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MSF in Kenya, 2007
Field Staff: 463
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Escalating violence has left many people unable to access healthcare in the Mount Elgon region. MSF has responded by using mobile clinics to reach those in need. Throughout the country HIV/AIDS and TB infection rates continued to rise. MSF is treating many co-infected patients using new technologies and facilities. Meanwhile MSF continues to campaign for access to drugs to treat the neglected disease, kala azar.
Responding to ongoing displacement
Since August 2006, ongoing violence and disputes over land in the Mount Elgon area of western Kenya have caused thousands of people to flee their homes and seek refuge in larger towns, higher parts of Mount Elgon, the forest or nearby villages. These people are often trapped between fighting groups and receive little assistance. In April, MSF began delivering humanitarian medical assistance to this population in the Mount Elgon district. MSF is mainly dealing with the health consequences of violence against civilians and repeated short-term displacement. Through a system of mobile clinics and support to primary healthcare structures in the area, MSF teams provide access to free quality medical care.
In Molo district, fighting, violence and intimidation displaced around 17,000 people by December. Many were living in small camps scattered around the district, so MSF started mobile clinics to assess needs and provide medical consultations and water sanitation services at different sites every week.
Ongoing HIV/AIDS care
Despite some positive progress in recent years, HIV/AIDS continues to have a devastating impact on every sector of Kenyan society. While around 5.9 per cent of adults are thought to be infected, this can be as high as 35 per cent in some rural areas where MSF works, such as Homa Bay. Working in two of Nairobi’s slums, Kibera and Mathare, and two locations in the west of the country, Busia and Homa Bay, MSF provides comprehensive HIV/ AIDS treatment and care to thousands of Kenyans. MSF’s first HIV/AIDS project opened in 1996. By the end of 2007, MSF was caring for over 17,000 people living with HIV/AIDS and providing anti-retroviral treatment (ART) to 10,500.
Treating HIV/AIDS without also addressing tuberculosis (TB) is ineffective. TB is the leading killer of people living with HIV/AIDS. Globally, around 11 million people are thought to be ‘co-infected’ and half of all deaths of HIV-positive people are due to TB. Throughout 2007, MSF expanded its efforts to treat people infected with TB in Kenya. By the end of the year, 1,445 people had been started on treatment in various projects around the country.
Diagnosing TB in patients who are HIV positive can be challenging as the sputum samples produced often do not show the presence of TB when analyzed in standard laboratory tests. After months of building and preparation work, MSF opened a TB culture laboratory in Homa Bay hospital in November. One of only five in the country, this laboratory will enable much more effective and accurate diagnosis of TB, particularly in patients who are co-infected with HIV.
Growing resistance to first-line TB treatment is another challenge and MSF has been treating people with multi-drug resistant MDR-TB since May 2006. In addition social issues, including housing and food availability, are assessed because these are often the main reasons why people fail to complete treatment. MSF remains the only provider of free treatment for MDR-TB in Kenya.
Treating neglected diseases
MSF works in West Pokot district, Rift Valley Region, treating people infected with kala azar, otherwise known as visceral Leishmaniasis. This disease, spread by the sandfly, is fatal if left untreated and affects around two million people globally every year. In 2007, MSF teams screened over 1,678 people for the disease and successfully treated 850.
Until mid-2006, the only drug available in Kenya to treat kala azar was a patented drug called Pentostan. MSF has lobbied the Kenyan Government for the use of a cheaper generic drug called Sodium Stibogluconate (SSG). In 2007, SSG was registered in Kenya, although manufacturing problems indicate that it will not be available for supply any time soon. MSF continues to advocate for the inclusion of SSG into the Kenyan Ministry of Health guidelines for treating kala azar. Whereas Pentostan costs 150 USD per treatment course, SSG costs 30 USD, so it will be much more easily absorbed into the Kenyan health system. As kala azar can be difficult to diagnose, MSF is also advocating for the use of a rapid diagnostic test that is ideal for resource-poor settings and is encouraging the use of these tests in health centers around the district.
MSF has worked in Kenya since 1987.