Chimezie Dimkpa, the KNCV Nigeria ACF (Active Case Finding) radiographer onboard the WoW truck shares his experience working with patients during this pandemic. The WoW trucks are mobile diagnostic units, procured with USAID funding by KNCV Nigeria. They reach remote locations to offer TB and COVID-19 tests.
Chimezie: “The COVID-19 pandemic has significantly altered our patient-centered approach throughout the WoW cascade. More emphasis is now placed on observing guidelines put forward by national and international health authorities. Right from enrollment of the client, to sample collection (nasopharyngeal swabs and sputum samples), screening (digital chest X-ray/HIV/Hepatitis/MP) and testing; social distancing is implemented.
When we arrive on our destination, an outdoor waiting room is created. The community has been informed of our visit beforehand and people know where to find us. It is sometimes heartbreaking to see families that hardly have access to health care, that have been carrying on with symptoms of TB or COVID-19. On our numerous sojourns with the WoW-truck we encounter people from all walks of life, religious affiliation, literacy level, socioeconomic and ethnicity within various community settings.
Most persons present in very bad conditions clinically and this makes me reminisce about one particular young woman who came to one of our TB screening outreaches in Nasarawa LGA in Kano State.
Her condition that day was such that she was emaciated and felt weakness and pains in her lower limbs. She couldn’t even climb up the stairs leading into the Radiography unit for her chest X-ray so she had to be physically lifted by Mr Joshua, my colleague in the WoW team. He is always watchful for such cases and is ever ready to carry them up the stairs when necessary. I owe him alot of gratitude. She had her chest Xray done and that showed she was presumptive for TB afterwhich she followed the cascade of sputum sample collection and testing.
Three months later we received a most pleasant surprise! We heard a knock on the Radiography unit door and guess who was smiling back at us?! The very same lady!
Her countenance was brighter, she looked healthy and better yet she walked up the stairs on her own! Our joy could not be quantified on hearing her testimony. She even came along with her son so he could see the people who made his mum happy again.
Protecting the team and the patients
Each member of the WoW-team is always clad in full PPEs (Personal Protective Equipment) – facemask, aprons, hair net, eye goggles, hand gloves and shoe covers or safety boots as is appropriate for the particular department in regards of the risk factor level (low to high) – radiography unit, laboratory unit, clerking area, sample collection area, etc.
Each unit is equipped with dirt bins (for disposing used hand gloves, etc), hand sanitizers (alcohol-based hand rubs) and surface decontamination solutions (i.e. 0.005% Chlorine) to clean regularly used objects such as door handles, work tables, hand rails and the erect bucky stand where patients place their chests during chest screening.
It is important to mention that every patient is given a face mask which is to be worn at all points during the workflow of a particular community intervention.
It has truly been a rewarding and learning experience thus far and has helped in improving our awareness to the realities of the virus, its implications as far as TB control is concerned and how to better protect ourselves as well as help enlighten more people on effective ways to stop the transmission of the virus within their families and their communities at large.
On a lighter note, in fact, we (the WoW team) wear face masks and carry hand sanitizers everywhere we go.
Ideally, the WoW team comprises the ACF coordinator, the ACF diagnostic Radiographer, the ACF driver and adhoc staff notably 1 Radiography Support Assistant and 2 data clerks. For the Kaduna State COVID-19 response the WoW team worked in tandem with the state epidemiologist, and 4 laboratory scientists majorly.
For TB-specific case finding the WoW team works with local government TB supervisors, CBOs and DOTs focal persons for each given LGA.”