Outside the Kalahari Slums in Mombasa, a coastal city on the eastern coast of Kenya, I meet Geoffrey, a tall 27-year-old with a shy smile. He invites me into his very modest one-room apartment, barely the size of a closet by Western standards. He boards up the small window after dark for security reasons, he explains, which traps in the moist heat from the nearby ocean. He rolls out a small mat at night where he sleeps.
“There’s no place to sit,” he says.
“That’s ok, Geoffrey,” says Ayesha, an International Medical Corps-trained Community Outreach Worker who is showing me our local Tuberculosis (TB) response program in Kenya. “My place is quite small too.”
We end up sitting on a wooden bench out front with Geoffrey where he explains that his friends noticed he was “coughing a lot, losing weight and was very weak.” After being tested by International Medical Corps, Geoffrey discovered he had contracted TB and needed to immediately begin the long course of treatment.
An infectious bacterial disease that most commonly affects the lungs, TB – like the common cold – is spread through the air from the throat and lungs of infected people. The symptoms of active TB are coughing, sometimes with blood, chest pains, weakness, weight loss, fever, and night-sweats. An estimated 1.4 million people died from TB in 2010, the majority of them in Africa.
The disease is most commonly treated through an uninterrupted course of antibiotics, which typically lasts six to eight months – a large burden on those without accessible medical facilities where they can seek treatment and medicines. Furthermore, the emergence of multi-drug-resistant TB has complicated treatment for many and while it is still generally treatable, patients must undergo extensive chemotherapy as well as costly, second-line TB drugs.
Kenya is ranked 13th on the list of 22 high-burden TB countries in the world and has the fifth highest burden in Africa. TB takes the greatest toll on the most productive age group of 15 to 44 years. Inadequate information about TB and stigma associated with the infectious disease also add to the high incidence rates and inhibit those from seeking treatment.
Through funding from the World Health Organization (WHO), International Medical Corps implemented the TB Reach program in Taita, Taveta, Mombasa, Malindi and Tana River districts in Coast Province. Implemented within the Ministry of Health structures to ensure sustainability, the project aims to reduce the TB burden in Coast through increased community knowledge, early case detection and proper management of TB cases. Based on our previous experience with TB programming, International Medical Corps trained local health care workers to more effectively provide TB diagnostic and treatment services over the long-term. To enhance the delivery of community TB care, International Medical Corps also trained 172 Community Health Workers in community mobilization, tracing TB patients who discontinue treatment, screening for TB and referring suspected TB cases to the nearest diagnostic sites for testing. The skills learned are not only transferable but also have a multiplier effect.
Having completed two weeks of TB treatment, Geoffrey says he’s already feeling better and getting back to his old self. He admits it’s difficult to stay on treatment and get to the clinic to get his medicines, but he credits International Medical Corps with helping him get better and understanding that his condition does not have to be a “life sentence”.