Writes Key Correspondent, Abjata Khalif.
As lack of proper health provision and hostile weather make northern Kenya inhospitable to health workers, many communities continues to tie outdated cultural beliefs to curable disease thus contributing to death, suffering and stigma against patients.
In recent years, Somali communities living in the Wajir, Mandera and Garissa district of northern Kenya have treated curable disease like TB as dangerous diseases that lack treatment. Those suffering from the diseases are regarded as cursed people.
For many years, the communities have valued their cultural beliefs and regard these as traditional law that must adhered to by everybody within society, otherwise they’ll be cursed and disowned by the community.
According to Mr Abdi Bashey, a TB coordinator in northern Kenya, the diseases has spread in every corner of the remote region and it is causing death, misery and poverty. He attributed the wide spread of the disease to outdated community culture that regards TB as incurable and believes those who have a curse from the community or their parents could contract the disease.
Mr Bashey said: “Right now we are grappling to address the TB cases in the region. The prevalence rate is too high and we cannot cope with offering treatment, though we are trying. The TB problem in the north is fuelled by community attitudes and cultural beliefs that have contributed to the massive spread of the disease.
“The pastoralist communities have ignored medical beliefs that the disease is curable and can be prevented. Instead they believe the disease is contracted by people who were either born out of wedlock or who have made mistakes against the communities, their parents or their elders.
Asha Ali, a TB patient in the Sankuri area of Garissa refutes that the diseases is caused by a curse or one born out of wedlock. She said “I don’t believe what my community is saying about the disease. I have not done anything wrong to warrant a curse and I was born from a respectable family in our village and I was not born out of wedlock. It’s a wrong belief and it’s causing a problem.”
Asha said that once she was diagnosed with the disease her family disowned her and she was chased from the family home. She did not know anything about the disease and at first subscribed to the belief that the disease was meant for those who have a curse.
She said: “I only realized that I was suffering from the diseases after I got uninterrupted coughs and my family said that I was suffering from the disease. First I was taken to a separate area in our family compound and I was under family observation to know if I am suffering from TB.”
Asha said that in the separate area in the family compound her condition started to deteriorate and the family summoned a health worker from a village 100 kilometres away. She said that the health worker checked her symptoms and informed the family that she was suffering from TB. Hell broke loose for Asha as she was ordered out of her family compound.
She said: “I was shocked when my parents and brothers ordered me out of the compound because I was suffering from TB. I fainted because I could not believe my eyes. I found myself outside our family home with my luggage lying beside me. I could not believe it and I went to some neighbors but they too chased me away.”
Asha said that she was forced to sleep in the cold and she was rescued by some Good Samaritan who transported her from their village to the main town, Garissa, where she was taken to the hospitable for care.
Asha is among thousands of community members who suffer silently due to cultural beliefs that are outdated and based on wrong notions. These people have been forced to leave their family homes and go to TB villages that are managed by the Kenyan Government with support from key donors like World Bank and international Development Association (IDA).
Abdi Ali, an elder, said the community regarded the diseases as a curse and they respected that version for many years. He said: “Our community respects cultural beliefs and we follow them to the letter. We don’t care if it’s your son or daughter who gets the disease. Once a member gets a disease, she or he is chased away because we cannot keep the curse and if we let them stay, the curse will affect other community members.”
The only way of preventing the diseases, Abdi said, was to chase the infected member away and by doing so, the curse will leave the families, community and the village.
Abdi said: “We have used the method of chasing away the infected family member so that we can respect our families and communities and ensure the curse is not passed to any other family members.”
But the situation for Abdi, the conservative elder, and Asha, the ostracized and chased patient, has changed considerably since the Kenya Pastoralist Journalist Network took TB education and awareness campaigns to various remote villages and grazing points in Wajir and Garissa.
The program brought various stakeholders together under the Pastoralist TB Awareness Campaign that is funded by Stop TB Partnership .The stakeholders were carefully selected from various sectors of the community.
Stakeholders including women, youth, TB patients, religious leaders, community elders and medical officials were brought together to brainstorm an entry point in addressing the problem and changing the community perception on the diseases.
Communities in all remote villages listened to various speakers from the stakeholders group and they were taught disease transmission, treatment and prevention. The communities were informed on the danger posed by high level stigma and ostracisation of the patients.
In one of the community forums, pastoralists were shocked to hear that the disease is curable. They heard it from religious and women leaders who are respected at the grass roots level and the same message was reinforced by medical officials.
Following the campaign, many community members were talking in low tones and then immediately flocked to health centers in places like Sankuri, Danyarey and Saqa areas of Garissa.
Bashir Hassan, a nurse at Sankuri Health Centre, said they could not cope with the number of people crowding into the centre for TB testing and inquiring whether TB medicines were in stock.
She said: “The campaign came at a good time. I had difficulty educating this community as they would hear nothing about the disease. It seems they are now hearing it because you have included religious and women leaders in the campaigns. I have received 300 people today for testing and I anticipate more as they will send words round.”
Hassan said such a campaign was necessary and it should be scaled up to address other diseases, lessen suffering in remote areas and save lives.