Kakuma, 21 November 2024 (Public Communications and Media Relations)

For the past seven years, community health promoter (CHP) Donatien Kwizeru has been conducting home visits in the Kalobeyei Refugee Settlement, in Turkana West Sub-county, to screen for and raise awareness about tuberculosis (TB).

Attached to the Kenya Red Cross Society-run Natukobenyo Health Centre, the Burundian CHP has observed significant progress in the community’s health-seeking behavior.

“Healthcare services are now closer to the people, and TB awareness has greatly increased,” said Kwizeru.

Kwizeru is among the 130 CHPs working in both the host community and Kakuma Refugee Camp under the Intergovernmental Authority on Development (IGAD)-TB Project.

Since 2016, this initiative has focused on empowering community health promoters, improving access to TB services, and addressing the gaps associated with its screening, testing, and treatment.

Implemented by the Kenya Red Cross Society, the project takes a community-centered approach to TB prevention, treatment, and care. The organization is also implementing the same project in Dadaab Refugee Camp, Garissa County.

Due to overcrowding in refugee living quarters, residents face a high risk of contracting TB. Refugees account for 60% of all new cases in Turkana West Sub-County. The case notification rate in this sub-county is 241 per 100,000 people, considerably higher than the national average of 154 per 100,000.

Another high-risk area for TB transmission is densely populated reception centers where new arrivals are housed awaiting registration. Oswana Thomas, a South Sudanese CHP at a Kakuma reception center, expressed concern about the heightened risk in these settings.

Turkana West Sub-County Medical Officer of Health (MoH), Joel Lochor, emphasized the importance of a comprehensive approach to TB management.

“One of the biggest contributors to TB treatment default is malnutrition, or a lack of adequate food while taking the medication,” Lochor said.

He called for nutritional support for all TB patients, including those from the host community, as well as children, who are particularly vulnerable.

Last year, 1,019 TB cases were reported in Turkana West Sub-County. Of these, 22% were paediatric cases at the sub-county level, while refugee camps reported an alarming 52% of cases among children.

Most paediatric TB cases involve malnourished children enrolled in nutrition programs or stabilization centers, where they are frequently screened for TB. This highlights the importance of intensified TB screening among adults, as children often contract the disease from someone close to them.

Lochor also stressed the need to strengthen TB services at cross-border facilities, ensuring diagnostic and treatment options for nomadic populations near the Kenya-South Sudan border.

Through Kenya’s National TB Program, the county government has maintained a consistent supply of TB medications. Mustafa Rugamba, a Burundian CHP, stated that drugs are readily available and that CHPs diligently follow up with defaulters to ensure they complete their treatment regimens.

A CHP leader in Kalobeyei, Florence Idiongo, highlighted that follow-up and defaulter tracking are key community-led strategies to ensure treatment adherence.

“Knowing their health status and receiving the support they need has made a big difference in patients completing their treatments,” she says.

She adds that CHPs also assist with other health services, such as tracing immunization and antenatal care visit defaulters, and conducting malnutrition screening and disease surveillance.

Community-led initiatives such as TB champions have assisted in getting more patients. From the host community, Elim Epua is a former TB patient and now a champion who knows the symptoms all too well—weight loss, heavy breathing, and night sweats.

A resident of Kaangura village, 20 kilometers from the health center, he now raises TB awareness and encourages his fellow villagers to seek timely medical care.

Other initiatives, such as songs, have supported the TB health promotion efforts. A song “Stop TB” was composed by Jared Mwati in 2022 when he became a CHP at the Kalobeyei Reception Center. It raises awareness and reduces TB stigma.

As the IGAD TB Project approaches its conclusion in March 2025, Kwizeru is optimistic about the next chapter.

“By working within our communities, we’re saving lives. We’re teaching others how to recognize TB symptoms and showing how early intervention can protect our families,” he said.