Meeting a Client in her Home

Day 3 continued

After leaving St. Stephen’s School, we drove to a local clinic and picked up a community health volunteer, Mama Agnetta, as well as the local government community health extension worker (CHEW) named Steven and drove to visit a client.

The roads we were driving on got smaller and smaller until it was essentially a path between fields growing corn and beans. When we got to a little shop, we parked and began walking. It was about 10 minutes to Evaline’s house, down paths between more fields—this part of Kenya is quite lush and all the fields had corn reaching about 2 ft high, with beans planted in between the corn. The house was larger than many I’d been to. It had a relatively big sitting room—which I suspect had extra chairs brought in for our visit—and a bed room, a packed dirt floor swept clean. And small windows that opened for ventilation.

[walking to Evaline's compound]
Mama Agnetta had heard that there was a woman who was house-bound when was visiting other people in the community about 2 years ago, and she came by to pay her a visit. Evaline says that her husband was living in Nairobi and her family had abandoned her when she became sick. Her . Mama Agnetta helped get Evaline to the Matibabu Clinic in Ukwala and advised her to get an HIV test while she was there.

When the test showed that Evaline was HIV positive, Mama Agnetta counseled her and talked about how to take care of herself and the importance of good nutrition. She arranged for Evaline to get multivitamins and other nutritional supplements and to get regular check-ups. When her CD4 count reached 120, Mama Agnetta helped Evaline go to the government's Community Care Clinic, across the street from Matibabu’s clinic, to get her antiretroviral drugs (ARVs). Today, Evaline credits Mama Agnetta with saving her life.

[Evaline says that Mama Agnetta, right has saved her life]

Visiting Evaline was very inspirational, and it was particularly interesting to hear how Mama Agnetta feels supported by Matibabu and how she’s seen the community change since CHWs began working in force. For example, the Kenyan District Health Office labels this area as prone to cholera. But in Ukwala, since the CHWs have been trained, there has not been a single case of cholera.

Mama Agnetta was a traditional birth attendant (TBA) for many years, and was even trained by the CDC as a “TB ambassador.” But as a CHW she is better able to address holistic needs of people in the community. She gives basic health information on health concerns ranging from diarrhea and worms to malaria and HIV, but more importantly, she knows when to refer someone to the health facility and can help clients negotiate what’s needed once they get there.

When asked what she thinks CHWs need, Mama Agnetta was quick to respond. “We need more CHWs who are trained [currently each CHW has about 20 households s/he is responsible for], and we should be more deeply trained in key areas.” She knows they can learn more—even though many of her colleagues are illiterate. Mama Agnetta also said that the CHWs need transportation—a bicycle—so they can get around more easily. All CHWs do their own chores and work in the mornings, in their home or on their farm, and then volunteer in the afternoons. A bike would certainly make their job easier. But few donors want to give funds for that kind of purchase. Philip is trying to find a way to help—though his hands are often tied, too.