Until five months ago, Joseph Lekupe had never accompanied his wife of 17 years, Agnes, to see a doctor or the local medicine man whenever she gave birth.
His wife had given birth to four children at their Manyatta in Loua Village in the heart of Samburu County, but Lekupe had not been there there during any of these births.
And it is not that he was an absentee father or preoccupied with other things. Lekupe explains that his wife’s reproductive health is considered a “women’s affair” among the Samburu, so it is considered dishonorable for men to concern themselves with such issues.
“A woman’s reproductive health is considered the concern of other women in the community. As the leaders and the defenders of the community, our focus, as men, is on issues such as resolving disputes and looking after livestock,” Lekupe explains matter-of-factly.
But contrary to popular opinion, Lekupe goes on to explain through an interpreter, it is actually not taboo for men to dabble in issues considered women’s affairs; that is just the way things have been in the community.
“When I came into the world, I found that men did not deal with or discuss women’s affairs, and I simply joined the crowd. We just don’t do it. It just the way things are, so it is considered dishonorable for a man to get involved in women’s affairs. But no one can give you a good reason,” he says.
That is why on August 19, 2014, he did what he considers one of the most radical things in his life: he accompanied his wife to a health centre eight kilometres east of their village in the small, single-street town of Barsaloi.
His gaze shifts towards the horizon as he recounts the day his fifth child was born. The sun had just peeked from behind the hills to the East of Loua Village when a heavily pregnant Agnes gasped to her husband, “I think it is time.”
Lekupe recalls me that he did not waste any time. “I left my Manyatta immediately and returned a few minutes later with a boda boda.”
The two men helped Agnes onto the motorbike after which Lekupe sat at the back, sandwiching his wife between him and the rider.
The eight kilometre ride to the sun-scorched Barsaloi was mostly shrouded in silence, except for the droning of the motorbike’s engine and the occasional whimper from Agnes as the gap between her contractions grew closer.
Hearing Lekupe recount the events that took place this day evokes images of his biblical namesake heading to Bethlehem — his wife Mary riding on a donkey — where their miracle baby would be born at night.
Only that in Lekupe’s case, their son was about to come into the world in much better conditions, unlike his four older siblings.
The significance of the day their son was born is clear from ,the amount of detail Lekupe and Agnes provide of the events surrounding it.
“His name is Stephen. Stephen Lekupe. He was born on a Tuesday, at exactly 9 am. I remember the nurses gave me tea with milk, as well as some bread. I also remember taking a bath every day for the few days that I stayed at the dispensary. I normally bathe after four days,” Agnes says.
The more I interacted with her Lekupe, the more I felt like a student sitting at the feet of a sage.
That is probably because he looks much older than he claims (he is not sure about his age but thinks he is in his thirties, and has been married for 17 years).
There is a way his gaze shifts towards the horizon when he is talking, which gives one the impression that what he is about to say is drawn from a wealth of experience and wisdom.
It doesn’t matter that he is talking about something as normal as taking his wife to the hospital.
And just as I am thinking that his “revolutionary” thinking ended with taking his wife to the hospital, and that at heart he’s a typical Samburu man who will not participate in child rearing, Lekupe does something quite unexpected; he absent-mindedly puts his club on the ground and picks up little Stephen.
Balancing his last born son on his right knee, Lekupe explains what compelled him to stop caring about what his fellow village men thought about “women’s issues.”
“I was tired of seeing my wife suffer. I knew what she had been through with our other four children and I decided that enough was enough. I could not bear to see her go through it again. Also, some people from the health centre had come to talk to us and told us that our women could go to have our child there for free and in much better conditions,” he says.
Estimates place the number of deaths due to maternal issues at more than 472 for every 100,000 live births in Samburu.
Another interesting thing is the fascination that Lekupe seems to have with his fifth child. You would think Stephen was his first child, or at least his first son. But he already has two sons.
Unable to contain my curiosity, I ask him what he thinks of his son and why he is special to him.
“Stephen is a very good boy. He doesn’t cry as much as the other children. He is very calm,” he answers without hesitating, eyes on little Stephen whose gaze is fixed on me – as if he has sensed we are talking about him.
