"PEPFAR gives health"

PEPFAR Kenya gives hope and health through...

providing testing for tuberculosis and other opportunistic infections

Achieving an AIDS-free generation is impossible without adequately addressing the tuberculosis (TB) epidemic. TB remains a challenge in Kenya, with 90,841 TB cases reported in 2022, and new innovative strategies are required to bridge the TB treatment coverage gap. People Living with HIV (PLHIV) with TB are at least three times more likely to die from TB than TB patients who do not have HIV. To improve survival of PLHIV with TB, the PEPFAR program continues to prioritize HIV Testing Services (HTS) among TB clients for timely diagnosis of TB and HIV co-infection and to ensure initiation of appropriate treatment. Access to TB services at facilities is important to test and treat TB, but it is challenging in sparsely populated, nomadic pastoralist settings like Narok, where distances to facilities are long, transport costs are high, and TB awareness is low. To mitigate these barriers, the PEPFAR program, in collaboration with the County Government of Narok, designed an outreach program to take integrated health services - including TB and HIV sensitization, screening, diagnosis, and treatment - closer to the community through Mobile Outreach vans staffed with medical personnel. Through such innovations, residents of remote villages like Maurice, Ben, and their neighbors can access quality services, and live healthier, more productive lives.



//

(Impact statements taken directly from interviews with Maurice Olekasale + Ben Karia in Olboma village, Sekanani, Narok)

"This boma (village) is a home for our people. We have been born here, lived here, educated here, and it is a culture that we really value. It is the numbers of people in this boma that attracted the mobile clinic … we are really happy that PEPFAR and the Narok County government found it valuable to bring the integrated mobile outreach program here.

Before the integrated program, we would go to Tanzania to seek health services – it was an eight-day journey on foot, through territory inhabited by wild animals and warring clans... Some people would die there, and it was hard.

This integrated mobile clinic has brought us a lot of good help, including for me. When the mobile clinic first came here one year ago, I was among the first beneficiaries. I got tested for HIV and it was negative. Once I knew my status, I was taught how to take care of myself and my family, to prevent getting HIV. We were very happy as a family, once we knew we were HIV negative. At the same outreach, some of my neighbors tested positive for HIV, and they were started on antiretroviral treatment; they are now healthy and well, and they are still in the boma. 

They have also made screening for TB possible here… Before the integrated mobile clinic, we used to take TB patients to Tanzania; they had to stay there until six months had lapsed and you finished your treatment, and then you could finally return home. Some would come back, and some would not; if you died there, you were left there. The other option was to go to Narok County referral hospital, which is about 120km from here and was a really difficult journey because the roads were not paved. It was hard for somebody to look for the transportation to go there, because you also had to take another person with you, and it was so difficult and expensive that people would postpone seeking treatment.

I once took my mother to Tanzania for treatment of TB, and we were more afraid of the rival tribes than the animals, since at least we are used to living among the wild animals. I was also fearful that my mother would not make it there and back again - but thankfully she got better and we made it back.

The most impactful outcome for me is the control of TB we now have in our village… a number of us had TB before, and we were spreading it and infecting one another within the boma. However, for one year now, we have not had any new cases of TB, courtesy of this integrated mobile clinic… I was screened and tested positive for TB one year ago when this mobile outreach was last here, and I was immediately referred to the local clinic for treatment and follow up, and I was also counseled how to prevent spreading it to my family and neighbors in the boma, For me, if I had had to go to Tanzania for treatment of my TB, I probably would not be here today… so it is a big gap that has been filled.

For those who were diagnosed with HIV and TB, they were connected with the local health clinic and given medication, and now none of them are sick. If someone fails to come to the health center to collect their drugs, the clinic brings them here… So right now, you would have no idea who is on treatment for HIV, or who is on treatment for TB, because everybody is healthy... Since the integrated program brought health services to us, we are getting services nearer, better.

Also, the health education has given us a lot of knowledge; everybody now knows how to practice healthy living.

This mobile clinic, the integrated program, and education through health talks is a great help for the Masai community. On behalf of our Olboma community and village, we are so happy about and grateful for this PEPFAR initiative… The mobile clinic and the integrated program have brought services to our boma that we would not have access to otherwise, and it is a godsend opportunity for us. We are very happy and impressed with the mobile outreaches, because it has given us good help… so we really pray that it will not come to an end anytime soon, but that it will continue.”