The document outlines the 'Total Health Village' (THV) model aimed at improving health and living conditions in the Burangi area of Kenya through community engagement and low-cost, high-impact strategies. It emphasizes participatory methodologies for community-led development, addressing issues like healthcare access, poverty, and poor infrastructure. The initiative seeks to empower local communities, enabling them to take charge of their own health and development using their resources and external support as needed.

1. ENGAGING COMMUNITIES IN WHOLISTIC HEALTH DEVELOPMENT: THE ‘THV MODEL’

2. INTRODUCTION

3. PURPOSE To collectively contribute to the improvement in the quality of health care and life of the people of Burangi area in Malindi /Magharini district along the Kenyan coast by engaging active community participation in its own development in a model we call “ Total Health Village .” THE MAP/GENESIS PARTNERSHIP

4. WHY? “ We are attracted and bound by absolute like mindedness in VISION MISSION AND CORE VALUES THE MAP/GENESIS PARTNERSHIP

5. SIMILAR CORE VALUES We are Christian with mirror visions and missions We are driven by a holistic participatory approach to health development emphasizing local sustainability We specialise in human health care We prioritise reaching to the poorest, the marginalised, and underprivileged in society

6. SIMILAR CORE VALUES Our philosophy is anchored on realistic empowerment of communities and individuals Our inputs are low but our expected outputs are high .....hence we support cost effective interventions Commitment to transparency and good stewardship of resources

7. SOME FEW HEALTH SECTOR INDICES FROM KENYA 5000 health facilities in Kenya 4500 doctors; 1000 in public service. 50% concentrated in Nairobi: Ratio 1 physician to 10,000 citizens (compared to 26:10,000 in US) 47,000 Nurses & other cadres of medical personnel (10:10,000) 4.6% GDP towards health financing ($29 USD per capita) far below the minimum $34 recommended for Africa by WHO. 40% of financing comes from Kenyan Government; 15% donors, rest by private sector

8. SOME FEW HEALTH SECTOR INDICES FROM KENYA 58% of health services run by private sector which caters to high income clientele 90% resources devoted to curative a service that only 10% of the population accesses. 90% of morbidity (and mortality) is caused by preventable infective diseases (and poverty)

9. Kenya HDI (Human Development Index) #147 (0.541) ( ranked out of 182 countries) Literacy Rate (age 15 and over that can read and write) #107 73.6% Infant Mortality Rate (per 1,000 live births) 54.7 deaths/M (2009 est.) Life expectancy at birth #152 53.6 years Combined primary, secondary and tertiary gross enrollment ratio #138 59.6% GDP per capita #149 $1,542 USD Per Capita (2009 est.)

10. THE BURANGI PROJECT is a total health village (THV) program

11. The THV is a ‘ low-input($15 pp/py), high-impact strategy for achieving the ‘Millennium Development Goals.’ It is a cost effective community development strategy that is expected lead to Total Well Being by impacting a whole village of close to a thousand people through a facilitative and low input cost strategy . It is a completely participatory strategy where communities analyze their situation, and plan a response strategy, and implement it using Community’s Own Resources/Persons and engaging External partners only in a facilitative role where they have no capacity in solving their own problems. WHAT IS A THV?

12. PARTICIPATORY METHODOLOGIES How? We have devised simple methods that can apply to any community (in any country).

13. Is the rallying point that initiates, stimulates and sustains enthusiasm in participation. THE TEN SEED (OR EQUIVALENT) TECHNIQUE Why TST? Win trust Ice breaker Neutralises threats of inferiority Neutralises the threat of illiteracy Stimulates thinking and visualisation (perception) Is the tool for data collection

14. EXAMPLE OF A TST ANALYSIS OF PROBLEMS IN THE BURANGI COMMUNITY OVERALL PROBLEMS MAJOR PROBLEMS Rampant diseases Poor health care No access roads Drought Poverty High illiteracy Lack of technology/ communication Floods Wild animals Poor leadership Inadequate health Facilities 30% Diseases 20% Communications/ Access Roads 5% Floods 5% Illiteracy 10% Poverty and hunger 30%

