It is common to see women and children taking a bath or washing clothes and utensils at the shores of Lake Victoria in Homa Bay County.
And there is a common notion about communities living by the lake shore that no one should be ashamed of seeing another person naked.
Because of this, more than 20 women and their children can gather at a beach to take bath.
As they do this, some would be answering the call of nature in the water or in the bush next to the lake before. The waste eventually finds its way into the water.
Many of the locals fetch water from the lake using buckets for domestic use such as cooking or drinking.
This makes them become hosts to different parasites that breed in the lake.
Over the years, multiple use of untreated water directly from Lake Victoria has contributed to transmission of diseases from one family to another.
Such diseases include schistosomiasis (bilharzia) and soil transmitted ailments (intestinal worms) which is a major public health problem in Kenya and Africa.
Bilharzia is one of the neglected tropical diseases.
Most people in the lake region only seek treatment when its effects in the body have reached an advanced stage such as affecting the liver or brain.
The worms have their life cycle in water and in the human body which is the main host.
Its physical symptoms include ringworms on the head and other body complications such as malnutrition, anemia and retarded growth in children.
Children are the most affected by neglected tropical diseases which cause stomach problems and contribute to school dropouts in communities living along the lake.
But this is set to change.
Kenya Medical Research Institute (KEMRI) is conducting a third clinical trial of a home grown and local herbal porridge designed to be taken as a school meal for nutrition and deworming purposes.
The success of the clinical trials of the revolutionary porridge called Ujiplus will determine whether the new product will be introduced to the market to be used as an alternative and child friendly means of eradicating neglected tropical diseases like bilharzia.
Ujiplus, whose innovation started in 2012 includes a formula which has scientifically been proven to be bioactive against common child infections.
The flour is a combination of nutrition, deworming and treatment of bacterial and fungal skin infection.
It was developed by scientists at KEMRI in partnership with a local flour processing firm.
Most school going children along the shores of the lake are currently not covering the whole syllabus because of failing to attend class consistently.
Before the clinical trial, it was established that at least 20 per cent of pupils missed school every day because of stomach problems at Nyamanga Primary School in Mbita Sub-county.
A recent study conducted in four schools in Mbita showed that 80 per cent of pupils are diagnosed with bilharzia and other intestinal infections which affect the liver, lungs, nervous system and the brain.
Nyamanga Primary School has 725 pupils.
Most of them live at the edge of the lake which is also their main source of water for drinking and cooking.
School head teacher Kennedy Kajwang’ said a lot of pupils have been complaining about stomach upsets.
“We have been having frequent cases of absenteeism as pupils complain of stomach problems.
They cannot concentrate in class when they have pain,” he said.
The school is among four learning institutions which have been selected for the clinical trials of the deworming flour and it is already having an effect on the health of children.
They no longer complain about stomach upset.
The same is at Bondo Township Primary School in Rusinga Island which has also seen increased enrolment of pupils who all want to benefit from the new deworming programme.
It is the third month since pupils in Grade One and Grade Two at the school started using the formula.
School headteacher Peter Oburu reported that pupils taking the uji are more active in class.
“Besides the medical value, the porridge has nutritional value and has helped pupils to be awake.
Previously, most pupils from vulnerable families would sleep in class because of starvation,” he said.
Before the programme was introduced by KEMRI, the government had been engaged in a nationwide deworming exercise since 2001.
Currently, at least 10 million children are being dewormed annually after the World health organization provided a road map for the deworming exercise.
Though the program has been successful, there are several other underlying gaps that affect children below the age of six.
Prof Elijah Songok, a researcher at KEMRI who developed the porridge said drugs used in the national exercise are toxic to young children.
He said most parents are always not aware of what is happening to their children.
Drugs used in deworming include praziquantal (the current available formulation is toxic to children) and albendazole which is not recommended for children below two years.
In addition, he said, children should be given deworming drugs when they have eaten but most families struggle to serve three meals in a day to their children.
“KEMRI decided to come up with a solution that combines nutrition and deworming.
Among them is to focus on designing an alternative deworming formula that is not only effective, safe and affordable but also enhance child nutrition status,” Prof Sangok said.
Use of the flour has been given a green light by the Pharmacy Poison Board.
Previous clinical trials of the herbal medicine were done in eight schools in Nandi and Kirinyaga counties.
Children were given the porridge formulation for two months.
Prof Songok, who is also the director of research and capacity building at KEMRI graduate school, said the outcome of the exercise was successful.
He said researchers managed to get the results they were expecting.
The researcher said children who took the formulation were dewormed and their nutritional indicators (weight) improved.
He said there was a significant reduction in worm infections; roundworms, hookworms and bilharzia.
“In Homa Bay, we are comparing the drugs used in deworming and the formulation to see which ones work best.
The local herbal innovation will likely change the approach to child deworming in Africa because our evaluation has seen positive changes in the health status of children” the researcher said.
Dr Elizabeth Matey, a scientist at KEMRI and one of the researchers of the product said the flour is made using millet, maize and other fortified products.
Researchers have also introduced local herbs in the flour as a way of solving local problems with local solutions.
“We have partnered with herbalists and farmers who are supplying us with ingredients which have all been tested in the lab.
It is a way of creating employment for farmers because they have a ready market for their products,” the scientist said.
The researcher gave an assurance that the innovation will be sustained because the raw materials are sourced locally.
Mr Wycliffe Omondi who works as the manager at the Preventive Chemotherapy and Transmission Control at the Division of Vector bone and Neglected Tropical Disease at the Ministry of Health said the national deworming campaign has its challenges as it leaves other children out of the programme.
He said the ongoing campaign is being conducted in 28 counties and only targets children aged 5 to 14 years.
“Children out of the age bracket are left out.
Those from other counties which are not targeted also fail to be dewormed,” he said, adding, “This is a setback to elimination of neglected tropical diseases.”
He said the magnitude of intestinal worms occur in 28 counties while bilharzia has its magnitude in the lake region and the coast.
Parents whose children are taking the porridge reported seeing significant changes in their health.
Mr Kennedy Ogolla said diarrheal disease in his family has reduced since his three children started using the porridge.
“At school, children touch surfaces and share food without washing their hands.
This is the greatest challenge in controlling intestinal infections,” he said.
He added that Ujiplus has provided a solution to a problem which faces all parents.
“It should be sustained,” he said.
Prof Songok called on the government to consider revising salaries paid to scientists.
This, he said, will encourage innovation and better funding to different research projects.
“Parents who did not consent to the programme started seeing other children having better lives.
We had to limit the number of beneficiaries when more parents wanted their children to be enrolled in the programme,” he said.
“All the challenges can be solved through proper funding.”