Ann Njogu is Chairperson of the Amref International University (AMIU) Student Council in Nairobi, Kenya where she is in her final year of the degree program in Health Systems Management & Development. Through Ann’s leadership, the Student Council has set up and run COVID-19 vaccine clinics in an area of Nairobi, called Kibra, where poverty rates are very high and access to vaccines has been limited.
Amref Health Africa in Canada spoke to Ann to find out more about her, Amref International University, and the COVID-19 vaccination clinics AMIU students have been conducting. Here’s our interview with Ann:
Amref: Tell us about your studies at Amref International University. What are you studying? Why did you choose that particular program of study?
Ann: “I am taking a degree program in Health Systems Management & Development. I’ve been at AMIU for three calendar years and I’m in my fourth academic year. I will be finishing my program in August 2022.
Why am I studying this program? Between 2009 and 2014, I worked as an administrator for a pharmaceutical company. My roles involved interaction with customers at different levels. During that time, one of our customers – a man in his 60s – got diagnosed with prostate cancer. His doctor put him on a particular medication long term. It is an expensive tablet. At that time in the Kenyan market, it was going for about $6 [USD] per tablet. When the man was put on this tablet, I remember his face because he could not afford it. And, the sad part for me was that the doctor did not take the patient through the fact that he would need to take the medication long term. When the patient first started taking the medication, he managed to find the money to pay for the tablets; he thought it would only be for a short time that he would need to take the medication to get better. That last day I saw the customer when he got a prescription for six months, he sat down because he couldn’t afford it. He didn’t buy the medicine and we never saw him again. In the back of my mind, I have always wondered: ‘What happened to this man? Is he alive?’
That’s the time when my passion for health care was really born. I thought that there has to be a better way to do this. So, health systems management, for me, was right. It felt right because health systems management is about how we finance health care, how we organize health care, how we deliver health care services to the people. The goal of health care services is to defend the people against ill health, and most importantly, to protect them from the financial consequences of ill health. Now, most of us in Africa know that this is a dire need. Our people are suffering because of the high costs of ill health and poor delivery even when certain services are available. That’s the background why I chose health systems management.”
Amref: Why did you choose Amref International University for your education?
Ann: “I have to admit that when I started looking for a university, I didn’t even know that Amref had a university. I was looking for more than a classroom experience. You and I agree that in this time and age, you can access notes and lessons on the Internet. I was looking for more than that. I was looking for a place where I can get what I would call competency-based training. When I came across Amref International University, there was no thinking twice about it. I knew about Amref, I knew about their work and so I thought that as a student this is the perfect place because I think there will be opportunities for me and other students to plug into Amref’s internship programs, or to go in the field and see how work is done. That’s why I chose AMIU.”
Amref: Why did you decide to run for the role of Chairperson of the AMIU Student Council?
Ann: “When you join AMIU, there’s one thing that stands out: it is very leadership-focused. I’m not talking about titles, or positions but rather leadership as a function. Even in the trainings in the classroom there is this emphasis on leadership. With time, as a student, it changes your perspective because you are in this environment where you are being trained to be a leader, to influence change. Students are taught to be part of identifying solutions. When the student council elections came up, I saw a platform where I could influence change in a number of areas in the AMIU student experience. I thought that if I could go for the Chair position, why not? And, that’s what I did.”
Amref: What are some challenges that AMIU students have been facing during the COVID-19 pandemic?
Ann: “First, we have to give props to the University. AMIU was among the first universities to transition immediately to online platforms, 100%. What that meant for us as the students is that we didn’t have any lost time. Our semesters continued seamlessly. However, being 100% online also presented some challenges. Some students did not have access to affordable and reliable broadband. We also have students who didn’t have laptops or smartphones. Those were really challenging in the early stages of COVID-19 when everything was 100% online. We also had some students where the home environment was not very conducive to learning because there may be many distractions.
We cannot talk about COVID-19 without talking about the social and mental impact that it had. Many of the students felt disconnected, like they were getting depressed. Immediately after I got into office, we did a webinar for International Youth Day on the impact of COVID-19 on the mental health of the youth in Kenya. We had AMIU students and faculty members on the panel. Our students said they had experienced the mental health effects of COVID-19.”
Amref: Describe how AMIU students have been supporting COVID-19 vaccine outreach clinics in Kibera, an informal settlement within Nairobi in Kenya.
Ann: “We had the first COVID-19 vaccine outreach clinic in Kibera on December 4, 2021, in partnership with the Kenya Ministry of Health and the Nairobi Metropolitan Services. The day before the clinic, our students, together with community health workers, visited community members in their homes, their small scale businesses, their social places like restaurants, and talked to them about the importance of getting a COVID-19 vaccine. We let everyone know that AMIU would be having an outreach clinic the following day; all they needed to do was show up. We held the clinic on a Saturday when most people would not be working or going to school.
