MALARIA COMMUNITY CASE MANAGEMENT HUMBLES A GREAT SOLITARY ONE
A story of Alice Kivai Kavele (Community Health Volunteer – CHV attached to Migosi Community Health Unit – CHU)
It was on Thursday, 14th May 2015, when I was doing my household visitation. I visited one of my households I cover, a “Mr. Otieno’s” family – not his real name. His wife wanted me to go and talk to them as a family. She had three children and had miscarried twice and could not use any family planning method other than condoms as was advised by a doctor. She had been advised to take with her, her husband to Migosi clinic for counselling but he refused. Mr. Otieno is a well off man who would not take advice from little penniless individuals. Having found himself in a slum dwelling, He ensured he had minimal interaction with his neighbours, approximately 500 people within the 100 households under my care.
When I entered the house, Mr. Otieno started abusing me while standing outside his mansion and shouting. Being a slum there were many people around who became anxious and came to see for themselves what was happening. The crowd built up and they were looking at me with pity. Some even hulling more insults at me. I could hear them say, “Poor woman, she thought she could get some food from Mr. Otieno’s home...., Today this woman has got the gut of popping at people’s homes
Due to Mr. Otieno’s rebellious nature, the neighbours feared to go in to his house on their own. Furthermore they did not know how to handle a sick person. Having gone through the basic community health services training and a further training on community case management for malaria, it was a golden opportunity for me to prove my worth and I said to myself, “I must make him understand the importance of a CHV”. I dashed out of my house and straight to Mr. Otieno’s home. On reaching, I made the mandatory knock at the door, pushed and entered even before he could raise his law tone voice to say “Karibu” (welcome. He was convulsing and had vomited all over his sitting room floor. On touching his cheeks, I realised he had high fever. I remembered my malaria community case management training class, When I entered the house, Mr. Otieno started abusing me while standing outside his mansion and shouting. Being a slum there were many people around who became anxious and came to see for themselves what was happening. The crowd built up and they were looking at me with pity. Some even hulling more insults at me. I could hear them say, “Poor woman, she thought she could get some food from Mr. Otieno’s home...., Today this woman has got the gut of popping at people’s homes the signs of severe malaria. I quickly checked my CHV kit got some Paracetamol and gave him. I then filled up a referral form, went out to call for a “TukTuk” and off we went to the Kisumu County Hospital. I chose the KCH because here our CHEW and our CSFP had introduced us.
On reaching the facility, I went straight to the consultation room handed over my referral form to the Clinician who ordered my patient to come in. After taking history, the clinician requested for Blood Smear (BS) for malaria test, which was done with the result being malaria +++. He was prescribed for Artesunate and AL s.
Back home I continued taking care of Mr. Otieno, visiting him in his house at least thrice a day for three days during which I was ensuring he took his anti-malarial drugs. Being so weak on the first day, I prepared for him porridge to drink before cooking for him his main meal. Mr. Otieno gave me his wife's number to calls to inform her how I helped him. At this juncture things became so easy for me with Mr. Otieno now accepting to do family planning with his wife as was advised by a doctor. Mr. Otieno’s hard-line stand on community health services waned out and it was a new dawn for him and me. Just after a few days, I went back to Mr. Otieno’s house and found his son, 17 years old coughing. Mr. Otieno asked me what he needed to do to help his son and I asked him to let me take the child to a TB clinic for investigation. TB test revealed that the child was sick with TB. I was assigned Mr. Otieno’s son to do DOT for him, to which I obliged and successfully carrying out
Mr. Otieno is now my right hand man and is assisting me in conducting health education especially to his fellow men. Mr. Otieno, Having become so close to me has left the community members wandering especially after having been chased out of his home with insults. The other Community members have since embraced community health services. Truly, community case management for malaria had finally, humbled this great solitary one.