FEATURE — Fall 2009


Sixty-five percent of those seen by the new health facility in Lwala, Kenya, are children. Taking care of his fellow villagers is internal medicine resident Milton Ochieng’s pledge and passion. (Courtesy Photo)

Caring for
a Village

Milton Ochieng, an internal medicine resident at Washington University’s School of Medicine, and his brother Fred, a medical student at Vanderbilt University, built a legacy to their father—the first medical clinic in Lwala, Kenya.

by Terri Nappier

When Milton Ochieng was a teenager, his best friend’s mother died during childbirth. She didn’t die in a hospital, medical clinic, or even at home, but in a wheelbarrow on a dirt road. The villagers of Lwala, Kenya, having no access to health care, tried to get the pregnant woman, who was in fetal distress, to the nearest medical facility some 20 miles away. Having no vehicle or ability to prop her on a bicycle, their usual means of transportation, they used the only apparatus they had. Sadly, they could not get her to the facility soon enough.

Milton remembers the sight of his friend’s mother, whose unborn baby was breech, upon their return to the village. He also remembers feeling a profound sadness, as well as a strong resolve. On that fateful day, he made a promise to himself that he would do something with his life to help those in need in his community.

Milton, an internal medicine resident at the School of Medicine, was not the only member of his family to harbor such thoughts. His father, Erastus Ochieng, a high school chemistry teacher, had a dream to build a medical clinic one day, so that no one else would have to die of preventable diseases or treatable conditions.

(Standing from left) Fred Ochieng, a medical student at Vanderbilt; Milton; Florence Ochieng, a nursing student; and Caitlin Reiner helped deliver a breech baby (center) during the 2007 holiday break. (Courtesy Photo)

Erastus and his wife, Margaret, a primary school teacher, also dreamed of opportunities for their children, ones that only education could provide. When Milton reached fifth grade, he attended boarding school. Afterward, he attended high school in Nairobi. He then ventured to the United States, spending his senior year as an exchange student at Brooks School in North Andover, Massachusetts.

His success in school prompted an acceptance to Dartmouth College. Back home in Kenya the summer after high school, Milton remembers not having the $900 for a plane ticket back to the States to start college. But he had lots of community support.

“In Lwala, you don’t just belong to your parents, you belong to everyone, the entire village,” Milton stresses. And the village elders had a plan.

They sat Milton down and expressed their pride in his opportunity. They wanted him to return to the United States for his higher education, but they also wanted him to remember them. “And they wanted me to come back,” he says. Milton was humbled and grateful when the elders gave him the money for his plane ticket—money they had gotten from selling their own livestock and donating their salaries.

He enrolled in Dartmouth in fall 2000, the first from his village to attend college in the United States. During this time, Milton never forgot about those in his village, those without access to proper health care.

During his junior year, Milton’s younger brother Fred joined him in Hanover. Together they worked toward three goals: getting an education, beginning the early stage work on a clinic back home with their father, and ultimately giving back to their community.

Since opening April 2, 2007, the Ochieng’ Memorial Lwala Community Health Center has treated some 32,000 patients. (Courtesy Photo)

Margaret Ochieng passed away from complications of HIV/AIDS during Milton’s senior year. She did not live to see him graduate or start medical school at Vanderbilt University in fall 2004. Erastus Ochieng passed away less than a year later from similar complications. He died a month before the groundbreaking for the clinic.

Devastated by losing their parents, Milton and Fred knew their only option was to carry on. They aspired to make their father’s dream a reality, and they aimed to help save parents of other children in the village.

Both still in school, the brothers experienced times of doubt and of not knowing how to proceed. Throughout, Milton says, “I told myself: ‘We have to build this clinic; it is going to serve the community; this is what they need.’”

Their focus was fueled by knowing that if they didn’t build a clinic, nobody would. “For us,” Milton says, “it’s been about realizing that every ounce of our energy—every extra second we spend answering an e-mail, making a phone call, or giving a talk somewhere—can translate to a life saved.”

“For us,” Milton says, “it’s been about realizing that every ounce of our
energy—every extra second we spend answering an e-mail, making a phone call, or giving a talk somewhere—can translate to a life saved.”

On April 2, 2007, it happened. After much hard work from Milton, Fred, their fellow villagers, and many U.S. friends, the Ochieng’ Memorial Lwala Community Health Center opened. The clinic is dedicated to their father.

