- Solomon Turkei realised his medical knowledge was not the only set of skills needed to take care of his patients.
- Healthcare workers in far-flung areas have had to adopt roles that they did not train for to achieve desirable clinical outcomes on their patients.
- Mothers accompanying their sick child carry with them the other children because they have no one to leave them to.
- At the hospital, even though it breaks the hospital’s budget, Turkei allows that they are all fed.
The heat in Kacheliba is at 32 degrees celsius, and it is licking people’s dry faces. It is coiled around their limbs like a great hot-blooded serpent, but in this heat, the heart of clinical officer Solomon Turkei is cool, calm and at peace.
While all healthcare workers approach their work with an attitude of ‘it is a matter of life and death’, Turkei’s is a lot more serious, and borders on humanitarian work, and for that, he realized his medical knowledge was not the only set of skills needed to take care of his patients.
Turkei— known to his colleagues as Turkey— is the medical superintendent at Kacheliba Hospital, the only of Kenya’s two hospitals that treats Kalaazar, a little known disease transmitted by sandflies, which attacks organs and kills if not treated on time. Apart from Kacheliba, there’s only a clinic in Baringo and another hospital across the border in Uganda.
The disease is one of the 18 diseases that the World Health Organisation (WHO) classified as “neglected tropical diseases” (NTDs). In Kenya, the Head of Neglected Tropical Diseases at the Ministry Dr Sultani Matendechero reports, that it threatens more than 600,000 people in Turkana, West Pokot, Baringo, Isiolo, Baringo, Marsabit and Wajir.
First, Turkei has had to budget for food for extra people that often accompany the patient. The treatment for Kalaazar requires daily injection for more than two weeks, and to avoid defaulting, they are often kept in the hospital. It is not advisable, and in this case, patients cannot be asked to come for the daily injections. Mothers accompanying their sick child carry with them the other children because they have no one to leave them to.
The clinician told Nation that patients travel as far as 400 kilometres seeking care when symptoms—severe fever for more than two weeks, weight loss and fatigue, swelling of liver and spleen— set in. It does not help that West Pokot records the highest malnutrition rates in Kenya, next to Kitui according to the 2014 Kenya Demographic Survey. With poor nutrition, he says patients’ immune systems runs so low that they fall victim to severe anaemia. In that undernourished state, they become defenceless to infections such as pneumonia and Malaria which as are endemic in West Pokot. If not organ failure, they would die of other diseases.
HEAVY BURDEN OF DISEASE
Eunice Chemanang’ for instance, travelled with her two children from Akulo at the periphery of Baringo-West Pokot County borders. She travelled with the youngest of her child, because she had no one to leave him with. She left the oldest with a family, and at the hospital, she told Nation: “I hope they have given him something to eat”. A mother of three who can only afford a meal a day, this journey to save her son’s life impoverished her even more because she had to part with Sh1,700.
“I walked for about four hours to Akorekwang’ then paid Ksh200 from Akorekwang’ to Sigor, and then Ksh1, 500 from Sigor to Kacheliba on a motorbike,” she explained.
At the hospital, even though it breaks the hospital’s budget, Turkei allows that they are all fed.
The management of Kalaazar sometimes requires blood transfusion due to anaemia, and it is not unusual that Kacheliba runs out of blood. When that happens, Turkei has to refer to the nearest hospital, 70 kilometres in Amudat, in the Kenya-Uganda border.
His colleague on the Ugandan side, Dr Patrick Sagaki, treats Kenyans from as far as Sigor. Dr Sagaki, from the Baganda community, has had to learn the key words in Pokot, West Pokot and Karamoja language so that he communicates with his patients. The facility he heads is the only one in Uganda that treats Kalaazar.
As he reviews the medical files in his computer, Dr Sagaki is interrupted by two bubbly boys running and playing around the hospital.
“Stop it,” he orders them, and when they calm down, he apologizes profusely for his “sons”.
The boys are children of one of Sagaki’s patients who travelled for more than 400 kilometres to seek care when her husband abandoned her after she fell sick. The woman, a Kenyan from Baringo County, was suffering from Kalaazar.