John Mwazighe Mnjalla, BScN' 07

When you first meet John Mwazighe Mnjalla, BScN ’07, he comes across as an unassuming, soft- spoken and modest man – yet, he is a leader. Since taking over the reins of a poorly run medical clinic in 2005, Mnjalla has overhauled the quality of primary healthcare services available for local residents in the small rural town of Mariakani, 36 kilometres northwest of Mombasa, Kenya. Today, the Mariakani Community Healthcare Services has earned a solid reputation for its work in providing basic and preventive healthcare, and especially in implementing the national HIV programme’s recommendations. 

Why did you feel the need to set up the Mariakani Community Healthcare Services here?
When I joined the military in 1994,I first worked in Nairobi. Later, I got posted to Mariakani. While working here, I came across a local clinic that was being run in an unprofessional manner, with nonmedical staff actually attending to patients. Most of the patients were ignorant of this fact, which was further compounded by the unavailability of essential drugs and medical supplies. In 2003, when the previous owner vacated the medical clinic, I decided to step in and fill the gap. It was a huge challenge, as I would attend the clinic after my official working hours, and work till 11 pm. This was the beginning of the Mariakani Community Healthcare Services, a local facility aimed at providing primary healthcare services to the local population in the area. It complements the government’s facility in the region, which is overstretched in terms of resources coupled with other challenges such as accessibility as it is too far away for many people.

How has this public-private partnership helped improve healthcare in the region?
A public-private partnership is crucial and critical as it directly benefits the local population. Through such partnerships, there is a medical referral system for patients. For example, those with severe hypertension, uncontrolled bleeding after childbirth, road traffic accidents and those requiring antenatal services can be referred to the local government healthcare institute, the Mariakani District Hospital. This has contributed to reducing mortality in this particular region.

How has the Adherence Counselling Centre progressed?
We opened this centre about seven months ago. It serves those who are infected or affected by HIV and face stigma and discrimination. Some of the ways we are impacting lives is by providing employment at the Centre to those who are living with HIV. We have established provider- initiated testing and counselling, where every patient can be easily tested or, at the very least, we ensure that we have a discussion on HIV and related lifestyle aspects with every patient who comes to us. Additionally, we have also developed a good rapport with government institutions and government chemists in Mariakani.

How do you think your AKU education helped you in all that you have achieved so far?
AKU taught me critical thinking skills. I have a passion to ignite change in my community and AKU helped me link my education and skills with service to the community.

What about your work for the Kenyan army’s HIV programme?
I have been in the Kenya Defence Forces (KDF) for over 14 years and have been coordinating the KDF HIV Programme for the last three. The programme focuses on prevention, care and treatment of HIV. It is a programme anchored by the Ministry of Health in partnership with the Walter Reed Army Institute of Research.

As a coordinator, I have been able to influence policy in the KDF HIV programme, especially in training in different programme areas. I strongly advocated for localised institutional/barrack based training as opposed to the external training model previously used, which was very expensive as participants would have to be accommodated in a hotel. My advocacy for such training enabled the institution to save funds, which went toward training more health workers and therefore enhancing the quality of care. Under this strategy we have managed to train over 400 healthcare workers across the country in areas such as the prevention of mother-to-child transmission of HIV and provider-initiated testing and counselling. As a result, we are seeing an upsurge in HIV testing and counselling uptake in the KDF.

What is your vision for the future of nursing in East Africa?
Nursing in East Africa is changing, and the Bachelor of Science in Nursing degree is making a real difference. AKU has contributed immensely in making a positive change. AKU alumni are at the forefront, having made significant contributions to healthcare policy and serving as influencers in their areas of work like the above mentioned training strategy for the barracks based training that I developed and implemented.

Delivering Care at the Primary Level
During the interview with John Mwazighe Mnjalla, a couple arrived at the clinic with their two-year-old son for a follow-up visit. Their young child had recently been attacked by a swarm of bees and had been treated by John. “I had left my son in my neighbour’s care, and when I heard his screams I rushed over,” the mother narrated. The boy was covered with bees and the mother and the neighbours desperately tried to brush them off. However, by the time the father arrived, the child was beginning to lose consciousness, and so they immediately rushed him to John’s clinic.

“When I saw the boy, I knew we had to act quickly as he had become limp and we were in danger of losing him, possibly in a matter of minutes,” said John. He immediately administered the treatment and, luckily, the boy began to respond. “The intervention saved his life,” recalls the boy’s mother. “Were it not for the quick action taken at the Mariakani Clinic and the diligence and expertise of the team, I would not want to imagine what would have happened,” she concluded with a grateful smile.