The nomadic people in Kenya are facing deeply-seated health problems as a result of poverty, lack of access to healthcare facilities, low education levels, and a lack of information. There is a general feeling of hopelessness and despondency, especially among the less privileged, that the nomadic people may never see the dawn of a better life.

Only a limited number of nomadic community members can make it to a healthcare facility (mostly dispensaries - the lowest level of the health system in Kenya) due to the long distances between available healthcare facilities, generally severe economic hardships, and lack of basic information on healthcare.A large percentage of the nomadic communities still have vague ideas about preventable killer diseases such as HIV/AIDS, Tuberculosis, Malaria, Sexually transmitted diseases (STDs), and Cholera. Tuberculosis and HIV/AIDS particularly have high incidences among the nomadic communities due to theirchronicity, the high stigma associated with both conditions and their specific complex management strategies. Additionally, there is very poor adherence to HIV/AIDS and TB therapy/treatment mainly due to ignorance, the high cost of life-saving drugs, and the chronic nature of the diseases.

Clean Water for domestic and agricultural activities is generally available for many people, but not in the Kenyan nomadic communities. People rely on seasonal rivers and rainfall runoff and are thus very vulnerable when rains fail to come due to climate change. They rarely boil or clean the brown muddy water in any way for drinking or cooking purposes. contaminated water is therefore a major cause of morbidity and mortality due to waterborne communicable diseases like Typhoid, Cholera, and Malaria. Nomadic communities lack internal house toilets and most homesteads do not even have Pit latrines, contributing significantly to poor sanitary practices and leading to high incidences of waterborne diseases.

There is also a significantly low ratio of available healthcare providers and the population in this region compared to the national average, leading mostly to heavy reliance on traditional medicine men and women.

There is therefore urgent need to upgrade the quality healthcare system available to the nomadic communities found in the Arid and semi-arid counties of Kenya. The model of the healthcare system for these regions proposed by Maiyian Heritage is a Hub and Spoke modelthat includes a main high-level hospital (hub) supporting well-established community outreach medical camps and mobile clinics(Spokes).

Such a model will provide much and urgently needed periodic preventive healthcare screening and basic treatment services at the spokes sites, and refer complex health condition cases to the main hospital. The model will ensure regular outreaches to isolated remote communities, identify health conditions early for better treatment success, and bring hope to otherwise unmanageable cases usually left to die after local healthcare efforts are exhausted for lack of requisite resources.

PROJECT OBJECTIVES:
There are three major goals for Maiyian Hospital, along with specific objectives under some of the goals.

Goal 1: To offer free and or affordable health-promoting services within the selected needy communities to help in disease prevention and control.

• Provide health education on selected topics relevant to the community members of the targeted site. such include the need to use boiled and clean water, better sanitation, and hygiene.
• Distribute vitamin supplements to expectant women, peadritic, and elderly populations
• Assist communities in constructing toilets to improve sanitation
• Upgrading and protection of community water points for better access to adequate clean water.

Goal 2: To offer free and or affordable health curative services.

• Conduct on-site clinical examinations, diagnoses, and treatments for common illnesses.
• improve the general health of the locals and ensure continued care for identified patients with chronic illnesses like Tuberculosis (anti-TB therapy and adherence to treatment), HIV/AIDS (Anti-Retroviral drugs administration and adherence to treatment), Cancer ( screening, early and middle stage treatments, and palliative care) as well as other priority conditions in the community.
• Refer outreach sites patients who may need further management of their complex conditions/illnesses to the main and other advanced health facilities.
• Provide logistics support for the management of all referrals from the medical camps.

Goal 3: Development of meaningful Strategic Partnerships with:

• Local healthcare facilities: Meet, discuss, and develop service delivery MoUs with local health facilities to provide "spoke" satellite/outreach healthcare services to the targeted nomadic communities.
• Funding Agencies: Meet, discuss, and develop MoUs and funding agreements with wells-wishing donors, Government agencies, and private philanthropists
• Local Implementing Partners ( LIPs): Meet, discuss, and develop MoUs and micro-project implementation agreementsIncluding NGOs, and Community-based organizations (CBOs) :
• Local Communities:That Maiyian Heritage serves through their recognized community structures; village elders, chiefs, and opinion leaders from community self-help groups.

Central Referral Facility:
Maiyian Heritage plans to develop a central referral healthcare facility in a populated area. The facility will be the primary source of funding for all future community outreach medical camps and the primary center for managing all Maiyian referral patients from field operations.

The medical facility will also allocate resources (medical supplies and personnel) as needed to satellite stations situated within each targeted county.

The central referral facility is estimated to cost Kshs 150 Million for construction, initial medical supplies, and startup operational costs.

The detailed version of this Project proposal is available upon request.