Lokiriama, Turkana County August 03 2026 (Public Communications and Media Relations)

Save the Children rolled out the Emergency Integrated Nutrition and WASH Response in Turkana, a six-month program supported by the Eastern and Southern Africa Humanitarian Fund (ESAHF) as part of the wider response to the worsening drought situation.

The drought had exposed a large population of children under five years (over 95,000), pregnant and breastfeeding women and girls to increased risks of malnutrition and limited access to water, sanitation and hygiene (WASH) services.Through a nutrition mass screening exercise conducted before the intervention in April 2026, it was revealed that the target population had surpassed the World Health Organization (WHO)-recommended GAM rates emergency threshold of less than 15 percent malnutrition prevalence.

“Many sites reported even up to 50 percent, indicating that one in every two children was malnourished. On average, the percentages fluctuated between 20 and 40 percent. The risk of sinking even further was very evident since the drought situation was worsening at the time,” says Akutan Lobolia, Health and Nutrition Coordinator at Save the Children’s Lodwar Office.

Before the rollout, the project details were presented to the County Steering Group (CSG), a platform where the County Government and development partners come together to review and adopt interventions for coordinated implementation.Save the Children revealed that the project would be implemented through integrated outreaches in 184 sites across Turkana County.

Each site was scheduled to benefit from eight outreach sessions before October 9, 2026.According to Akutan, the program was designed to achieve two critical goals: reverse the increasing cases of malnutrition and improve WASH outcomes among vulnerable communities.

“After six rounds of outreaches, Save the Children believes it is possible to screen up to 103,000 children and pregnant and breastfeeding women and girls for malnutrition, provide integrated services at last-mile locations, distribute 10,265 WASH NFIs for hygiene promotion and disseminate Infant and Young Child Feeding messages to communities at the grassroots level,” he said.

When the sixth round of outreaches commenced in Loima and Lokiriama sub-counties, officials from the County Directorate of Partnerships and Resource Mobilization joined the team for a monitoring exercise covering four last-mile locations, also described as hard-to-reach areas.These included Komio in Urum, Puch in Namoruputh, Lokoropus in Lobei/Kotaruk and Nakatiyan in Loima.

In all four locations, the journey to healthcare began where the road ended.The smooth roads gave way to rocky tracks immediately after leaving the link health facilities. The tracks disappeared into dry riverbeds, steep hills and endless stretches of unforgiving terrain.

Drivers had to carefully navigate through boulders, deep gullies and loose sand, with occasional stops required to free vehicles stuck along the way. At times, wild animals were spotted as the teams travelled through sparsely populated pastoralist settlements. The areas also lacked mobile phone network coverage.

For the medical teams, however, it was another day at work another opportunity to reach populations in need of catch-up vaccination.For the families waiting at the end of the journey, the outreach represented the difference between receiving treatment and going without care. It meant access to immunization, antenatal care services, Infant and Young Child Feeding messages, water treatment chemicals and essential commodities for managing malnutrition.

In the remote village of Komio, about 156 kilometres away from Lodwar, mothers carrying children began arriving one after another.The nutrition desk screened 136 children and identified 40 cases of malnutrition. This meant that nearly one in every three children screened required nutritional intervention.The numbers represented a workload beyond what the local health facility would normally handle on an ordinary day.

Area Chief Titus Lokwang said he had received reports that more children were still at home because their families could not manage the distance on foot.

“I am happy that today’s group will benefit without having to endure the distance. Since we expect another outreach in two weeks’ time, I will spend my time encouraging residents to turn up in even larger numbers for the next edition,” said the Assistant Chief.

Across the hilly and unforgiving terrain of Puch, the nurse leading the outreach team encountered a child requiring catch-up immunization.Akai Emuria, a mother of three, had started her journey the previous day, leaving her two older children behind to take care of the family’s livestock. She walked for several hours before requesting strangers to offer her shelter for the night, allowing her to continue to the outreach site the following morning.Her child was among the first to be attended to, and health workers administered six vaccinations at once to the two-and-a-half-year-old.

When asked by the medical team why she had missed previous outreach visits, Akai explained that she had repeatedly tried to reach earlier sessions but always arrived after the teams had already left.

