Because of her training, Nguta first discussed the surgery with the village elder, who then approached Brighton’s grandmother. Nguta said she learned that the grandmother did not want people to know that her grandson had a cleft lip.

It was only when Brighton fell ill with pneumonia, and Nguta found him with his mother at the clinic, his head covered with a piece of cloth to shield his face from scrutiny, that she convinced his mother to bring him in for the surgery.

Nguta told her to “avoid these many beliefs, because if you hold them, the child will suffer.”

Finally, at five months old, the family traveled four hours to the Makueni County Referral Hospital to have the procedure.

“Now that they surgery is done they are happy,” Nguta said. “The boy is eating well … is active, and they have hope for their future, and the future for the boy.”

If the surgery hadn’t been free, Mueni and her family wouldn’t have been able to afford it. They are subsistence farmers, dependent on each season’s harvest. Their village has been struck with hard times recently. It lies in a path frequented by elephants, which destroyed all of their crops this year. Brighton’s grandmother had to borrow the $20 to travel to the hospital for the surgery.

Ensuring that health care reaches people living on low incomes is a challenge across Kenya. But the government is trying to overcome this challenge in the coming years, taking steps to rollout a national universal health coverage scheme that aims to lessen the financial hardship that accompanies paying medical bills. Brighton’s case underscores the role development partners and community health volunteers play in helping fill in the gaps.