Feature Story

Ambrose Kitpum has helped to stop
the spread of TB in his community.

Kapenguria, Kenya - Several days a week, Ambrose Kiptum, 21, travels through his community, visiting barazas (village meetings), group meetings, and the homes of his neighbors, for his work as a DOW-trained TB cough monitor.  Though he has only been on the job for a few months, some in the community have begun to recognize him as a community health worker, and trust him to get care for those who are sick.

Ambrose first became aware of TB when a relative became sick with the disease.  Bedridden and ill, the relative stayed with Ambrose’s mother during the 8 months it took for treatment at the Kapenguria District Hospital.  Like many people in West Pokot, Ambrose at that time knew little about TB. 

Now, as a cough monitor, Ambrose makes the rounds in his community, educating his neighbors about TB prevention, identification, and treatment.  In addition to educating the public, his job is to find people who present with symptoms of TB (persistent cough, long term fever, loss of appetite, presence of a household member with TB), and discuss the disease with them.  If TB is suspected, he advises the patient to let him take three samples of sputum to be tested in the laboratory at the hospital.  If the samples prove positive, Ambrose returns to the patient to encourage them to visit the hospital for treatment.  If the samples are negative, Ambrose informs the patient that, with symptoms persisting, a clinician should be seen for further diagnosis.  In Kenya, all sputum testing and TB treatment is free.  

Kenya has one of the highest TB incidence rates in Africa, with approximately five percent of Kenyans suffering from the disease.  In addition, TB is one of the leading causes of death for those with HIV.  Though TB is both preventable and curable, many people in West Pokot lack a basic understanding of the disease, causing it to spread, and perpetuating a stigma against those with TB which prevents many from seeking treatment.     

Ambrose is one of many Kenyans who have been trained through DOW’s projects to educate their communities about TB and help those infected access care.  In addition to cough monitors, who take sputum samples from patients for testing, traditional birth attendants (TBAs) are being trained by DOW as cough referrers throughout the West Pokot District.  The TBAs, often located in rural areas with few health workers, learn to recognize the signs of TB, and refer patients for testing and treatment.

Although not everyone listens to Ambrose when he comes to speak, or agrees to be tested (some suspect the cough monitor of witchcraft; others simply hope the cough will disappear), he finds that his work is making a difference.  As a cough monitor, he has learned that he can help his community by being a link between them and the health system. 

“What I enjoy most about my work,” Ambrose says, “is when I meet people, learn about their problems, and hear that they want to be healthy and free of the disease.”  As a cough monitor, he can show them the way.