Naitwati Antunyoi’s face shows it all; despair, hunger, pain! The 30-year-old mother of three treks 20 kilometres each day to access treatment for multi-drug resistant tuberculosis (MDR-TB) that doctors recently diagnosed.
MDR-TB is caused by an organism that is resistant to at least two most powerful first-line TB drugs, Isoniazid and Rifampin, and is deadlier than ordinary TB.
Never mind that she is hunchbacked. Antunyoi, who says a meal a day is a luxury, carries along her sons aged four and six years, who like their mother, are victims of MDR-TB.
The 10km journey from Segera Mission Clinic in the semi-arid depths of Nanyuki town, Laikipa County, is even more agonising for the trio, which has to endure the aftermath pains of the jabs all the way back to their shanty at Poise village.
“I have covered five of the eight months required for the TB jabs. My sons have done only three. The pain is excruciating, sometimes I want to quit this treatment,” says Antunyoi who keeps flinching due to the pain on her behind. Her husband, who is hardly at home, will return to demand for food and squeeze into their poorly ventilated six by six metres house that leaks when it rains.
She says that on some days she lacks the energy to walk to Segera Mission and rests at home, hoping that a nurse will be sent from the facility to attend to her family. Aside from the MDR treatment, the other reason she finds strength to trek daily to the hospital is the free meals she enjoys with her sons at the facility.
Antunyoi and her sons represent the three MDR-TB cases handled by Segera Mission alongside another 20 ordinary TB cases.
“We make follow ups on their nutritional needs, feed them at times and hold frequent barazas to educate them on TB and HIV,” says Serge Musasilwa, the director at Segera Mission.
The hospital can be described as an oasis in the middle of nowhere. It is about 40kms from Nanyuki town and was founded by US national Carlton Cleason in 2002 when he first visited Kenya.
Malnutrition, animal/human conflicts and insecurity are the biggest challenges facing the community around the facility which seats on 36-acres and borders River Ewaso Ng’iro. Angela Wali, a nutritionist, explains that TB waste away muscles and fat yet the treatment requires both in order to be effective.
“If you have TB and you do not eat well, tolerance to the treatment will be very poor. Remember, the drugs have side effects such as nausea and vomiting,” she says.
TB is strongly associated with poverty and patients and households affected are likely to be caught up in a ‘‘medical poverty trap’’ — a situation where treatment expenditures increase as income levels decrease.
According to the National Strategic Plan for Tuberculosis, Leprosy and Lung Health 2015-2018, over half of TB patients are malnourished at the onset of treatment.
In an effort to change this state of affairs for the community dominated by people of the Turkana, Samburu and Ndorobo ethnic groups, Segera Mission has made it a priority to educate people on nutrition, agriculture and water harvesting.
To cater for the nutrition needs of the community, the facility has constructed pans with capacity to hold between one and two million litres of water each.
This is the water that residents use to irrigate their gardens and stallholder farms where they grow vegetables, beans and maize.
Aside from this, the mission runs a water supply programme where each household gets at least 40 litres of drinking water twice a week.
“It is easier and cheaper to supply them with water rather than wait for them to fall sick and have them come to the clinic where we spend a minimum of Sh10,000 on every patient,” said Mr Musasilwa.
Patients throng to the hospital for free treatment. Mondays are reserved for the malnutrition programme, Fridays for immunisation campaigns while the pre- and post-natal care programme runs in the course of the week.
For Antunyoi and her sons, it is this access to medication and good nutrition that gives them hope of a better tomorrow. While patients with ordinary TB are put on oral treatment for six months, those with MDR-TB are subjected to jabs for a period of eight months.
MDR-TB is fuelled by improper treatment of patients, poor management of supply and quality of drugs, and airborne transmission of bacteria in public places.
The bacteria thrives in areas with poor ventilation hence those living with the disease risk the lives of people around them.
In Antunyoi’s case, both her husband and daughter are at risk and require screening to start them on preventive treatment.
The 2017 Economic Survey lists TB as the number five killer in Kenya behind malaria, pneumonia, cancer and HIV/Aids.
Deaths caused by TB dropped by 54 per cent from 10,183 to 4,735 between 2015 and 2016, thanks to government intervention.
Early this year, the Ministry of Health unveiled results of the National TB Prevalence Survey, the first of its kind since Kenya attained independence in 1963.
The survey shows that four out of 10 Kenyans suffering from TB are unknown, which could be fanning the spread of the disease in the country.
The study shows that out of 138,105 Kenyans who contract the disease every year, only about 82,000 are captured by the health system.
In 2015, before commissioning of the study, the prevalence of the disease was thought to be 233 cases per every 100,000 Kenyans.
However, the fresh data shows that it is 558 infections per every 100,000 people.
In 2015, the World Health Organisation (WHO) estimated that there were 480,000 new cases of multidrug-resistant TB globally.
Kenya is among the 14 high burden countries with TB and HIV co-infection.
While the number of TB cases declines, the government is still mulling on how to bring the contagious disease under control.