria and the Dangote Group.  The Dangote Group is headed by Aliko Dangote, who is Africa’s richest man and a Kano native, and now an important partner working to improve the health system in northern Nigeria.  Our MOU pledges that each of us will work to strengthen the routine immunization system in Nigeria in hopes of vaccinating nearly all children so they can be protected from preventable diseases like polio and measles.

 It is vital that we keep investing in human promise around the world.

In Kano we also visited a cold storage facility used for keeping vaccines refrigerated so they don’t go bad before they are ready to be used.  Unfortunately, we encountered a situation that is all too common in low-income parts of the world – refrigerators that were broken, unpowered, or otherwise not working.  With only two of the facility’s five fridges operational, not enough vaccine could be stocked to immunize the children of this region.

 


Observing the “cattle crush” at a farm outside of Nairobi where cows were being vaccinated against East Coast Fever.

Together with Mr. Dangote and Chris Elias, our team brainstormed some potential solutions to the cold storage facility’s challenge. We discussed the possibility of using various inexpensive power sources for the fridges, as well as an improved management system to stock vaccines.  It reinforced to us that without seeing the problems on the ground, it can often be difficult to design the right solutions.

In Kenya, we spent considerable time in some of Nairobi’s larger slums, talking to families and business owners in Kibera and Mukuru Kwa Njenga about topics as varied as child health, HIV, and family planning.  We also visited a “cattle crush” at a local smallholder farm where I met Grace and her son Nicholas who were working with Sidai, a grantee that offers services to livestock keepers in Kenya.  Sidai provided Grace and Nicholas an important vaccine to protect their cows against the deadly East Coast Fever which had been killing up to a quarter of all livestock in the area.  While the approach to vaccinating cows is quite different in Kenya than on my family’s farm in Nebraska, Grace and Nicholas’ passion and drive to protect their animals felt very familiar.

But the most powerful encounter I had during my trip was with a young woman named Milkah. Milkah lives in the Mukuru Kwa Njenga slum in Nairobi and is the main caregiver for five children. As her family’s breadwinner, Milkah runs a t-shirt and undergarment shop.  When business is good, she can afford to provide two meals a day for her children.  But when things are slow, she might only be able to feed them once a day.  Milkah’s husband is a day laborer who doesn’t always have consistent work.  Still, even with five kids, Milkah’s husband was pressuring her for more – for children she did not want, and for children she knew they could not afford to raise.

Milkah is a strong woman. She shared with us that she got a contraceptive implant – a tiny rod that was inserted under the skin of her arm – to provide birth control for up to five years, or until she wants it removed.   When her husband found out, he was outraged.  He brought Milkah to a clinic and demanded the contraceptive implant be removed.  But Milkah refused and left her husband with one choice: she would either go home with him and the implant, or she would not go home with him at all. Today, Milkah continues to use the contraceptive implant.

Milkah’s struggle is not uncommon in Kenya or other parts of the world. Her actions took strength, courage, and determination, and are a great example of how many women are doing what’s best for them and for their families. 

We will continue to help communities offer information and products for safe and affordable family planning decisions.  While this work can be challenging, the hardships that Milkah and women like her must endure are a powerful reminder of the urgency of our efforts. Working together, we have the opportunity to improve the lives of millions of women like Milkah and their families.  It is vital that we keep investing in human promise around the world.

 
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