Health by All Means: The “Health is Wealth” Response to COVID19 in Rural Kenya

Written by: Olivia Dahlquist, Assistant Director of the 4W Women & Wellbeing Initiative at the University of Wisconsin-Madison

As the coronavirus pandemic wreaks havoc in high-income countries like Spain, Italy, the the UK, and the United States, many of us are asking, “What will happen in Africa?” Reflecting on the pandemic’s impacts on her native home of Madrid, Spain, Dr. Araceli Alonso, Director of UW-Madison’s UNESCO Chair on Gender, Wellbeing, and a Culture of Peace, felt immediate concern for another place she calls home: 13 villages in Kwale County, Kenya. Dr. Alonso has been working there since 2009 through her multidisciplinary project, Health by All Means (HbAM). Recognized by a United Nations Public Service Award in 2013, HbAM creates change from within communities to improve health outcomes, particularly for the wellbeing of women and girls in the Global South.

Dr. Alonso knew that saving lives in the face of the pandemic would require an immediate response and global solidarity, as well as support for and trust in the resilient, rural women who would likely be leading response efforts for their communities – particularly in areas like Kwale County that lack basic health infrastructure.

Kwale County is shown on this map of Kenya as primarily numbers 1 and 13.

Kwale County is located in the southeast coastal region of Kenya, called South Mombasa, and is one of the four counties that has been struck hardest by the coronavirus. The Kenyan Coast Province has struggled, in general, with poverty-related health concerns and higher-than-average rates of child mortality when compared to the national averages. Thus, effects of COVID-19 may be exponentially more damaging in an area where respiratory infections already rank second for death and morbidity in the population, after malaria.

With this in mind, Alonso worked with women leaders from villages throughout Kwale County to develop and implement an effective, community-engaged response model to COVID19 – now coined the Health by All Means “Health is Wealth” model, a hygiene and infection prevention, surveillance, and response model. Women leaders mobilized quickly, using this model to educate and protect their communities against the new pandemic, even before the Kenyan government announced the first case of COVID19 in the country.

“Health is Wealth” surveillance and response model developed by Araceli Alonso and Health by All Means local leaders.

In less than two weeks after the model was created, the women of Kwale County had reached approximately 1,200 families with the Health is Wealth information; distributed thousands of medicated bars of soap; delivered large quantities of acetaminophen to those in need; and built hundreds of tippy taps – hands-free washing devices – for their communities. The women also conducted workshops to teach others how to safely and hygienically build and use the tippy taps. Additionally, through the Nikumbuke Tailoring School, a Health by All Means vocational training and health initiative, women have begun sewing masks to distribute throughout their communities.

Women wait in line to use tippy taps for hands-free washing.
Woman sews masks at Nikumbuke Tailoring School in Lunga Lunga, Kenya to distribute to community members.







Alonso proudly credits her Kenyan colleagues Julietta Mlongo Wanini, Josephine Matini, Bendettah Muthina Thomas, and Anna Akhot for their quick, on-the-ground mobilization efforts. Thanks to their rapid implementation of the Health by All Means model, Kwale County is better equipped to manage COVID19-related health issues, and to share their methods with others via Facebook and WhatsApp.

Health by All Means leaders from left to right: Julietta Mlongo Wanini, Director of Nikumbuke Tailoring School; Josephine Matini, Community Health Leader; Bendettah Muthina Thomas, Director of the Nikumbuke Project; and Anna Akhot, Assistant Director of the Nikumbuke Project.

This work is a testament to how “local” the world can feel amidst a global pandemic that does not discriminate among nationality, race, class, or gender. Though we are advised to distance ourselves physically, these collaborative community outreach efforts demonstrate what can happen when we “come together” with care, support, and solidarity.

Health by All Means is a program of the University of Wisconsin-Madison’s 4W Women & Wellbeing Initiative, with collaboration from the Department of Gender and Women’s Studies and the Global Health Institute. To learn more, see Health by All Means: Women Turning Structural Violence into Peace and Wellbeing (Deep University Press, 2019) by Araceli Alonso and Teresa Langle de Paz.