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Home Visitation by Visually impaired Community Health Volunteer

The Soweto area in Kibra is densely populated. The spread of contagious diseases could easily confine the infected to their sickbed. Angela Nzilani, knows this well. She understands that prevention is better than cure. She’s a community health volunteer (CHV).

At the height of the Covid-19 pandemic series of vaccination, Nzilani, despite her visual impairment, immersed herself in her work by engaging in home visitation (watch video). She would regularly work with a team of health officers under the then Nairobi Metropolitan Services (NMS).

“I have 100 households that I care for,” she says. “Besides, I visit people living with disabilities elsewhere since community health work has no boundaries.”

Even though much attention on the Covid-19 pandemic has dropped, CHVs played a pivotal role in one of the strategies employed to accelerate the uptake of the vaccines. At one time, there was some vaccine apathy in several parts of Nairobi, including informal settlements. Nzilani’s passionate goal was to persuade householders to be vaccinated against the communicable disease.

Due to some myths and misconceptions regarding the various vaccines, Nzilani would encounter a number of dissenting views, including outright refusal. “Why are you declining yet you have such little children that you could easily infect?” She would ask.

Her householder would maintain adamancy, “I won’t accept to be vaccinated!” Alternatives were sometimes sought. A few people would suggest to her, “We’ve had too many injections. There should be tablets and syrups instead of injections.”

Nzilani and her team recognized that they couldn’t compel residents to accept the vaccine. Nzilani didn’t allow negative views to put her down. She would relate her personal experience. “I’m a role model,” she would say. “I received the recommended two jabs and the boosters as well. I never suffered any adverse effects.”

Nzilani isn’t sure of the exact number of persons that she urged to accept the vaccination. What counts for her is that some progress was achieved in her quest.

The Deputy Director who was in charge of promotive and preventive health under NMS, Dr Carol Ngunu said, “We have over 1500 healthcare workers and community health volunteers who have been trained. They are able to administer the vaccine and give proper messaging to the public on the importance of the Covid-19 vaccine.”

The NMS was aiming at promoting equitable access to the vaccines. Nzilani was on the lookout for the visually impaired, lest they be left out. She reached out to Michael Wamae to go to the AMREF health facility within the settlement, for his first booster shot. Wamae heeded the plea.

A nurse at the facility, Modestar Yambasa, said, “Michael got his first and second doses of the Moderna vaccine. I’m going to administer Pfizer.” About 180 facilities in Nairobi were at hand to jab the primary vaccinations and the booster.

Recounting how Wamae lost his sight, he said, “I suffered a meningitis attack in 2004 and as a result, I couldn’t differentiate day from night.” Nzilani enlightened him on the importance of the boosters.

“A blind person has to walk about with a personal assistant,” she said. “Maintaining social distancing was not practical.”

Nzilani’s determination compelled her to wind through the narrow alleys of Soweto whenever a health issue needed to be brought to the attention of her households. Many a time, she delicately balanced herself on thin portions of earth sandwiched between a wall and a waste-drainage trench.

Dr. Ngunu admitted that, “There was a lot of infondemic going on within social media in different areas.” She recommended that credible information could be obtained from the Ministry of Health website or from healthcare workers at the nearest facility.

Unlike Wamae whom Nzilani convinced fast to accept a booster, Esther Nduku, also totally blind, was difficult to convince. Misinformation abounded. She had the primary shots of the vaccine. But she had rejected the booster.

“I heard it said that if I accept the booster, I could die,” Nduku disclosed. “When I heard that, I decided not to accept the booster.” Such a situation would demand some reasoning. The healthcare workers accompanying Nzilani would chip in by explaining why the vaccination was necessary.

“How many boosters do we need?” like Nduku, some residents would inquire. Nzilani would answer, “The government, through the Ministry of Health will tell us.” When such people would accede to the vaccination call, it would be triumph for Nzilani.

As their details would be keyed into the Ministry of Health’s Chanjo system portal, Nzilani wouldn’t see but would sense it. The goal of having at least three million inhabitants of Nairobi vaccinated by the end of that campaign was within reach. Nzilani knows that her volunteer spirit was not an exercise in futility.

By William Inganga

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