Organic Health Response: Supporting an Ecosystem of Diverse Community Health Initiatives on Mfangano Island, Lake Victoria, Kenya

When you hear the word “organic”, what is the first thing that comes to mind? Maybe a fruit? A vegetable? Or, maybe crops grown without pesticides? 

For second-year University of Minnesota North Memorial family medicine resident Charles (Chas) Salmen, MD, MPhil, the word “organic” means much more. In 2008, Salmen helped develop Organic Health Response, a non-profit organization that cultivates a resilient, healthy future for the people of Lake Victoria, Kenya.

Charles (Chas) Salmen, MD, MPhil

What is Organic Health Response? 

OHR is committed to addressing the devastating impact of HIV/AIDS among the remote island communities of Lake Victoria in Western Kenya. Through local and global partnerships, OHR is pioneering a series of initiatives to help these villages “respond organically--as unified communities--to the overwhelming socioeconomic, epidemiological, and ecological challenges they face.” 

The following post is a Q&A with OHR founder Chas Salmen, MD, MPhil.

How do you describe Organic Health Response (OHR) in your own words and what inspired you to help develop this organization?

OHR represents a team of local farmers, teachers, and health workers in Kenya supported by a network of graduate students, physicians, researchers and activists from around the world. I helped start OHR with a group of friends back in 2008. I had been living on Mfangano Island conducting ethnographic research to try to understand how these remote island communities on Lake Victoria had become some of the most HIV-infected populations on the planet. While working in a small village called Kitawi, I was approached by two farmers, Joel Oguta and Richard Magerenge, to see if I would help them build a community center on some land that they wanted to donate to their community. I had no idea what I was getting into, but we dove right in. 

Eight years later our community center, the Ekialo Kiona Center, is a 100% solar powered, free community center that provides unlimited access to high speed Internet to any resident who agrees to learn his/her own HIV status. We also use this center as our headquarters to support a "community health ecosystem" of diverse education, agriculture, and health programs. We have about 35 full-time Kenyan staff who run the center on Mfangano Island, and dozens of volunteers that support our work in the US.

Salmen onsite with the original members of the Ekialo Kiona design guild

Why did you decide to pursue family medicine? OHR seeks to minimize the impact of HIV/AIDS, so why family medicine vs. something like infectious disease?

I grew up in a small town in the mountains of Colorado, where my dad is a family doctor. I had a chance there to see the impact that family medicine can have not only within the confines of a clinic, but "out in the world". On Mfangano, it was clear that people lacked access to basic primary care. While the HIV virus is certainly a predominant pathogen in this part of the world, addressing AIDS, among other crucial health issues requires a broad approach, tackling sanitation, nutrition, education, livelihoods and gender equity. These are broad community health issues that family doctors are well equipped to tackle, alongside the innumerable infections, broken bones, unexpected deliveries, and health screenings that family docs are trained to treat. Once I realized I was hooked on Mfangano and wanted to be a doctor, family medicine was the only choice!

What has been your greatest takeaway from your involvement with OHR?

Humility. Working on a remote island in Western Kenya has been unbelievably challenging and rewarding. If I've become an expert in anything, it’s learning from mistakes because we've made so many over the years! Going slow, taking small steps, iterating and iterating, and revising and adapting to unexpected changes in your plan are a critical part of the slow, but steady march towards community health in rural sub-Saharan Africa. This process is not something that can be accomplished in a summer or within 1 grant cycle. Embracing patience and finding satisfaction in good teamwork and growing capacity are keys to happiness in this game. I'm grateful for my Kenyan colleagues and American partners who have helped me see this.

Microclinic seminar at Ekialo Kiona Center

What are your plans after completing residency at North Memorial?

I hope to continue working on Mfangano for the rest of my life. My wife and I have small thatch home there and plan to return often, visiting friends and family, and also assisting the EK center. I hope to stay connected with the University of Minnesota professionally to allow students, residents, other physicians, and learners to get involved as well. 

Are there any other interesting facts about yourself or OHR that you would like to share?

Check us out at organichealthresponse.org or shoot me an email at csalmen@organichealthresponse.org. I'm always happy to talk about this special place and our latest crazy ideas for community health. 

Ekialo Kiona (EK) farm team loads indigenous tree seedlings onto the EK emergency boat for transport to Kitawi Beach

To learn more about Organic Health Response, visit organichealthresponse.org.