---------- Forwarded message ----------
From: IRIN <[email protected]>
Date: Tue, May 17, 2011 at 4:33 PM
Subject: KENYA: For want of a mask - how TB targets health workers
To: Jean-Francois Darcq <[email protected]>


KENYA: For want of a mask - how TB targets health workers

NAIROBI, 17 May 2011 (IRIN) - Peter*, a lab technologist at a
government-run health facility in the Kenyan capital, Nairobi,
recently took the last dose of his six-month course of tuberculosis
medicine; he is fairly sure he contracted the disease at work.

 "This is a big facility and we come into contact with many patients
infected with TB - it is by no accident that I got infected," he told
IRIN. "As health workers, we can't escape coming into contact with
people with highly infectious diseases like TB because it is our work
to help them."

 Kenya ranks 13th on the UN World Health Organization's (WHO) list of
22 high-burden TB countries globally, and has the fifth-highest burden
in Africa. According to WHO, the country has more than 130,000 new TB
cases every year.

 Safety equipment - including protective masks and proper waste
disposal facilities - are rarely available in rural centres, something
health workers say must be addressed urgently.

 According to Victor Were, a clinical officer in western Kenya's
Mumias town, over-crowded and poorly ventilated clinics pose a big
risk to health workers.

 "We don't have protective gear and only one hospital in Mumias has
proper waste disposal facilities where they incinerate their medical
waste," he said. "We have about 40 TB health workers in Mumias - we
don't regularly screen them for TB, but last year four who presented
with signs of the disease were tested and treated."

 Were said the government urgently needed to address the issues of
training health workers on risk reduction, provision of masks and
ensure proper ventilation or even outdoor clinics to reduce the risk
of infection.

 "Many health workers are bogged down by heavy workloads and therefore
even those who are infected [with TB] stay for long without treating
themselves and by the time they do, they might have infected quite a
number of people, including their colleagues," said Andrew Suleh,
medical superintendent of Nairobi's Mbagathi District Hospital.

 Supply chain problems

 Government officials say problems with the supply chain and funding
shortages are the main reason for the lack of protective gear.

 "Health personnel cannot stop treating or offering services to
patients even without these [safety] commodities and during that time,
they risk getting infected by the very patients they treat, so it is
[down to] us as the government to ensure facilities don't run out - at
times stock-outs do occur and this is due to procurement challenges,
which makes it hard to expedite the delivery of these commodities to
health facilities," said Joseph Sitienei, head of the National Leprosy
and TB Control Programme. "Sometimes health facilities delay in
requesting these much-needed materials and only do so when they
completely run out.

 "One cannot ignore the financial challenges faced at times and they
do lead to stock-outs, but we have seen increased funding to the
health sector recently and I hope this will soon change for the
better," he added. "What we have started doing is to make waiting
areas in health facilities well ventilated, making the consultation
rooms more spacious, and of course providing protective masks... the
government is streamlining procurement and supply of commodities
including protective gear to health facilities."

 According to local NGOs, corruption within the health system [
http://www.irinnews.org/PrintReport.aspx?ReportID=91242 ] is also to
blame for the haphazard availability of medical supplies, with drugs
often 'disappearing' from government health facilities and sold to
private pharmacies by government pharmacists.

 Sitienei noted that the risk of TB infection ran both ways between
patient and health worker, and the government encouraged "frontline"
staff such as nurses and lab technologists to regularly test for TB
and if found positive, to seek treatment immediately.

 "Also, availability does not always translate to use - we have to
constantly sensitize personnel on the need to use the protective
gear," he said. "To reduce stigma, it is also important - we have done
this - to sensitize patients too on why those attending to them must
have a mask, for example."

 He said that to reduce health facility-related infection, isolation
wards were being established in health centres that attended to large
numbers of TB patients.

 In November 2010, WHO, UNAIDS and the International Labour
Organization launched international guidelines [
http://www.who.int/mediacentre/news/releases/2010/HIV_TB_20101119/en/index.html
] to protect health workers against HIV and TB. Among the
recommendations were development and implementation of free regular TB
and HIV screening, free HIV and TB treatment for infected health
workers and the incorporation of training for all health workers on
HIV and TB prevention, treatment, care and support into existing
training programmes.

 ko/kr/mw

 *Not his real name[END]

This report online: http://www.irinnews.org/report.aspx?reportID=92736



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