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Kenya, 19 December 2016: A community health worker empowers his community to fight disease

© UNCEF Kenya/2016/Duale
Banda B. (Centre) with Community Health Volunteers from the Sera Community Unit, sorting out supplies that will be used in cholera response activities in Sera Dispensary.

By Bibi Mbete and Ayub Duale

Tana River, Kenya, 19 December 2016 – It is early morning in Garsen Town where we are part of a UNICEF team that has travelled to Tana River County to provide technical support for disease outbreak preparedness and response to the County Health Department following a cholera outbreak. After a brief meeting with the Sub-county Medical Officer of Health at Garsen Health Centre, we decide to embark on a joint visit to health facilities in Sera Division to assess and monitor the situation.

Accompanying us as an enthusiastic young man wearing jeans, a short-sleeved shirt and black gumboots. “Meet Banda B. Makorani,” says David Ndumary. The Public Health Officer in charge of Sera Division. Banda B., 32, is a Community Health Extension Worker (CHEW) and holds a diploma in Community Health. He has been attached to the Sera Community Unit for the last 2 years.

After quick introductions, we set off with Banda B. to Sera Dispensary, located 21 kilometers from Garsen Town. Within an hour we arrive carrying supplies that will be crucial to the response activities. As we enter the dispensary we are met with a scene typical of a facility grappling with a serious disease outbreak. There are many people inside milling around seeking assistance for their loved ones. In one of the rooms, an 18 month-old child is on a drip, resting on the arm of his mother, as the only nurse at the facility rushes out to look at a new case that has just been brought in from Kurole Village.

The first cholera case in the village was recorded on Sunday, 18 December 2016. Banda B. recalls this day vividly as he narrates his first encounter with the disease. “It was a cold early morning when suddenly my phone rung and I noticed the call was from one of my Community Health Committee members who lives in Abaganda B Village.” Banda B. says he was informed that an old man’s illness had taken a turn for the worst. “They told me that the mzee was complaining of sharp stomach pains and was vomiting continuously and that they were completely helpless,” he remembers.

He immediately got on his personal motorbike and rode for over 30km to the village where he found the patient on the floor gasping and vomiting excessively. Banda B. says, “It was painful to see him like that but I knew that I had to act fast and rush him to the nearest health facility. All we could do was place him on my motorbike and move.” It took them an hour to reach Garsen Health Centre where the nurse confirmed to Banda B. that the patient had tested positive for cholera. “This news sent shivers down my spine since I was never trained on how to control cholera, yet I knew my community unit relied on my skills and knowledge,” said Banda B.

Banda B. knew that cholera risk factors were present in his community as all community members practiced open defecation while handwashing practices during critical times remained low. Additionally, the entire community relied on unsafe water that they fetch from the Tana River. Soon thereafter he underwent extensive training on how to handle cholera cases in the even that they occurred.

After handing over the jerricans, buckets, soap and water purification tablets that we came with to the nurse in charge at Sera Dispensary, Banda B. guides us outside the building to meet a group of people seated under a nearby tree. He informs us that they are a mix of Community Health Volunteers (CHVs) and residents who have come for a community dialogue session. During these sessions the CHVs engage with county health workers and the community to conduct sensitization exercises on various health topics. Today’s meeting focuses on good hygiene practices and water purification to prevent water-borne diseases like cholera. Residents of the area have found the lessons given, especially the one on water treatment, to be to be very useful. Bathi Idriss, from Sera says, “Before we used to feel shy when giving river water to important visitors from town. But now, we feel confident giving them clear and safe water to drink.”

© UNCEF Kenya/2016/Mbete
Banda B. at a community health dialogue session at Kurole, Sera Division. The sessions include demonstrations on how to treat water collected from the Tana River using purification tablets.

In addition to facilitating community dialogues, Banda B. treks daily from his home in Garsen to Sera Division to supervise and work with his CHVs in undertaking hygiene promotion activities. He hopes his community will adopt good hygiene practices. “I knew something had to change at the community level now that I had water and sanitation hygiene supplies and information and education materials supplied to us by UNICEF. This made me confident because I felt that I had the right tools,” he says.

Banda B. rides his motorbike from Garsen Town to conduct health education and sensitization activities in the villages supported by his CHVs. He is well known and respected in his community where the impact of his work of creating hygiene awareness has been felt. This is expressed by Halima Olow, a mother who recently recovered from cholera in the village. “I will take care of my children while remembering all that I have learnt from Banda B. and his team. I will show them how to closely follow the handwashing steps and ensure that I store my treated water, in clean jerricans or buckets provided to us by UNICEF and even buy more from Garsen Town,” declares Halima.

At the end of the day as we leave Kurole and head back to Garsen, we say goodbye to the CHVs and members of the community feeling positive that the response activities currently underway will lead to the control of the cholera outbreak in the region. These efforts can only be achieved through an effective community strategy involving the county government, CHVs and households.

We salute Banda B. and all health workers across the country, who continue to dedicate their time and expertise in ensuring the well-being of their communities.

UNICEF, ECHO and the Government of Kenya are working together to scale-up preparedness, preventive and life-saving interventions for water-borne disease outbreaks due to El Nino weather conditions in 2015 and 2016 with a focus on ASAL and other high-risk counties.



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