Out In The Field
Tracy and Alice with the urine sampling tools.
At Keheala, our main purpose is to achieve a 100% adherence record amongst the patients enrolled in our program, all of whom are battling tuberculosis. Guided by multiple daily reminders, as well as information aimed at de-stigmatizing treatment, patients are prompted to self-verify that they’ve taken their medicine. In order to ensure that a positive self-verification reflects the true actions of a patient, Keheala conducts random house visits that include urine sampling. To guarantee results reflective of everyday participation, participating counties were randomly selected and patients received no advance notice (other than when consented at the time of enrollment) regarding the visit.
The field team, comprised of individuals dedicated to the health of every single patient, is equipped with an IsoScreen Kit. This kit accurately identifies the presence of medication metabolites in urine and provides an accurate description of a patient’s recent adherence history. Despite both patients and field workers reflecting on this part of Keheala’s process as incredibly valuable, the road to improved adherence outcomes is far from easy (literally).
Take, for instance, this make-shift bridge constructed by a field worker in order to provide one-on-one attention to a patient. Hazardous trenches and dangerous motorbike rides are common occurrences, especially during the rainy season.
Another obstacle in the way of ensuring that patients take their medicine is the stigma and misinformation associated with tuberculosis and its treatment in many places across the globe. On multiple occasions field workers have visited a patient’s house only to find a witch doctor present who would denounce the current treatment program and completely discourage adherence. An integral part of Keheala’s program is the digital dissemination of factual information pertaining to the disease and treatment. This is one way in which Keheala is working to counter deep-rooted community-held beliefs that make it more difficult to ensure healthy outcomes.
On a lighter note, a recent trip to see a patient was complicated when a cat appeared to have mistaken our field worker’s laptop as a resting place. Considering our colleague’s cat phobia, a solution was needed so as not to offend the host. Instead of inputting all the data from the patient’s results on her computer, our field worker wrote it down manually.
As is clearly evident, Keheala’s field workers are incredibly devoted to ensuring the best for each of their patients. Their perseverance is admirable and brave, and we couldn’t be more grateful for every single one of them.