As a nurse at Rongo Subcounty Hospital, Benter had seen countless women in need of a Cesarean section. Until recently, Migori County only had one public hospital offering surgeries to a population of 1.1 million. But like many hospitals across Kenya, Rongo Subcounty Hospital lacked the staff and equipment to provide surgical services. This meant that women in Lwala-supported communities were often referred to distant private hospitals, where they had to pay out of pocket, find their own transportation, and accept lost wages for family members who travel with them. The result is a life-threatening breakdown in care for mothers and their infants–and anyone else in need of surgery.
“Every minute matters when delivering a child. When women have to be transferred elsewhere for a C-section, they lose money on transport, they lose support from family who cannot travel with them, and most importantly, they lose precious time.”
– Benter Anyango Polo, nurse at Rongo Subcounty Hospital
Access to high-quality, affordable surgical care is not just a problem in Rongo Subcounty–it’s connected to a greater global issue impacting as many as five billion people. While surgeries to repair injuries like long bone fractures and obstetric fistulas are readily available in high-income countries, they are often not accessible to people living in low-resource settings. Pregnant women in need of emergency Cesarean sections are the most vulnerable–each additional minute she waits for surgical care risks her life and the life of her baby. In Kenya, the rate of Cesarean deliveries, a leading indicator for strong surgical capacity, has continued to increase since 2014. These improvements, however, are centered around major urban areas like Nairobi and Mombasa. People in rural communities must travel long distances to access surgical care, accept low-quality services, or go without surgery at all.
As community health workers (CHWs) in our communities encourage more women to deliver in a health facility, Lwala wanted to meet new demand with high-quality services–including Cesarean sections. In 2019, we began engaging with the Ministry of Health and Health Facility Management Committee–a community group that oversees health services at Rongo Subcounty Hospital–to find a solution. There had been previous investments in building an operating theater, but it was unfinished, unstaffed, and lacked stable electricity and running water. Together, we worked to make the operating theater functional. We developed a plan with the Ministry of Health to account for long-term costs, like lighting, water, equipment, and staff. After years of advocacy and collaboration, the operating theater was ready for its first patient in June 2022.
“Putting a smile on the next baby and mother’s face brings a joy that inspires me everyday.”
- Susan Agundah, Subcounty Reproductive Health Coordinator
As fate would have it, that first patient was nurse Benter. She needed a Cesarean section to safely deliver her son, and when she learned the operating theater was ready, she agreed without hesitation. “I had so much faith in my facility and my co-workers,” Benter recalls.
On June 22nd, Benter’s healthy baby boy took his first breath of life at the new operating theater. Overwhelmingly grateful to have safely delivered her child, right in her home of Rongo with her family present, Benter reflected on what made this moment possible. She decided to name her boy Milton after one of Lwala’s co-founders. “I’m happy about his name, and the legacy I know it represents,” Benter says. “I would love if he too can become a doctor!”
Benter’s colleague and friend Susan speaks about the joy of the first delivery: “We thank Benter for her trust in us… it brings us so much joy!” The new operating theater has already begun to transform health care in Rongo. Since its opening, there have been more than 100 surgeries, including 87 infants delivered through C-section. Because of collaboration between Lwala, the Ministry of Health, and the community, more people can access the care they need, closer to home–ultimately building trust between communities and the health system.
