Since 1997/98 climate change has had a pronounced effect on Kenya, causing flooding coupled with focal and large scale malaria epidemics. Unusually heavy rains in 1997/98, 98/99, 2001/2, 2006/7 and 2008/9 resulted in suffering and high malaria fatality rates. In all but one instance the North Eastern province (NEP) has been most severely affected. NEP is home to more than 1,000,000 ethnic Somali Kenyans. Being a semiarid, marginalized and economically depressed area of Kenya, security is often very poor. Outside of epidemics, malaria reports to represent up to 30% of the burden in health facilities. Capacity of health workers is weak in regards to malaria diagnosis, treatment, reporting and surveillance, and has resulted in frequent malaria diagnostic and treatment stock outs when malaria patient case loads have been at their highest. This has also led to failure to identify or respond to epidemics promptly in the past and resulted in high malaria death rates.