CHW determined to eliminate Trachoma in Kenya through cross-county referrals

When Stella Longori, a resident of Suguta MarMar in Samburu County, decided to become a Community Health Worker (CHW), she thought the knowledge gained would only serve her immediate community. A couple of years later, and upon receiving training on Trachoma, through Leap, the mHealth platform, Stella not only helps her community but also serves communities from other nearby counties.

 

“I am happy that I can reach so many people, and help Kenya, not just Samburu County, get rid of Trachoma,” she states happily.

Trachoma (TT) is an eye disease that is highly transmittable. Caused by the Chlamydia Trachomatis bacterium, the eye condition is characterised by poor hygiene practices. Samburu County has one of the highest prevalence rates of TT in Kenya. The county’s prevalence rate among children below age 9 is 35%. Among people aged 15 and above, the prevalence rate stands at 6% for blinding TT. In order to eliminate TT in Kenya, WHO recommends less than 10% and 1% for the two age categories respectively, for control, and less than 5% and 0.2%, for elimination.

Stella’s journey to help the over 19% Kenyans suffering from Trachoma, a highly infectious eye disease characterised by poor hygiene, actively began when she attended a health outreach. “From where I stood, I noticed a group of women who had sat under a tree. There were very many flies around them, and thinking back to the lessons I had already received on Trachoma through Leap, I decided to go and speak to the elderly women,” explains Stella.

When Stella approached the women, three of them covered their heads with their scarfs. She introduced herself according to the Samburu culture, and asked the women if they were feeling okay. “They told me they are fine, but their eyes hurt. To them, the pain was normal as they had seen so many elderly women suffer from the same,” Stella narrates.

A few weeks before the outreach, Stella joined several CHWs in Suguta Community Unit and was introduced to Leap. The platform runs on the most basic of phones, making it very scalable. Trachoma is one of the numerous topics that are currently being taught through the mobile platform.

Stella was able to convince the women to allow her to inspect their eyes, just to make sure they were okay. “I was able to confirm that three of the women had Trachoma. Their eyes were red with swollen eyelids; their eyelashes were turned inwards; and they all had pus in their eyes,” she explains. Stella referred the three women to an eye camp, where they were assessed and qualified for surgery.

Stella’s esteem grew stronger after the successful surgeries. Happy about her achievement, she went to her local church to speak to the community on prevention and treatment of Trachoma. “I was confident to speak about the condition as I had success stories on the treatment of the disease. I was also keen to mention how Trachoma is linked to hygiene and urged the community to always keep clean,” she adds cautiously.

Two days after her speech in church, Stella received a call from a lady she did not know. “She told me her name and said she had heard me speaking about Trachoma in the church,” Stella reveals. What struck Stella the most was the fact that the lady was not even from Samburu County, let alone from Suguta MarMar! “She was calling from Meru County, which is about 250 kilometres away!” she narrates.

The lady, Esther, informed Stella that she suspected her mother was suffering from Trachoma as she had all the symptoms Stella had highlighted in the church meeting. “I was skeptic about diagnosing her through the phone. But I had seen the effect of Trachoma and was not comfortable knowing her mother was suffering,” Stella explains. She asked Esther to tell her the symptoms her mother showed and even went further to speak to the patient.

“I agreed that indeed, the mother had Trachoma,” she adds. Stella gave Esther’s mother a referral to Maralal, where an eye camp was being conducted.  “Esther accompanied her mother and I met them at the eye camp. She was assessed and qualified for surgery, and can now see very well,” Stella states happily.

Amref Health Africa, in partnership with Sight-Savers through the Kenya Elimination of Trachoma Programme, has trained 336 CHWs on Trachoma, in a pilot project, through the Leap mHealth solution. Leap, an innovation by Amref Health Africa, allows partners to train CHWs on different health topics in an easy, efficient and effective way. Through strengthened support, peer collaboration and continuous learning, Leap empowers CHWs with knowledge on health issues that affect their communities by providing a platform for learning that runs on the very basic of phones. CHWs are able to learn, interact with each other and with their supervisors and also sit for exams through their mobile phones.

Through Leap, and CHWs such as Stella, the 8 indicators of success for the pilot project have been achieved. The number of community members screened for TT surgery has indeed increased. Also, the number of referrals for TT surgery by the CHWs in the region has gone up. Importantly, the number of referred clients who have been confirmed to be TT positive has also gone up.

To Stella, her fight against Trachoma continues and her passion to ensure that the over 2.7 million Kenyans still under threat of Trachoma are educated on preventive measures. “Two days after Esther and her mother went back to Meru, I received two calls from her neighbours in Meru inquiring about Trachoma. I am pleased that the training I got was relevant. I am also pleased that the training was flexible enough to allow me to study and understand the concepts without necessarily going to a physical class. I thoroughly enjoyed using the Leap platform, and the group chat. It is due to the quality of training I got that I can now refer people from as far as Meru County,” she concludes.

 

To learn more about Leap, visit Leap health mobile

 

Story by: Michelle Dibo – Communications, Amref Health Africa

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