By Enock Marita, Knowledge Management/Research Officer – Amref Health Africa
A five-year-old boy in Busia town is taken to Busia Hospital for wound treatment. On that evening, he develops a fever and looks weak.
His mother, thinks of returning him to hospital, but because it is raining, she cannot imagine being rained all the way walking for about two kilometres. She remembers this Community Health Worker (CHW) who has been visiting to check on their wellbeing.
She decides to call him against the counsel (via phone) of the husband, and within no time, the CHW is in their house despite the rain, and with no umbrella. The mother quickly explains to him the condition of the boy.
He observes the boy, takes his medical history, and opts to do a Malaria rapid diagnostic test, which turns out positive. He then prescribes and provides antimalarial drugs – Artemether Lumefantrine (ALs) for free, and even waits and watches him take the first dose. The house help who has been not feeling well also tests positive for Malaria, and the CHW gives her the drugs as well.
He counsels them on malaria prevention, emphasising the need to adhere to the prescription. After he’s done, he humbly bids them bye and leaves even though it’s still raining. The next day he passes by to check on the progress of his patients. He encourages them to complete the dose despite the improvement. He keeps visiting to make follow up and ensure the patients are on course with the medication.
On receiving the good news, the father who was initially against the boy’s mother seeking services from the CHW does not believe how he (CHW) has attended to his family.
A few days later, the boy’s 3 year old sibling also falls sick and shows signs and symptoms of Malaria. Now the father asks the mother to call the CHW. As usual, the CHW promptly comes, assesses the boy carefully following all the protocols, and just like the others, he prescribes medication after testing.
All this time, the boy’s father is keenly observing although he seems to be busy reading a newspaper. They have a quick chat, and finally the dad retorts, “I am satisfied with your work, and may God bless you for the services you offer to the community.”
Meet Charles Kariuki Mwangi, the CHW from Busia town who recently turned 90 years.
He belongs to Mjini Community Unit, Bulumba B Village within Busia, a town located in the Kenyan boarder with Uganda. He takes care of 989 households against the recommended average of 100 households.
Amref Health Africa with funding from Global Fund, support CHWs such as Kariuki to provide community case management for malaria in former Western and Nyanza regions of Kenya. Together with local partners, Amref has trained over 7,500 CHWs on uncompleted malaria management and equipped them with knowledge to help them offer services in their respective communities with support from Ministry of Health (MoH). Over 350 community health extension workers (CHEWs), who are MoH employees, have also been trained to supervise CHWs.
Kariuki moved to Busia from Central Kenya in 1950 as a missionary and he has lived there since. He has mastered Luhya and Kiganda dialects in which he freely and easily communicates with the residents. He has been a CHW for thirteen years.
We meet him at his home. Upon visiting, he goes on with his chores, looks strong and boasts of endeavouring to visit all his households in a month. He warmly welcomes us and is ready to take us to the households where he works.
“I still ride my motorbike and I love to strictly adhere to traffic rules,’’ he says as he cautions us to park off the road.
We ask him what really keeps him moving despite the advanced age. He is quick to respond: “Deep down in me, there is strong urge to leave a legacy and encourage the young people to diligently work for their people. If I did not have a good record, then you could have not come to visit this place.”
We learn that he had not been paid his monthly stipend for over six months. But this does not deter him from carrying out his duties even in difficult times like when it’s raining. Indeed, age is nothing but a number.