By Dr. Emily Koech
Kenya Country Director
The COVID-19 pandemic reached Kenya on March 13, when a 27-year-old Kenyan woman who had traveled from the United States via London tested positive. The growth of cases was initially slow, but just last week we experienced a surge in cases. Initially the virus was just in Nairobi, which is the capital city and a major port and international center. However, the outbreak is now spread into the countryside. As of today, there have been 621 confirmed cases, 29 deaths, and 202 patients recovered.
Since the beginning of the pandemic, continuity of HIV treatment was a key priority area for Ciheb Kenya. Our programs support health facilities that care for 110,000 HIV-infected clients who are on antiretroviral treatment. We have been ensuring that these patients continue to get their treatment without interruption. With the exception of those who are virally unstable, we have been distributing three-month supplies of antiretroviral medication so that clients do not have to visit the clinic as often. And those who require continued testing are being tested; staff have been working very hard to follow up with clients on the phone.
We also provide support to methadone clinics at the Mathari National Teaching and Referral Hospital and Ngara Health Centre. Treatment at the clinics requires daily interaction, and to help reduce the need for clinic visits we are assisting in developing national standard operating procedures that will either provide patients with by delivering medication to patients via a mobile van. Finalization of these is expected very soon.
We have been working with the CDC to implement infection prevention and control measures at the clinics we support. We have been ensuring that frontline healthcare workers at those facilities have protection, and have been procuring masks, gown, gloves, soap, and disinfectant. We have also been training healthcare workers about how to recognize and manage COVID-19 patients, how to triage arrivals and fast-track chronic cases, and how to immediately isolate those who have COVID-19 symptoms.
We learned the importance of prevention measures at the very start. One of our facilities was where the first COVID-19 healthcare worker case was confirmed in the nation. The facility was immediately closed and had to remain closed for more than a month, because there were no backup healthcare workers to keep it going. What our teams did was to call all clients, and direct them to the nearest facilities where they could get their medication. The shortage of healthcare workers is an issue across Kenya, and along with shortages of PPE and test kits, are among the key challenges we face in combatting COVID-19.
In terms of testing, we have been helping identify labs around the country capable of testing for COVID-19. In the western region, we have been conducting on-site physical assessments of those facilities to verify they have the necessary capacity.
Kenya has experience with disease outbreaks, e.g., cholera. These outbreaks have become almost accepted as a part of life. COVID-19 is different. There is a greater sense of fear and uncertainty. At the same time, the public is not adhering to social distance rules despite the fact that Kenya is in lockdown. This will have to change if we are going to effectively control the spread.
Country Director Emily Koech, MD, is a physician and public health specialist, with 14 years of experience with HIV programs at the national, regional, and facility level. She was an antiretroviral officer and program manager for the Kenyan National AIDS and STI Control Program (NASCOP) during the successful rollout of antiretroviral therapy in the country’s public sector.