Exploring TB in the World of Herbs – The Story of Patient Referral Model to Formal Health Centres


Call her a herbalist, traditional healer, magician or sorceress; improving the health of people in her community is all that Phoebe desires. To the best of her ability, Phoebe is dedicated and passionate in attending to people with all kind of body illness. “I am happy to do what I do, and I am not afraid or embarrassed to speak out about it,” she says boldly. Phoebe walked me through life as a herbalist one chilly morning when I visited her home where she unearthed more about plant power.

Sixty-six-year-old Phoebe lives in the informal community of Kibera and she is one of many who offer herbal remedies to treat diseases.  She started the practice back in 1968 as a way of maintaining wellness when little was known of current medicines. She would seek spiritual intervention before treating people. “Some patients link their problems to witchcraft, the reason why they will not seek treatment from the formal health centres,” she explains.

Phoebe displays plant medicine at her home

Phoebe treats women, men and even childhood illnesses from the comfort of her house and often gets up to 10 cases a day. She has placed a bench outside her house where patients sit while they wait to be ushered in for treatment. Her drugs are all sourced from plants and her “Green Pharmacy” has a range of medicines that she gets from her rural home in Kapsabet and occasionally from the leafy suburbs of Karen in Nairobi when she cannot afford to travel to the country side.

Her plant-sourced medicines are gathered from a variety of plant materials including leaves, stem covers, fruits, branches and even roots. To fully produce the medicines, she either boils or dries these parts and instructs her patients to drink, swallow or bath with the contents depending on the type of disease they have.  Her medicinal plants are affordable ranging from about Kshs 50 to 500.

The medicines


She receives patients with all sorts of problems from dental, pregnancy complications, infertility, low libido, HIV, malaria and even TB. Phoebe believes that her treatment works for her patients as several them have often come back to her with positive feedback. However, those with illnesses like TB and HIV had often become worse. At one point, there were very many TB defaulters from health facilities around Kibera and other urban villages in Nairobi. Upon investigation, the community health volunteers (CHVs) discovered that majority of the patients had turned to traditional medicine. In light of this, the CHVs through the National Tuberculosis, Leprosy and Lung Disease Program (NTLD-Program) and various partners planned for a training to reach out to and sensitize the herbalists.

With funding from USAID, the TB ARC activity through sub awardee KANCO, identified the herbalists and traditional healers and trained them on how to identify and refer presumptive TB cases to formal health centres. Phoebe was one of the beneficiaries of this training and she can now identify all the common TB symptoms from the top of her head. She is now fully aware that the moment a patient presents these symptoms to her, her role is not to treat, but to link the patient to the CHV who then takes the patient to the nearest TB clinic.

So far, she has referred 20 patients with two testing positive for TB. KANCO has so far conducted orientation of 63 informal service providers (ISPs) in Nairobi, Tharaka Nithi, Marsabit, Kisumu and Homabay Counties. The ISPs have further been linked to formal health systems within the five focus counties, supervised and given screening and referral tools.  This model has seen 237 patients referred by informal service providers including unregistered chemists from the five counties with 28 of these patients testing positive.

To successfully execute smooth referrals, KANCO offers an incentive to the herbalists for referred patients. Phoebe appreciates this referral model as she treasures life. “Money is the least of my priorities so long as people in my community are healthy,” she affirms. However, this has greatly reduced her income from selling medicines as many of her patients now prefer to go to hospital. She therefore hopes to venture into a different business to sustain herself.

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