Then he adds: “I want him to be a doctor when he grows up.”
Now, “What do you want to be when you grow up?” is not a question men in Samburu often get asked. More than 90 per cent of the total 224,000 residents of the county (according to the 2009 census figures) are nomadic pastoralists.
For most of them, the trajectory of their life is basically settled even before they are born – taking care of livestock.
But Lekupe explains that, after seeing the way the nurses at the health centre took care of his wife, and how comfortable the birth of Stephen was, he decided he wanted his son to be a doctor when he grows up.
I take this opportunity to point out to him the fact that most nurses and gynaecologists who take care of the women at the health centre are male and ask whether he has a problem with this, given Samburu men do not find these dignified profession for men.
“It is only shameful for men in the community to handle our women when they are sick or pregnant. It is not forbidden. If these nurses want to do it, shame on them. But I still struggle to understand why a man would want to do that,” he says.
He adds that he wants his son Stephen to be a doctor because he has seen what doctors can do: “They change people’s lives.”
Lekupe wants his son to be part of the profession that brought him safely into this world – modern medicine. So, although he comes from a long line of pastoralists, Stephen’s life will be a radical break from tradition.
Lekupe’s dream for his son is not just inspired only by the way his wife was handled at the health centre when she went there to give birth; developments in the county have also reinforced his desire to see his son become a doctor.
Recently, the ill-equipped and poorly staffed health centres at Barsaloi and Suguta Marmar were refurbished and upgraded with new equipment, a fully stocked pharmacy, trained staff and new emergency transport to improve maternal and newborn health outcomes in the region – a joint project by the Mpesa Foundation, Amref, PharmAccess Group and the Ministry of Health through the Samburu County Health Department.
The project, which cost Sh36.2 million, included the provision of two motorbike (tuk-tuk) ambulances and one 4×4 ambulance to support emergency transport for pregnant women to health facilities, the provision of 40 new pieces of medical equipment as well as monitoring of quality improvement of both health facilities.
In addition to financial support, 40 health workers have been trained in emergency obstetric care to support the two centres. An additional 70 community health volunteers will be trained using a health enabling and learning platform, which is a revolutionary m-learning solution.
They will also enjoy access to a dedicated e-learning centre in Maralal Hospital to ensure continuous training of health workers.
A Safaricom Base Station has also been set up in Barsaloi and is expected to enhance coverage to support referral efforts.
Lekupe says he is both overwhelmed by and excited about all the changes taking place around him. He feels like everything is happening too fast. He does not even own a mobile phone because he never needed one before.
Before the base station was set up, the area had no cell-phone network coverage. But now he sees a world of possibilities opening up before his eyes, and his son will be there to seize every one of them.
Even though our entire conversation is done through an interpretor, Lekupe’s body speaks a universal language. I do not need an interpreter to notice his wife helping him remember when they got married, or when he tickles Stephen’s cheek as he talks about him.
It is also obvious that the couple is not just posturing because they are being interviewed. Some things simply cannot be faked – like the way Agnes blushes and smiles when I ask her husband about the baby, or the way they unconsciously team up while trying to remember specific details of their lives.
I notice that Agnes does not hesitate to correct her husband or to complete his sentences. I also notice that Joseph doesn’t mind this.
But Lekupe’s and Agnes’ story largely remains the exception. Even though the health centre at Barsaloi has witnessed a 90 per cent increase in the number of women coming for maternity services, the men continue to give it a wide berth.
“Most partners refuse to accompany the women,” says Stephen Ochola, the nursing officer in charge of Barsaloi Health Centre.
“They say they don’t see the point. But we would want them to come and be involved because they are needed when it comes to ensuring their wives take their medication and return for follow-up services.”
Not surprisingly, most maternal and newborn health indicators in Samburu County are still lower than the national average, with skilled deliveries, for example, standing at 32 per cent compared with 44 per cent nationally.
As Lekupe and Agnes walk off into the Samburu sunset, our interpreter, Justice Leorto, a medical volunteer in the area, thinks aloud: “I wish other men would follow his example and care more about the reproductive health of their wives.”