As the rest of the country buckles down to fight Covid-19, the Boni minority community in Lamu is dreading the day the pandemic will reach its shores.
They risk a worst-case scenario as their healthcare system has collapsed, the roads are terror-prone and information flow is hindered by lack of mobile network, let alone TVs and radios.
In 2014-17, their dispensaries were looted, vandalised and torched by al Shabaab militants, who kept raiding, forcing medical staff to flee.
Today, many of those dispensaries still stand desolate with no one to run them.
The Boni, one of Kenya’s last forest communities, occupy the terror-prone areas of Milimani, Basuba, Mangai, Mararani, Madina and Kiangwe in Lamu East. They are also found in Bargoni and Pandanguo in Lamu West.
In September last year, the county opened a new dispensary at Kiangwe worth Sh7 million to serve the over 3,000 residents from across all the Boni villages.
The new facility is, however, reportedly low on drugs, medical supplies and staff as many health workers shy away due to the history of al Shabaab attacks.
Speaking on condition of anonymity, a medic privy to the region’s struggling healthcare situation said Lamu isn’t at all prepared for a coronavirus outbreak, let alone the Boni region.
“The situation in Boni is so shameful. All the dispensaries are still as they were when they were attacked by terrorists years back. The new facility at Kiangwe is a big joke," he said.
"If ever there was an outbreak here in Boni areas, the death toll would bring the world to a standstill."
He said the county has done little to rebuild dispensaries, adding that the facility at Kiangwe, even if it were operationable, isn’t enough to handle the enormous health burden.
Last month, while appearing before the county assembly Health Committee, Health executive Anne Gathoni admitted to the region’s shortcomings.
“We have not had an ICU in Lamu. However, we have plans to put up a five-bed one. The building is ready, we're working on the other bits,” she said.
She said together with the county commissioner’s office, all plans have been made to ensure Bonis and the rest of Lamu are well attended to in case of an outbreak.
Locals, however, want all affected dispensaries in all the villages to be reopened to help them in the event of an outbreak of the coronavirus.
If ever there was an outbreak here in Boni areas, the death toll will bring the world to a standstill
INFRASTRUCTURE HURDLES
Lamu is among the few counties that have yet to record any case of the coronavirus.
Elders of this forest community are concerned that in case it reaches, it would be deadly and impossible to ferry patients all the way from their villages to the Lamu King Fahad Hospital on Lamu island, over 200 km away. The process is both expensive and time consuming.
Boni elder Abdalla Wakati says they are deeply concerned. “We have been offering sacrifices to our ancestors in our shrines, asking them to keep this disease away from us; otherwise, we shall be wiped out," he said.
"We don’t have any medical facilities here and neither the county nor national government has made efforts to help.”
The Boni areas all fall under zones earmarked for the Linda Boni security operation that has been underway since 2015, with the major objective of smoking out al Shabaab militants.
Movement by road is impossible since the roads have been declared unusable by the security forces and PSVs don’t ply the route.
The poor road infrastructure has made a terrible experience for the few motorcycle operators brave enough to ply the roads once in a while.
The only viable option, therefore, will be to transport coronavirus patients via boat on the Indian Ocean all the way to the Lamu King Fahad hospital, hundreds of kilometres away.
Boat transport remains an affair for those with deep pockets as the cheapest two-way boat ride costs about Sh50,000, which is way too expensive for the locals, most of whom are herders and hunters.
Elder Doza Diza says it’s unrealistic for the government to claim the county is ready to tackle the pandemic when there is not a single functional health facility.
“They say they have made plans to transport patients to the big hospital in Lamu town. That process takes hours, during which the patient will have deteriorated,” he said.
"As a community, we demand a feasible plan before this disease comes knocking. We can be calm."
Women from these areas have borne the brunt as pregnant women lose their lives and those of their babies at the hands of unskilled traditional birth attendants.
STILL UNDEVELOPED
Apart from transport challenges, locals have for decades been without a reliable means of communication, and the Covid-19 outbreak hasn’t made it any easier.
All the villages are known for their poor mobile network. Even at the peak of terror attacks years back, residents couldn’t call for help.
For a community that has spent much of their time inside the Boni forest, TV sets are unheard of, while portable radios remain the preserve of a few well-to-do individuals.
Bonis have for the longest time felt marginalised and sidelined on everything, and the coronavirus debate is no different. Elders and local leaders of this community have been agitating for better communication and aid.
Community leader Bakhshwein Alamin said, “Nobody wants to come closer to us and tell us anything or even consult. It has been that way for us for decades and we have painfully gotten used to being ignored.”
Basuba MCA Deko Barissa feels it’s unfair that the entire community has no go-to health system at a time when the globe is battling the pandemic.
“These dispensaries have been closed for over seven years now and we have struggled as a community,” he said.
"But at this time of coronavirus, we need those asap, plus we need supplies and medical personnel here to run them."
COUNTY PREPAREDNESS
On April 5, the county government unveiled the Covid-19 Strategic Preparedness and Response Plan.
The plan aims to prevent transmission of the disease and convene locals and stakeholders for collective action to protect people’s livelihoods.
It calls for coordinating communication, facilitating business continuity and mobilising support for effective response to the coronavirus.
However Boni elders feel this is in stark contrast to the reality on the ground.
Elder Waqo Hassan said, “There is a serious issue on information flow. They know our areas don’t have mobile network. Neither does it allow for luxuries like TV sets. We are literally groping in the dark unless something is done.”
The entire situation has brought to the core key questions on the level of preparedness of Lamu in dealing with the coronavirus.
Lamu county commissioner Irungu Macharia, who is also the chairperson the County Covid-19 Task Force, says they have relied mainly on local administrators like chiefs and Nyumba Kumi elders to ensure a steady flow of information and updates on coronavirus.
As for testing, the commissioner said they are currently relying on the KDF camps in the various villages as well as the Safari Doctors organisation to conduct them.
“In case of any eventualities, they will transport them to isolation centres on the other side,” Macharia said, referring to Lamu town and Mpeketoni.
Coast regional commissioner John Elungata warned politicians in Lamu and Tana River against shuttling between Covid-19 hit areas and their regions in the name of distributing humanitarian aid.
He said the two counties are grappling with long-term infrastructural problems that might make it difficult to fight the coronavirus pandemic in the unfortunate incident of an outbreak.
Edited by T Jalio