Community volunteers help gold digger to overcome TB

After losing his job at a factory in Nairobi, Danson Imbale, 53, returned to try his luck at mining gold near his rural home in Kakamega County.

Although he had been away for over 20 years, he quickly fitted in among the artisanal gold miners. While in the city, he had learnt carpentry and helped to build support structures for mines, spending hours in the deep, narrow underground shafts.

With the proceeds from his work, he bought low-grade ore, which he panned at home for gold. The future looked bright until he suffered a double tragedy. His wife left him, taking with her four of their children and the few tiny pieces of gold he had accolated. Then he got very ill.

The illness started with a cough that he blamed on his smoking habit. The cough persisted for over two weeks. He lost weight and started getting night sweats and pain in the chest. 

“One day I opened the door, fell and couldn’t get up. My sister-in-law came to my help and gave me money to go to the hospital.”

At the local dispensary, he was given painkillers and three injections over several days. The chest pain got worse. 

“I had no money for treatment, so I stayed at home, hoping that the illness would just go,” says Danson.

“The chest pains got worse and I felt as if there was a big lump, but I did not have money and stayed at home,” says Danson. “I used over 10 small tins of liniment, but the chest pain only got worse. I couldn’t understand what type of illness had struck me.”

A community health worker, who heard about Danson, visited the home. After asking a few questions, the CHV produced a tube from his bag and asked Danson to provide a sputum sample.

The CHV, Jacob Miheso, had been trained to safely collect samples, pack them into a cooler box and take them to a health centre for onward transportation to a GeneXpert hub for analysis. He is attached to Community Support Platform (CSP), an Amref Health Africa Global TB Programme sub-recipient. 

The test results were positive and the CHV took Danson to a health centre where he started treatment for TB.

“The medicine helped and finally I could sleep well,” he says. 

Danson was given a therapeutic porridge.

“Sometimes, meals delayed and they used to prepare it for me to take before swallowing the pills.”

Every two weeks, he went to the health centre for checks until he completed the six-month treatment and returned to work.

“After learning about TB, I realised that I could have been infected by a friend at the mines with whom I shared cigarettes. I have stopped smoking and tell my friends how to prevent the spread of TB.”

During contact tracing in the mines, health workers identified a patient with multi-drug resistant TB, who had interrupted his treatment. 

Community  Support Programme (CSP) works with the Kakamega County’s Department of Health to conduct targeted outreaches to gold mines to offer health education, screen workers for TB and refer those with symptoms for treatment. CSP also implements a TB education outreach intervention involving health clubs in 75 schools. Through this intervention, which is one of the innovations under the Amref Global Fund TB Programme, teachers have been trained as TB champions and 177,000 students have been screened. Teachers work with community health workers to trace the contacts of students found with TB.