The Kenyan Kalaazar Caregivers Holding the Line Against a Deadly Disease That Chooses No Tribe and No Child

Mar 19, 2026 | Faith Kathambi Mutegi
Environmental Peacebuilding Association

March 2026, West Pokot: For three days, the rain has fallen without pause. The road leading to Sigor Subcounty Hospital, usually a lifeline for families across West Pokot, is now a flowing river of brown water. Deep trenches cut through the earth where vehicles once passed. Trucks carrying supplies, some loaded with relief items, are stranded on the opposite side, unable to move. A few kilometers beyond the mud, inside Sigor hospital, the walls are painted gentle shades of green and blue. The halls feel unusually quiet for a place surrounded by communities facing floods, drought, and conflict. Yet the women keep arriving. Some walk for hours through flooded paths, children tied to their backs, their pleated, colorful skirts impossible to overlook. They come because of visceral leishmaniasis, commonly known as kala-azar, or locally as termes, a deadly parasitic disease that does not pause for frightening weather, dangerous borders, or interethnic conflict. One of them is heavily pregnant, and this disease is making her increasingly weak, sick, and incoherent. She urgently needs a referral to Kapenguria County Referral Hospital, roughly 76 km away.

Climate change is intensifying the kala‑azar crisis across 12 counties in Kenya. Rising temperatures, erratic rainfall, and cycles of deep drought followed by flash floods have expanded the breeding grounds of sandflies, the vectors of visceral leishmaniasis. Research in West Pokot and Turkana shows that environmental features such as seasonal rain‑water pathways, rock piles, acacia trees, animal sheds, and anthills around homes become high‑risk sites after climate‑driven weather shifts. These patterns are reinforced by prolonged droughts that push pastoralists farther in search of water and pasture, increasing contact with infected sandflies. Climate variability, therefore, not only fuels kala‑azar transmission but also exacerbates resource‑based tensions, making environmental degradation both a health and peacebuilding challenge.

A Child Caring for a Child:

Within Sigor Sub County Hospital, it is hard to miss Monica, who is eleven years old. She arrived with her seven‑year‑old sister, Magdalena, whose body is fragile from severe anaemia and infection. Monica left school to care for her. She moves through the ward with purpose, comforting other children, helping mothers, offering quiet moments of laughter in a place that has too few.

The staff greet her warmly. “She dropped out of school in Class Two,” says Nurse Emily, who is in charge of the kala‑azar ward. They admire Monica’s strength, but there is something they do not say aloud. Once her little sister recovers, Monica may be married off to a warrior. For these seventeen days of treatment, she is simply a sister fighting to keep another sister alive. That is the only freedom she has for now.

Her situation is a stark symbol of a wider crisis.

In Kenya’s arid counties, visceral leishmaniasis (kala-azar) remains a critical health challenge, overwhelmingly affecting children. According to data from Amref Health Africa and the Division of Vector Borne and Neglected Tropical Diseases (DVBNTD) within Kenya's Ministry of Health, a staggering 11,000 cases have been reported from 2017 to date. The last five years alone account for 8,257 of these cases, with 3,638 reported in 2025. This number is expected to rise as enhanced surveillance and sensitization efforts lead to early detection. Studies consistently show the highest disease burden and mortality occur in children under 15, particularly among school going children aged 5-14 years, whose immunity is often weakened by malnutrition and harsh living conditions. During recent outbreaks in Turkana, Marsabit, and Wajir, children comprised the majority of hospitalized patients. Boys aged five to fifteen, who frequently herd livestock at dawn and dusk when sandflies are most active, face especially high exposure.

Crossing Invisible Borders:

Across the Kerio River, which marks a tense boundary between the Turkana and Pokot communities, another caregiver, a mother, recounts how she made her way toward Chemolingot. She trekked for two days and two nights, stopping only when she finally reached Chemolingot Hospital. Her daughter was dangerously anaemic and urgently needed blood. The nearest hospital on the Turkana side was closer, but she could not risk crossing into a community her own people had recently clashed with, where raids had claimed lives on both sides. So she walked for days to reach care she could trust.

Her daughter needed O‑negative blood, a rare type everywhere and even harder to find in remote regions. Eventually, relief arrived, and blood was sourced from Kabarnet. Seventeen days later, the child recovered, and the mother prepared to start the long journey home. Her daughter, just like Monica, and like many others in the region, does not attend school, but she is alive, and that is what matters most to her mother. The little girl’s name is Cheptarus Lochoria. She is ten years old.