We chose to integrate COVID-19 vaccination services with other health care services, such as blood sugar and blood pressure screening, because COVID-19 does not exist in isolation. Other health challenges, especially non-communicable diseases such as diabetes and heart disease, affect our people as well. All these health services were offered by the Amref International University students in tents set up outside the Amref Kibera Health Centre.
During our engagement with the community members, the students helped to demystify myths and misconceptions about COVID-19 vaccines. Many of the community members were receptive because they received information at a personal level in a language they understand broken down in the simplest way possible.”
Amref: What have some successes been of the COVID-19 vaccine outreach clinics in Kibera?
Ann: “During that very first outreach clinic, we vaccinated 352 people against COVID-19, screened 165 people for blood sugar, 205 people for high blood pressure, and 189 received physiotherapy services. All in just a few hours on a rainy day! More than 100 Amref International University students took part in the clinic. All of the health services provided were free of charge. The Global CEO of Amref Health Africa, Dr. Githinji Gitahi, was there to support the students and community members. The clinic was so successful, we held two more in January and plan to continue them for some time.
The other success is that AMIU students are able to get competency-based training that is beyond the classroom. They get an opportunity to experience real service to the people, practice desired attributes and other competencies nurtured in the classroom, as well as deepen their knowledge on socio-economic determinants of health.
One of the most important successes is busting the myth that Africa and Kenya are dealing with vaccine hesitancy. The real issue is not hesitancy and it was very clear that the real issue is access. We have this assumption that because the vaccine is available in the health facilities and in hospitals then there is access. That is not enough. We must take this vaccination to the people, to the community and be able to answer their questions, be able to allay their fears…not to sit back and say ‘OK we have the shots in the hospital; that is access.’ That is not enough. Information is a key pillar when it comes to access.
In Africa, we have a population where health needs are competing with other needs – for example, food and shelter –and, therefore, if someone has to get up in the morning to go to work they will not go get a COVID-19 vaccine if they are not feeling sick. For them, it is not a priority; they would rather go to work to be able to make some money to pay for food and school fees. That is why it is important to take these services from the facility to the community. So, when a woman is going to the shop to buy some milk she can come by the vaccine clinic and get vaccinated. It only takes a few minutes. When a man is walking to work or coming home and he sees us there in the community and we have our vaccine tent there, he will come in and get his vaccination. We have to change strategy as a continent and as a country.”
Amref: What have been some challenges of the COVID-19 vaccine outreach clinics in Kibera?
Ann: “When members of the community get very severe side-effects from the first dose, they may get discouraged from getting the second dose. Another challenge is that some people can’t remember which brand of vaccine they got for their first dose, and as a country [Kenya] we are giving the same brand of vaccine for first and second doses. When they don’t remember, we have to try to get a Ministry of Health official who can access the system to find out what they got, or to advise us what to do. In Kenya, in particular, you have to register in the Ministry of Health portal so that you get vaccinated. Some of our community members are not technically savvy so they cannot navigate through the website and do the registration. That can discourage people. So, when we are running the vaccination drive we have AMIU students whose job specifically is to help people register on the portal. We cannot fail to talk about the financial aspect. The vaccination outreach requires funds. We are very grateful for the support we received from the Amref global CEO’s office because now we are able to do more vaccinations drives.”
Amref: As a student, what have you learned through the COVID-19 vaccine outreach clinics in Kibera that you can use for your future career?
Ann: “Let me share my own lesson as a student. When you go to the field and you interact with people at that level, it changes you. You can see you are dealing with human beings who have real challenges. You can see that people want to get vaccinated but they don’t know how to register on the portal. You can see someone who wants to honestly and sincerely get their second shot but they don’t know the brand of their first shot. The strategies we develop must be about the people. The most important thing I’ve learned as we’ve done these vaccination clinics is that at the centre of everything we do in health care are the people. The strategies, the interventions, the programs, the products and services we are developing are for the people. It doesn’t matter how good a strategy may look on paper, if it is not delivering the outcomes that we expect, then it is not good enough. You lose sight of the people and you miss it all. That is the biggest lesson I’ve learned as we’ve done these vaccination outreaches.”
Amref: What are you most proud of in your role at Chair, AMIU Student Council?
Ann: “I am glad I ran for this position. When we were doing the first vaccination drive in December , it was raining like crazy in Nairobi. Africa has mud. I’m not sure if you’ve experienced the mud. We were going to an informal settlement where the mud is even worse. That morning, a part of me was scared that our students were not going to show up because it was raining. What amazed me was that the number of students who showed up actually surpassed what we had planned. That moved me to the core. I am extremely proud of the team in the student council. I am extremely proud of the AMIU students who understood what we wanted to do, the mission, took it, embraced it and ran with it. None of what we’ve done with these vaccination drives would have been possible without the students. That was my proudest moment as the Chair of the AMIU Student Council