“My only option was to wait for them to return. As a pastoralist, I cannot travel with my animals down the escarpment to Namoruputh or Lokwatuba because it is such a long distance. This is how all my other children were immunized and enrolled in the nutrition program,” she said.

For Peterson Nakani, the area’s village administrator and a long-serving community health promoter, geography is not the only obstacle facing residents. He identifies distance, lack of mobile phone connectivity and fear as some of the major challenges affecting access to services.

“This is an area where we have to search for parents physically across scattered settlements. We want both the government and development partners to consider equipping us with motorbikes to ease movement challenges,” he said.

Nakani recalled an incident where a vehicle providing humanitarian services was involved in an accident while attempting to navigate the difficult escarpment.

“The news of the accident caused fear. Other vehicles kept off from travelling to Puch, and the population went without services. This difficult landscape has continued to test every outreach team,” he said.

Having travelled with the outreach team through the challenging terrain, Mike Aupe, Deputy Director in charge of Partnerships and Resource Mobilization, said the successful execution of the exercise reflected Governor Jeremiah Lomorukai’s agenda of taking services closer to communities through partnerships with development organizations such as Save the Children.

“Having seen the roads, the height and the difficult terrain these communities endure, it is clear that outreaches are serving their purpose. Through a working partnership with Save the Children, residents of these areas are able to access services that would otherwise remain out of reach,” he said.

Sam Lokopu, the area’s Community Health Promoter, said the outreach also served pastoralist populations from Kaapel, Kalokula, Naurenudung, Lobur Angkaala, Sogoo, Kanaroo, Nangoleki and Aminit.

On the third day, the team moved to Lokoropus in Lobei/Kotaruk Ward.Rebecca Amuruan arrived with four of her seven children. She was among the group already waiting when the service vehicles arrived at the outreach site. Health workers proceeded to examine both the mother and her children before delivering difficult news: three of the four children fell within the red zone on the Mid-Upper Arm Circumference scale. The measurement indicated severe malnutrition and immediate eligibility for treatment. Despite the diagnosis, Rebecca remained grateful that the outreach team had arrived.

“I would have walked for three or four hours either to Lorgum Mission Hospital or the Health Centre at Kalemnyang,” Rebecca said.

After listening carefully to the health workers during the Infant and Young Child Feeding and hygiene promotion sessions, Rebecca acknowledged that many families served through the outreach understood the importance of providing nutritious food.However, she explained that their financial circumstances made it difficult to afford the foods they knew were necessary for their children’s wellbeing.

“The challenge is not that families do not know what their children need. Many understand the importance of nutritious food, but their economic situation does not allow them to provide it consistently,” she said.

On the final day, the outreach team travelled to Nakatiyan, where a five-year-old child born on January 25, 2021, arrived accompanied by the area’s Community Health Promoter. The child was another eligible case for catch-up immunization.Health workers Benta Ekadeli and Emma Lomil, who were providing medical services at the outreach site, established that the child’s parents were pure pastoralists whose migratory lifestyle had often taken them away from locations where they could access routine health services. Regina Areman, the CHP from Nakeju Akaal village, said that in recent years, many pastoralist families had shifted their movement patterns in search of alternative sources of income.

She explained that some families had moved to gold mining areas in an attempt to make ends meet, but the change had come with consequences for children’s health.

“Children’s health has suffered neglect. Parents no longer take their children to health facilities, exposing them to health and nutrition risks,” she said.

The challenges experienced across Komio, Puch, Lokoropus and Nakatiyan reflect the complex realities facing families living in some of Turkana’s most remote areas.While health facilities remain critical anchors for service delivery, many communities continue to live several hours away from the nearest facility, separated by difficult terrain, limited transport options and changing livelihoods.

For the outreach teams, reaching these communities requires more than medical supplies and equipment. It demands determination to navigate landscapes that often discourage regular service delivery.

For residents, every visit brings services that would otherwise remain beyond their reach from childhood vaccinations and nutrition screening to antenatal care, hygiene promotion and treatment support.Through the Emergency Integrated Nutrition and WASH Response, Save the Children and its partners continue to bridge the distance between health services and communities living at the last mile.In Turkana’s remote villages, healthcare does not always begin inside a clinic.

Sometimes, it begins with a journey.