Women in pastoralist communities face multiple barriers when seeking treatment for kala‑azar. Many must walk long distances,  sometimes over 80 to100 kilometers, to reach facilities with diagnostics, blood supplies, or treatment drugs. Conflict along county borders often forces them to avoid nearer hospitals, stretching journeys into days. Social norms limit women’s autonomy in deciding when and where to seek care, while heavy domestic workloads mean that leaving home disrupts childcare, household labor, and economic activity. Girls like Monica, frequently drop out of school to become caregivers, reinforcing cycles of gender inequality. These barriers collectively widen health inequities and deepen the economic and social burdens shouldered by women in pastoralist regions.

Where Shortages Cost Lives:

The nurses at Sigor know the limits of what they can provide. The hospital is the largest consumer of donated blood in West Pokot County, yet supplies never meet the need. Nearly half of kala‑azar patients arrive severely anaemic. When the blood banks in Sigor run dry, staff must travel 80 kilometers to Kapenguria if the roads are open, if the rains have been kind, and if the ambulance is not stranded.

The National Public Health Institute, the END Fund, Children Investment Fund Foundation, DNDi and Amref Health Africa are some of the leading organizations supporting Kenya’s fight against visceral leishmaniasis. Working alongside the Ministry of Health and county governments, Amref integrates kala‑azar control into primary health care systems and strengthens surveillance, early detection, and community awareness; especially in hard‑to‑reach pastoralist regions. The organization has raised national alarm over the rising burden of kala‑azar, noting thousands of cases across 12 endemic counties in the past year and emphasizing that early detection and trained frontline health workers are lifesaving.

Conflict That Takes and Takes:

Far beyond the river, in a Turkana village, a mother sits beside her son. He has just completed the full 17‑day treatment for kala‑azar. He is weak, but healing. While she waited by his bedside, their village was raided. Their goats were taken, everything they owned. She returned to loss, but she returned with her son alive. In a place where survival is never guaranteed, this is everything. Here, conflict is not an ancient story. It is present and ongoing, rooted in scarce pasture, shared water points, and a cycle of retaliation carried out by boys barely older than children.

Where Mothers Meet as Equals:

And yet the women keep coming. They cross rivers and invisible borders. They walk through landscapes shaped by both nature and conflict. They enter hospitals where the walls are painted for calm, green and blue, and lay their children on beds that belong to no tribe.

Inside the wards, a Turkana mother and a Pokot mother may not share a language. They may not share trust. But they share fear, hope, and blood for their children. They share the same doctor, the same shortages, the same fragile chance for survival.

Kala‑azar does not ask about ethnicity. The sandfly that carries it bites without distinction. This parasite swells spleens and starves blood cells the same way, no matter where a child sleeps at night.

The Long Road and the Small Victories:

Government officials and local communities alike often speak of long‑term solutions. One proposal, supported by both sides, imagines creating a twenty‑year buffer zone along the contested border, transforming the tense stretch of land into shared community conservancies with shared amenities, where neither the Pokot nor the Turkana would settle or graze. The hope is to let the land rest long enough for hostility to lose its fuel, and for a new generation to grow up learning from peace schools rather than hearing stories of early marriages, guns, and cattle raids. It is the kind of vision that could slowly unwind the cycle that turns boys into warriors and reduces women, often the caregivers, to property.

For the mothers in these wards, such ideas represent the possibility of something they rarely dare to imagine: a future where the road to the hospital is no longer a front line, and where bringing a sick child to safety does not require crossing invisible borders weighted with history and fear. If the buffer zone holds for twenty years, a girl like Monica might one day walk between Turkana and West Pokot not as someone escaping conflict, but simply as a school‑going girl seeking care for her little sister, to share a hospital bed, a doctor, and a future with another child like Cheptarus from the other side of the river, then returning home to continue her education without the fear of being married off.

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Faith Kathambi Mutegi is a Knowledge Management and Strategic Communications Specialist with 11+ years of experience shaping advocacy and strategic narratives across Sub-Saharan Africa. Her expertise spans public health, gender equality, climate justice, and conflict-sensitive development.

She holds a Bachelor of Technology (First-Class Honors) in Journalism and Mass Communication from the Technical University of Kenya and is currently pursuing a Master of Development Studies at The Catholic University of Eastern Africa.

Faith serves as a Knowledge Management Specialist at Amref Health Africa, where she designs communication strategies for Neglected Tropical Diseases (NTDs), strengthens donor stewardship for partners such as The END Fund and CIFF, and produces multimedia content to advance community-led health systems.

Previously, as Senior Communications and Advocacy Officer at Polycom Girls, she co-led the development of the organization’s five-year strategic plan, spearheaded its rebranding, and partnered with the UNFCCC on gender and climate justice initiatives showcased at COP28. Earlier roles include print journalism at Radio Africa Group (The Star) and communications at the National Cohesion and Integration Commission (NCIC), where she focused on peacebuilding in post-election contexts.

Her superpower is multimedia impact storytelling. She is the founder of Kushoto.org, a Nature Footprints artist, and a Thunda Fund grantee.