In four counties of western Kenya, a silent but intense battle is being fought against two ancient and debilitating diseases, schistosomiasis (commonly known as bilharzia) and soil-transmitted helminths (intestinal worms). These neglected tropical diseases (NTDs), often overlooked in global health discussions, disproportionately affect the most vulnerable, trapping them in cycles of illness and poverty. However, in Kakamega, Bungoma, Vihiga, and Trans Nzoia, a groundbreaking initiative led by Amref Health Africa is changing the narrative, providing hope and treatment to millions.
In these counties, millions of people face the constant threat of bilharzia and intestinal worms. These diseases thrive in areas with poor sanitation and limited access to clean water, leading to long-term health problems. bilharzia, transmitted through contaminated freshwater, can cause severe organ damage, while intestinal worms spread through soil, leading to malnutrition, anemia, and stunted growth in children. Both diseases are preventable and treatable, yet they continue to afflict millions, particularly in rural communities.
At the forefront of this effort is Gentrix Mtunguti, a 29-year-old mother from Namasanda A village in Bungoma County. Her life revolves around her family, where she dreams of a healthier future. When community health promoters arrived at her doorstep with Mebendazole and Praziquantel medicines that would protect her family from intestinal worms and bilharzia, she welcomed them with open arms. The cost of these medications had been prohibitive for her, and she would only have sought them out when critically ill.
“I’m happy they brought the drugs to my home,” Gentrix says, cradling her youngest child after a bath. “I know these diseases are real, and I want my family to be safe. There are myths, like people saying the drugs are for family planning, but I encourage my neighbors to take them. The professionals know what is best for us.”
Gentrix’s story is not unique. Thousands of families across Western Kenya benefit from the massive Community-Based Mass Drug Administration (MDA) campaign, which delivers life-saving treatments door-to-door. Behind this effort is a well-coordinated operation driven by health workers, government officials, and international partners, all united by a shared goal to eliminate these diseases by 2030.
Bilharzia and intestinal worms are more than just diseases, they are signs of deep-rooted health inequities and poverty. Both thrive in communities with limited access to sanitation and clean water. The World Health Organization (WHO) has set an ambitious target to eliminate these diseases as public health threats by 2030. However, in Western Kenya, Amref Health Africa aims to interrupt transmission by 2027, three years ahead of the global deadline. The strategy relies on preventive chemotherapy, distributing medications like Mebendazole for intestinal worms and Praziquantel for bilharzia to entire at-risk populations.
Dr. Meshack Ndirangu Wanjuki, Country Director of Amref Kenya, underscores the scale of the December 2024 campaign: “This MDA targeted 5.1 million people for intestinal worms and 1.3 million for bilharzia across 142 wards. It’s a massive undertaking, but we are committed to ensuring no one is left behind.”
The MDA campaign requires careful coordination at all levels of the health system. It starts with macro-planning at the national level, where officials determine drug quantities and allocate resources to counties. At the county level, health workers and community health promoters are trained to deliver medications directly to households.
Technology has revolutionized the fight against NTDs. Community health promoters like Shamim Nyangala Mohammed now use the Electronic Community Health Information System (eCHIS) to track progress in real-time. “With eCHIS, I can instantly record who has received treatment and track progress,” Shamim explains. “This digital innovation reduces errors and ensures no household is left behind.”
“I’m excited to use this technology,” she adds, her face bright with enthusiasm. “It makes our work easier and more efficient. I can click on a person’s name, record the service provided, and submit the data, all without the risk of lost papers or guesswork.”
The campaign also benefits from the generosity of pharmaceutical companies like Johnson & Johnson and Merck, which donate medications through the WHO. These partnerships are vital, ensuring life-saving drugs reach even the most remote communities.
Irene Chami, Director of Programs for the END Fund, highlights the importance of collaboration: “Our mission aligns with the WHO roadmap to eliminate NTDs by 2030. We work with governments and partners like Amref to improve the health and well-being of those affected by these debilitating diseases. Success is only possible through a multisectoral approach focused on sustainable solutions.”
While significant progress has been made, misinformation remains a significant challenge. In some communities, people fear that deworming drugs are a form of involuntary family planning. To counter these myths, Amref, in partnership with the national and county governments, has launched a comprehensive social mobilization campaign. This involves engaging local leaders, religious groups, and schools to dispel myths and build trust.
Patrick Nyaieka, Subcounty NTD Coordinator in Navakholo, has witnessed the impact of these efforts. “We trained 70 community drug distributors (CDDs) to use eCHIS for real-time reporting,” he says. “They’re the bridge between the health system and the community. When people see their neighbors delivering the drugs, they’re more likely to trust the process.”
Dr. Debra Mulongo Barasa, Kenya’s Cabinet Secretary for Health, underscores the value of grassroots efforts. A former community health promoter herself, she reflects, “I started as a CHP, testing for HIV and encouraging people to take their medication. Today, CHPs are the pillars of our health system. They stay in the community, know the families, and play a crucial role in bringing health to the people.”
The MDA campaign is more than just a health intervention, it is a step toward a brighter future for Western Kenya. By eliminating these diseases, the region can break the cycle of poverty and unlock its full potential.
Ayub Savula, Deputy Governor of Kakamega County, stresses the importance of community involvement: “We’ve established 12 primary care networks (PCNs) to enhance service delivery. I encourage every member of the community to participate in this exercise. Together, we can break the cycle of transmission.”
The fight against NTDs is far from over, but the momentum is undeniable. With every dose administered, every community mobilized, and every life transformed, Western Kenya is moving closer to a future where bilharzia and intestinal worms are no longer public health threats. The key to success lies in sustained government investment, community participation, and continued innovation. Together, we can turn the dream of elimination into reality.
“Addressing NTDs not only saves lives but also unlocks economic opportunities. Let’s work together to make universal health coverage a reality for every Kenyan,” says Dr. Barasa.
As Shamim, the community health promoter, puts it, “I can’t wait for Friday to come and start the MDA. I’m ready,” and so is Western Kenya ready to heal, thrive, and claim its future.
Author: Faith Mutegi, Communication NTD Pgramme, Amref Health Africa in Kenyas