Dr Lucy Obolensky working in Africa

The Horn of Africa is experiencing the worst drought it has seen since 1945. 

With drought comes famine and a downward spiral of escalating health issues. Those worst affected communities often live miles from any health facilities.
In April and May 2017 I was asked to be the medical co-ordinator for the Doctors of the World relief programme to Northern Kenya, working in conjunction with Unicef. Although I knew it would be challenging, particularly as I would be taking my two young children in tow, it was an offer I couldn’t refuse. The prospect of making a difference – even a drop in the ocean to the plight of these communities – and gaining experience working at a strategic level for a large NGO made it a fantastic opportunity. I was asked to write a blog for the charity website whilst I was away, but having no ‘blogging’ experience and the daunting challenge of a busy job combined with a 2 and 4-year-old with me, I politely declined. Instead, I offered to write some public Facebook posts, as I was a little more familiar with this social media. Initially I posted photos and stories of the positive impact we were making: delivering Plumpynut to those with malnutrition; enabling a community nurse join us on outreach clinics to deliver vaccinations and diagnose and treat medical conditions.
Getting out to Gotu might have been quicker by camel! Incredibly resilient people living in Nakuprat-Gotu.
We did an integrated outreach here, so we took medicines, vaccines, ultrasound (for antenatal care) as well as the nutritional support. The community here live 60km from the nearest health service and even when they get there cannot be sure it will be either staffed or stocked with meds. The need for basic primary and public health services in communities like this is enormous. We had many people still queuing when we had to leave – but thanks to Doctors of the World and Northern Rangelands Trust we will be back to this community every two weeks for the next six months. I might find a camel to ride on for next week!
However, as the raw inequalities began to wear me down I found myself writing more provocative posts:
Out of the office and into the bush for a fantastic mobile outreach service. We met truly inspirational people and were accompanied by wonderful volunteers. There were some tough moments though: The MoH / UNICEF mandate states that only those with ‘clinical malnutrition’ can receive food supplements. We saw one mother of twins who had walked over 5 hours to the outreach clinic with her four young children. She looked gaunt and all the children were thin and clearly hungry. The mother and the twins were just outside the ‘criteria markers’ for malnutrition so they leave with nothing. The deep accusatory look she gave haunted me all night. How would I feel if faced with the desperate guilt of a hungry crying child but had nothing to provided?
I received zero comments, zero shares and zero ‘likes’.
The following day we went even further north where I met children with terrible diarrhoea and gastrointestinal diseases. The small amount of water they had been able to collect looked like green sludge. I was so frustrated, bewildered and angry that I posted this:
182 UN member states joined the Millennium Development Goals that finished in 2015, we are two years into the Sustainable Development goals (ofwhich Goal 6 is ‘Clean Water and Sanitation’) and yet thousands of children still have no access to clean water. Why? How? What can be done? 
I received a smattering of comments and a few shares. I decided to change my approach and the following day edited my post to a more light-hearted version: 
There are some things in the world I find quite astounding given we are in the 21st century: for example, Waitrose does not deliver in Cornwall; I can’t get phone signal when lying in bed with a cup of tea; and some children in the world do not have access to clean drinking water. Society – what’s going on???? 
The following week we went to another rural village. There was a similar story to be told here, however I took a different slant: That day I had no child care so I took my kids along to the local school where they spent the day whilst I was in the clinic next door. They had a whale of a time. That evening I posted a few photos and a video of my 2-year-old daughter entertaining a class of Kenyan children. 
Within 24 hours I had 536 likes and 147 shares!

What does this tell us about how to communicate health and social inequalities? 

For a start Facebook may be entirely the wrong medium, but what is does show is that people do not like to be challenged whilst sitting on their sofa, in the comfort of their own home, eating food flown in from all over the world and home delivered to their doorstep. We do not want to be made to feel guilty about our lives and have the stark reality of such brutal inequity forced upon us. If this can be communicated in a positive, relaxed manner with perhaps a simple question raised, then maybe, just maybe every person reading those type of posts may make one small change in their own lives to the benefit of another.