Over a century later after Tuberculosis has been in existence, it is still enshrouded in myths and misconceptions especially in the rural areas of Kenya. This has led to TB patient to delay in seeking treatment while others misdiagnose themselves putting them at a higher risk of developing the deadly strain of Tuberculosis that is multi drug resistant TB or MDRTB.
During a field trip to Wote in Makueni, the thing which came out strongly to me is that despite the successes achieved in TB advocacy in the area, communities still need to be sensitized on TB awareness its primary cause and mode of transmission.
In this area it is interesting to note that people are still not fully aware of TB’s mode of transmission. For most of the residents in the area, TB is caused by witchcraft and cold. It is not uncommon to find mud and grass thatched huts with no windows or any opening besides the door. This measure which is meant to keep the cold wind away from the family has and can be very dangerous in the long run because it fuels rather than control the spread of TB.
Inside the hurts it is naturally dark that you cannot see your hand when you close the door even during the day. Besides this the huts are stuffy probably due to the fact that there isn’t a fresh flow of clean air. This environment is conducive for many disease causing agents and if not addressed or measures taken up to enlighten, educate the people then TB cases will not stop in the area and cases of re-infection will also increase.
Witchcraft is also believed to be a cause of Tuberculosis in the area. Most residents will therefore go to witchdoctors to break the evil spell and heal them. It is not uncommon to find TB patients taking local herbs and remedies alongside the conventional anti- TB regimen for psychological effects.
KANCO through local groups like the Wote Youth group have been conducting TB awareness campaigns and has been supporting them to advocate for TB and do TB related activities such as patient support, defaulter tracing, and community sensitization.
One of the people who has directly been receiving assistance from this group which does TB advocacy at the community level is Mutheu*. At first when you look at her you could easily mistake her for a young girl in her teens, however, she is a mother of four and her story is as sad like all the other stories.
She was just an ordinary homemaker who took care of her family in their family home. Her TB first manifested as a cough which she dully ignored despite advice from her peers to get treatment. She thought maybe it was a result of the hard chores such as carrying firewood and water on a hilly terrain that was causing her to chest pains and the cough. However with time, the symptoms did not go away and so she went to the next best remedy that she could think of, and that was local herbal remedies from the local herbalist or witchdoctor because to her and her husband, she had been bewitched or looked at with an evil eye.
This too did not bear any results because she continued coughing, finally though she was taken to hospital where she was examined and diagnosed with Tuberculosis. After completion of her treatment, her husband blocked all the windows in their house because to him his wife had become infected with Tuberculosis as a result of the cold wind and the only way to stop this from recurring was to block up all the windows.
Shortly after Mutheu became sick again and this time she was tested for her HIV status and she was found to be HIV positive. She lost weight was bedridden; she could not walk on her own and had to be supported. Unfortunately for her the Tuberculosis recurred and she had to again take TB medicine which she did and finished successfully.
Currently she is well and living positively having finished her anti Tb drugs and has been set up a small kiosk by her husband where she sells basic foodstuffs. She is yet to fully recover but the windows in her house are still blocked.
Is this an area of intervention? Mutheu and her husband are not the only ones who have this belief in the area. Looking at most houses in the vicinity the first thing you will notice if you are observant is the fact that the houses do not have windows and if they do have then they have been blocked and cannot be opened.
This is very dangerous considering the known and documented facts about Tuberculosis transmission. It is known that the TB germs nourish in dark stuffy areas, so what should be done to sensitize these people to change their perception? Are the TB advocacy programs not effective as such?