15. A ‘SWOT’ analysis that uses information gathered through the TST. Analyses 3 components simultaneously Problems Means of earning livelihood Uncertainties (W)HOLISTIC WORLD VIEW ANALYSIS:W(H)WVA

16. WWVA Explanation Community Strengths Community Weakness Community Vulnerabilities

17. Lack of Health Facilities Outbreak of deseases e.g Cholera Problems Rampant Diseases Poor Roads Wild Animals Floods Tapping (Traditional Licker Farming E mploymen t Canoe Rowing Lack of Education Small Scale Businesses Poverty From: Uncertainty Analysis From: Livelihood Analysis From: Problem Analysis Color code

18. PRIORITY SETTING

19. There is a significant margin of statistical error being higher for quantitative data than for qualitative data compared to conventional statistical methods It has been tested that the perception results derived are reasonable enough to enable communities to analyse themselves and make informed plans that they can sustain SHORTCOMINGS OF THE TST

20. POINT OF ENTRY THEMATIC AREAS FOR BURANGI THV HEALTH Access to quality medical care through mobile and static health clinics Access to quality drinking water Improved community, domestic and personal sanitation SUSTAINABLE DAILY LIVELIHOOD Improved food security Improved income generation Environmental preservation Through tree planting and use of alternative renewable sources of energy and others

21. EXPECTED IMPACT THE GOAL: Improved quality of life as measured by positive changes in the human development index EXPECTED MAIN OUTCOME: A community empowered to take charge of its own destiny

22. RESOURCES ALLOCATION THE 50 | 40 | 10® PRINCIPLE 50% TOWARDS PROMOTION. INVEST IN PEOPLE 40% TOWARDS PREVENTION. INVEST IN SYSTEMS/STRATEGIES 10% TOWARDS PROVISION: INVEST IN CONSUMABLES

23. WHAT ABOUT SUSTAINABILITY? Involve the people right from the beginning Teach them to ‘learn how to learn“ To ‘learn how to dream constructively” Elevation of self esteem and self confidence “ Doing with” rather than “doing for” Weigh when to give what…don’t interfere with their strength. Support their vulnerabilities and their weakness. Don’t do what they do well. Emphasize transferable skills and locally sustainable technology

24. WWVA Explanation Community Strengths Community Weakness Community Vulnerabilities

25. WHAT ABOUT SUSTAINABILITY? Involve local leadership from the start Involve women and school children who provide great potential as change agents Understand and respect their culture and social values; handle what you might think is retrogressive culture with tact. Don’t aim to make them a mirror image of your self. Let them discover their inherent ability. Enthusiasm is the driver of sustainability.

26. WHAT ABOUT SUSTAINABILITY? Think “small,” think real, build on what they know/have. Avoid ‘elephants with strange colors’

27. SIGNIFICANT PROGRESS TO DATE IN BURANGI Conducted Medical camps (April/August ’10/Feb ‘11) 3800 people served with combination of US & Kenyan medical professionals and community members

28. SIGNIFICANT PROGRESS TO DATE IN BURANGI Done a WWVA together that generated great understanding of group dynamics (August 2010) Construction of an access road though high level advocacy and community involvement

29. SIGNIFICANT PROGRESS TO DATE IN BURANGI Conducted a surgical camp in which 2 individuals with severe filarial morbidity

30. SOME OF OUR CURRENT WORK

31. PROVIDED NEEDY SURGICAL SERVICES

32. BURANGI CHALLENGES The greatest challenge is adequate resources to facilitate this worthy cause Financial…extreme poverty (1/3 of average Kenyan daily earnings) Human….not labor but knowledge Material…….technology

33. ACKNOWLEDGEMENT Tracy Haworth – Genesis Project Director Dave Hall – Genesis Board Member Medical teams, background teams, donors and well wishers

34. OPEN INVITATION All of you Health care professionals (and students) Technical people in other areas Any person with a heart for sharing or witness. Any person who can donate a dollar or two (or more) or any other gifts in-kind towards this mission

35. ABUNDANT BLESSINGS THANK YOU