AMPATH Rises to This Year’s Challenges
The year since COVID-19 was first confirmed in Kenya has been tough. But, among the many ways we’ve been challenged, there are many examples of our ability to get back up and to adapt. In the face of bad news, we’d like to share some good news from the past year.
COVID-19 Impacts
HIV laboratories supported by USG PEPFAR funding were able to rapidly adjust to accommodate PCR testing for COVID-19. Philanthropic and corporate support was redirected toward COVID efforts to improve infection control and provide necessary supplies. Kenyan and North American faculty collaborated on training, protocol development, and establishing a home-based care effort. In addition to a formal lecture series, hundreds of informal collaborations between AMPATH partners occurred to share knowledge and resources.
Initially, the COVID-19 related shutdowns caused disruption in most of AMPATH’s core mission areas, but through creativity and perseverance, most activities resumed as soon as it was safe to do so. After suspending non-essential, in-person research activities from March to July 2020, research resumed at AMPATH for the remainder of the year in accordance with comprehensive safety guidelines.
Many Kenyan registrars (residents) returned to MTRH in mid-2020 and all Moi University School of Medicine students returned on February 1, 2021. AMPATH’s fellowships in maternal fetal medicine, gynecologic oncology, cardiology and pediatric oncology continue with virtual support from North American faculty and staff.
Program Updates
The Sally Test Child Life Program continues to provide child life services to approximately 200 children per day at Shoe4Africa Children’s Hospital and the Orphan and Vulnerable Children (OVC) program expanded to include Trans Nzoia County in November. Clinic and home-based programs have lowered mother-to-child transmission of HIV to four percent. Despite COVID, there was an increase of 30 percent in pediatric cancer patients as a result of AMPATH’s efforts to improve diagnosis.
COVID-19 testing storage
A study to assess the impact of COVID-19 on people living with HIV using a telephone survey was developed by the East Africa International Epidemiologic Databases to Evaluate AIDS (EA IeDEA) and adapted and adopted by investigators for three other studies in East Africa as well as projects in the U.S. Additionally, AMPATH’s electronic medical records system was quickly adapted to assist with COVID screening and has recorded approximately 70,000 encounters since April 2020.
Street-connected youth have been particularly challenged during the pandemic and the Rafiki Center for Adolescent Health has offered hot meals to youth coming daily to the clinic for their medication. A similar effort is scaling up in Kitale. AMPATH’s partners at the Tumaini Center rescued and reintegrated 200 street children during the pandemic and also completed a 100-bed dormitory for boys.
The increased need for telemedicine opportunities and mental health services necessitated by the pandemic were met by AMPATH colleagues. Construction of a mental health transitional home continues as does the integration of mental health into community-based care.
Current Situation
COVID-19 cases surged in Kenya in late 2020, but have declined over the past several weeks. Since the beginning of the pandemic, Kenya has confirmed 105,467 cases and 1,853 deaths as a result of the coronavirus. Hospitalizations from COVID-19 have also declined, but a healthcare worker strike has closed many care facilities making Moi Teaching and Referral Hospital (MTRH) extremely busy with patients that might typically be cared for in other facilities.
There is significant concern in Kenya about how COVID-19 is impacting people living with HIV, tuberculosis, malaria, and non-communicable diseases as well. Delays in diagnosis, treatment initiation and adherence, interruption of public health campaigns and dramatic increases in food insecurity are already being documented. In response to the continuing economic hardship, AMPATH has begun some direct cash transfers to patients and to provide working capital to GISHE (microfinance) groups.
Most of the AMPATH Consortium’s leadership team has now returned to Kenya and to work at MTRH, though medical resident and student exchanges are still on hold. Continually changing testing and mitigation requirements in both Kenya and other countries do make shorter-term visits challenging, but not impossible.
Vaccines are Expected
COVID-19 vaccines are expected to start arriving in Kenya with healthcare workers designated for the first, limited doses. The expectation is that 9-10 million doses will be available for people over 50 and those with chronic conditions. A full distribution plan has been developed and a public education effort to overcome vaccine hesitancy is planned.
As we walk together past the one year milestone of the first case of COVID-19 in Kenya, we take many lessons learned and new collaborations forged. We are grateful for donors and supporters who have helped get us and many Kenyans through this past year with your generosity. Health equity and global health are on the mind of world leaders and policymakers and we’re hopeful that this will lead to lasting change in the long run.