How volunteers are changing lives in Nairobi's slums

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Janet has heart of gold. Spend just a few minutes with her, and you will sense her warmth and kindness, and her natural ability to make you smile. She's also a skilled listener and has a wealth of healthcare knowledge and life experience to draw upon.

Put all that together - and Janet is the perfect Community Health Volunteer.

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Now widowed, Janet earns what she can from washing laundry to feed her six children. Her husband fought a three year battle with cancer, and because the family couldn't afford expensive treatment, Janet gave him palliative care in their one bedroom temporary slum home. She dedicated each day to looking after his needs, right to the end.

Today, most of Janet's time is taken up in her role as a CHV, visiting around 100 families living in the Highridge Village area of Korogocho. That same compassion to respond to the needs of others is still on display.

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39-year-old Janet Awino once dreamed of being a nurse but she married at the age of 16 and dropped out of school. After Janet's second daughter became malnourished, the life-saving assistance she received inspired Janet to become a Community Health Volunteer in one of Nairobi's poorest slums.

One day, a woman came to my house and referred me to the clinic. I was taught what food to give her and how to maintain her health. And I was inspired. I was just like the mothers I meet today. I was miserable, I was neglected, I felt ashamed. Everywhere I went people looked down on me and my child. That's what inspired me to become active in the community.

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Janet prides herself in giving practical advice to mothers and girls who face the same challenges she once encountered. And she's been doing it for the past 18 years.

Now I teach others and they pass on what they have learned. It's like a chain, it's also a calling. When people are in a dilemma, I give them examples from my own life, and when I tell them my story they receive courage to keep going. It gives me energy to help someone suffering more than me.

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Like each of the 450 Community Health Volunteers supported by Concern Worldwide in Korogocho, Janet lives in the locality she serves and was selected by the community. That way, she understands the particular challenges faced by her neighbours.

On her daily rounds, she looks out for people who are vulnerable and in need of support. She offers advice and refers them to specialist help.

Janet is well respected. As she walks around the streets of the slum - the poorest in all of Nairobi, she greets people with an enthusiastic wave, some with a warm embrace. In one hand, she carries a colour-coded MUAC band which helps indicate if a child is at risk of malnutrition, in the other, her mobile phone.

That's all she needs. The rest she carries in her head and heart.

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When we join Janet on one of her morning visits she takes us to meet 31-year-old Agnes Auma - a married mother of six children, all of whom are at home when we arrive. Her eldest son, 13-year-old James, has a badly infected and swollen leg from a injury he sustained while playing soccer.

Janet inspects the weeping wound, it is not healing as it should. Her advice to mum Agnes: he must go immediately to the nearby health clinic to have it dressed and for antibiotics. Janet's tone is clear and assertive.

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It's that firm counsel that probably saved the life of Agnes' youngest child, 18-month-old Michelle. After a visit three months ago, Janet saw that something was wrong and referred her immediately to the local clinic. Michelle was severely malnourished and dehydrated, she wasn't taking her mother's milk, and was weak and listless.

The toddler is beginning to improve - but only just. Despite receiving therapeutic food, she is still in the danger zone and weighs only 6.6 kilos.

Once again, Janet intervenes with well-meaning guidance.

"Right now, I have found that this child has been given chapatti bread and rice - full of carbohydrates," said Janet. She's not supposed to feed the child those things. Instead, she should give her a lot of protein, like fish and beans. She should also be given special energy-rich porridge in order to help her improve. The trouble is she cannot always afford to buy these things."

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It's a sad reality that while Janet can offer all the advice in the world and provide much-needed support - there is only so much she can do. Many of the women she visits struggle to put food on the table every day, let alone provide nutritious meals of meat, beans and fresh vegetables.

In Agnes' case, she is also unable to pay school fees for her children - that's what they are all at home - and is already three months in arrears with her rent. And she probably won't be able to afford a regular portion of protein-rich beans for little Michelle, or pay for medicines for her son's injured leg.

There is a gap between knowing the right thing to do - and having the ability and means to do it.

At times like this, it is hard for Janet to remain detached.

Sometimes they don't have anything to eat, that's why it's hard to go and visit them without bringing something. The moment I enter their house, they know that I will have brought them some food. I cannot ignore them. The moment I do, the situation will worsen, things will fall apart.

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Within a few minutes, we are standing outside the door another neighbour's house. Caroline Anyango (26) is a married mother of five. It's a similar story to that of Agnes - and one that is repeated time and time again in the streets of the slum.

Caroline's youngest child, 18-month-old Shallet, was severely malnourished and weighed just over 5 kilos at one point. Thanks to Janet's intervention, Shallat was put on a course of high energy therapeutic food and began to slowly improve. Now, two months later, she is alert and active and looks much more healthy. And that brings great satisfaction to Janet.

This is one of the achievements in the community. It shows that we are doing something - we are saving lives and reducing the number of infant deaths. And also, the mother has gained something - she knows what to do with her child.

Caroline agrees. She now knows what she has to do to help Shallat grown up to be strong and healthy. And while it is often a struggle to make ends meet, having someone like Janet to rely on for advice and wisdom is invaluable.

I'm very excited that Janet came to my rescue because she's given me advice about how to take care of my baby. Shallet's health has improved because Janet is keeping an eye on us all the time. I don't want to think about what might have happened without her.

Caroline

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