“Since the clinic’s opening, we have seen more than 32,000 patients,” Milton says. “Our clinicians see, on average, probably 100 patients a day, on an outpatient basis.”

After its opening, Milton and Fred, then both medical students at Vanderbilt, spearheaded efforts from Nashville. In addition to taking courses and studying, they worked with government officials in Kenya, NGOs, lawyers, and countless others in maintaining and furnishing the clinic.

“Two years later, we have two clinical officers, three nurses, a lab technician, a pharmacist, and several support staff,” he says.

Discussing the clinic’s patients, Milton continues: “People come in with malaria, our most-prevalent disease—and the most expensive to treat thus far. We also treat people with diarrheal diseases, upper respiratory infections, typhoid, HIV, TB, and we see pregnant women for pre-natal and post-natal care. Sadly, 65 percent of those we treat are kids under the age of 5.”

To address other pressing community needs, Milton and Fred created the Lwala Community Alliance, a nonprofit dedicated to improving life in the village.

“We want to develop synergistic interventions,” Milton says, “in terms of economic development, education, infrastructure, and public health measures.”

Regarding education, friends from Dartmouth helped establish a scholarship fund for boys and girls to attend secondary school, which costs $500 a year in Kenya, while Dartmouth neighbors Richmond Middle School are sponsoring girls.

Awarding-Winning Documentary Details Building of Medical Clinic
Throughout their journey, Milton and Fred Ochieng experienced serendipity—when others would come into their lives at just the right time, eager and willing to help them build a medical clinic in Lwala, Kenya.

Image courtesy of Stone Castle Productions; Photographer: Jeremy Cowert
Barry Simmons, then a reporter for WTVF-TV in Nashville, for example, was assigned to write a story about Milton in late 2005. Simmons quit his job after completing the story and shadowed Milton for two years. The end result is Sons of Lwala (March 2008), a moving documentary looking at the challenges and triumphs of Milton, Fred, their friends, family, and fellow villagers in building the clinic.

Washington University School of Medicine, Barnes-Jewish Hospital, the Missouri Botanical Garden (MBG), and St. Louis alumni of Dartmouth and Vanderbilt are all partnering to host a viewing of the documentary on November 3, 2009, at MBG. Please check lwalacommunityalliance.org for details.

For more on the award-winning Sons of Lwala, visit: sonsoflwala.com.

“We realize that education is very important, and it’s the only reason Fred and I are where we are today,” Milton says. “We are to-date sponsoring 23 girls and boys for secondary school.”

Friends from Vanderbilt are pitching in, too. The undergraduate student group Students for Kenya helped raise $25,000 by rallying sororities, fraternities, and other groups on campus.

One requirement of all these scholarships is that when students are done with school, they return to the village and work a certain number of years.

The village also lacks infrastructure, having no electricity or running water. The alliance is partnering with Blood Water Mission, a Nashville-based nonprofit formed by the musical group Jars of Clay, aiming to build clean-water wells in Africa.

In Lwala, the objective is to drill wells for 12 primary schools, which educate thousands of students in the clinic’s catchment area.

“Because there is no clean water in these schools, hundreds of children come to the clinic with diarrheal diseases and intestinal parasites,” Milton says. “We can give them pills to make them feel better, but then they go back and drink the same dirty water. They’re soon right back at the clinic.”

Discussing how the Washington University School of Medicine can partner with Milton in Lwala, Internal Medicine Residency Program Director Melvin Blanchard says: “The most important way we can support Milton and his clinic is by providing him outstanding training in internal medicine and preparing him for fellowship training in gastrointestinal diseases. We may also assist his clinic with supplies and portable diagnostic equipment, as well as provide telemedicine in specialties amenable to this technology where practical.”

Milton appreciates such support, and he knows firsthand how assistance through telemedicine can help save lives.

He talks movingly about an early experience at the clinic. During the semester break in 2007, Milton and Fred were both home. One day a young pregnant woman, who was in fetal distress, came into the clinic. Because the other clinicians had left for the holidays, Milton; Fred; their sister, Florence, a nursing student; and a volunteer, Caitlin Reiner, were the only ones there.

Using only a donated Steven Gabbe obstetrics and gynecology book and long-distance phone support from Caitlin’s mom, who is an obstetrician in Florida, the foursome delivered their first breech baby. As fate would have it, the young woman was the wife of Milton’s childhood best friend.

Terri Nappier is editor of this magazine.

For more on the Lwala Community Alliance, visit: lwalacommunityalliance.org.