Community health volunteers in Kilifi County recount traumatic experiences during Kenya's Covid-19 pandemic.
When the Kenyan government announced the country’s first confirmed Covid-19 infections on March 13, 2020, strict measures were taken to curb the spread of the deadly virus.
As measures such as social distancing, isolation, use of face masks and constant hand sanitisation became the order of the day, health workers on the frontline witnessed the horrors of the disease.
Among these health workers were Community Health Volunteers (CHVs).
In Kilifi County, which was among the towns majorly affected during the first months of Covid-19 in Kenya, besides Nairobi and Mombasa, some of the community health volunteers have revealed harrowing details of their experience.
The volunteers were supposed to be on duty without fail, earning a paltry stipend of Sh500 per day of work.
In an interview with Nation.Africa, they disclosed that interacting with the pandemic for the first time was a matter of life and death.
Community Health Promoter Ruth Mbogo during an interview in Kilifi town on Tuesday, November 26 ,2024.
Ms Ruth Mbogo, now a Community Health Promoter (CHP) from the Sokoni ward, narrated that with the pandemic, the days were long, full of fear of being infected by the Coronavirus, psychological torture and stigma from their families and communities.
She narrated how the CHVs were called to a meeting and informed that the Department of Health would engage them in cleaning the Kilifi Covid-19 Medical Complex.
Ready for the task ahead, they reported to the venue as instructed. Before starting the work, they were provided with Personal Protective Equipment (PPEs).
However, the process was horrible and traumatising. They were all first required to strip naked and get sprayed with a liquid before putting on the PPEs.
“We removed all our clothes and jewelry, sprayed with chemical water before putting on the PPEs, and then moved to clean the isolation rooms,” she said.
Anything worn when cleaning the isolation rooms, including innerwear, had to be left behind as a safety measure against infection.
Ms Mbogo described the moments as harsh and scary since they used to clean the isolation rooms with the Covid-19 patients inside.
“We spent the whole day with the PPEs on and sometimes we felt like we were suffocating. There was no communication because we couldn’t identify our colleagues and again we were not even supposed to use the same route more than once,” she said.
She said because it was voluntary work, the CHVs could not raise any complaints but focus on their assignment.
Many of the CHVs were women who were breadwinners for their children. The Kilifi Covid-19 Medical Complex was branded the Red Zone due to handling critical patients.
Ms Mbogo said from cleaning, they were also to follow up on Covid-19 patients in isolation at home.
At the end of the day, they once again had to endure an agonising moment of carefully removing the PPEs to avoid infection and getting sprayed with chlorinated water before putting on their clothes.
Ms Mbogo disclosed that some of the CHVs contracted the virus, and they suffered while struggling alone in their houses.
“If one of us died, people would prepare the burial and that is it. Up to date when we sit and recall what happened during the Covid-19 period… it’s only God who saved us. We were suffering while the community we served discriminated against us because Covid-19 kills.
“This was the lowest moment for us because we felt nobody valued us. We are only important when we are engaged to help but useless when in need,” she said.
The health worker suggested that in a pandemic, the government and partners should always conduct thorough training for CHPs and allocate a budget to cushion them from all risks.
Community Health Promoter Rehema Ngumbao from Sokoni ward in Kilifi North sub-county during an interview on December10, 2024.
Another CHP, Ms Rehema Ngumbao from Kibarani Ward in Kilifi, said they also felt frustrated since all focus was on Covid-19 patients, leaving other patients without proper care at the referral hospital.
In addition, medics did not want to attend to patients without masks which were at the time scarce and costly.
“A patient would be asked to stay away from the hospital until they get a mask yet some were critical and too poor to afford a mask,” she said.
Ms Ngumbao said patients who could not afford masks had to cover their nose and mouth with a cloth to access medication.
Even with their direct contact with Covid-19 patients, she said CHPs were not among those prioritised for vaccination.
“It was difficult for CHVs to access Covid-19 vaccination and every time we would go to the hospital we would find a long queue,” she explained.
Ms Ngumbao narrated that as CHVs went home after work, other medical officers were in isolation at hotels to protect their families from contracting the virus.
After the assignment, they had to follow up on payment of their dues several times.
“We anticipated to be paid our dues in time to support our families but that did not happen, what was left for us was a hide and seek game with many promises that were never honored,” Ms Ngumbao.
Community Health Promoter Khadija Mwinyi from Kibarani ward in Kilifi North sub-county during an interview on December 10, 2024.
Ms Khadija Mwinyi, a CHP from Kibarani ward, said working during the pandemic was the toughest for them even as they had no detailed information about the virus.
She said some of the Covid-19 patients kept spitting on the floor in their presence.
“We worked under the mercy of God because, with the lack of knowledge on Coronavirus and a hazardous environment, our assurance was on the chlorinated water we were being sprayed for our safety unlike the medics,” she said.
According to Ms Mwinyi, after the pandemic, the CHVs have never undergone psychosocial support.
“The community judged us harshly and said we fell sick. You would see them backbiting at us, frowning their faces as we passed by from work and we were greatly affected,” she added.
She said in case of another pandemic that calls for direct engagement of community healthcare workers, the government should humanely treat CHPs and accord them equal treatment as other medical workers.
Kilifi County Reproductive Health Coordinator Kenneth Miriti during an interview at Kilifi County Referral Hospital on Wednesday, December 18, 2024.
Kilifi County Reproductive Health Coordinator Kenneth Miriti, among the first healthcare workers to attend to Covid-19 patients, narrated how the experience left him troubled.
“I was tasked to attend to the first patient that was diagnosed in Kilifi and I had to transfer the patient to a Covid-19 centre in Mombasa. After the assignment, we were supposed to still give care to these patients.
“I (felt) depressed and detached myself from people. I never used to feel safe going home and would go home very late to avoid contact with my children. There was no particular care that I was given,” he said.
Mr Miriti continued to take samples for many people who ended up testing positive for the virus and took care of them in isolation centres, especially pregnant women.
“People never wanted to stay near us and it took a toll on us. I remember I took a lot of alcohol that time to overcome the stress that was being caused by stigma,” he said.
Initially, he worried about his wife, children, and everybody around him.
He and his wife, a nurse, eventually got infected and had to isolate themselves from their children.
“There was a time that we thought we were going to die so we discussed whether we should get a relative who will take care of the children or not,” he said.
Mr Miriti says he still suffers health problems that he had not experienced before Covid-19 and suspects they could be related to the pandemic.
“There was no Medical Insurance cover that took care of my colleagues and their families. If a pandemic came today, it would find us not prepared and most healthcare workers would not be willing to attend to the victims,” he added.
Research on Women in Health and their Economic, Equity, and Livelihood statutes during the Emergency Preparedness and Response (Wheeler) has revealed that more women CHPs had extreme Covid-19 effects as opposed to their male counterparts.
Wheeler Principal Investigator Evaline Lang’at, a researcher at the Aga Khan University in Nairobi, said research found out that healthcare workers could not access care because it was expensive and it was a difficult time for the CHPs.
“What we found out from the study is that the healthcare workers suffered in terms of their mental health, wellbeing as well as livelihood,” she said.
The research was carried out in Kilifi and Mombasa from October 2022.
According to Dr Lisa Avery, Wheeler Co-Principal Investigator from the University of Manitoba in Canada, both unpaid and paid female healthcare workers were affected from a mental health and social perspective more than men. However, the CHPs were more negatively affected.
Kilifi North Medical Officer of Health Dr Bilal Mazoya said there is a need for a healing process for the health workers and policies to cushion them.
Dr Mazoya called on the national government to allocate enough funds for the health sector.
