Treatment of tuberculosis involves taking tablets daily for at least six months. TB patients must take all their medications as prescribed, failing which they may not recover and dangerous drug-resistant TB strains may develop. That is why it is considered ideal for TB patients to come to a treatment facility to take their tablets in the presence of a health worker — at least in the early, intensive phase of the treatment.
Not everyone can travel daily to a health facility, however. The closest treatment facility may be too far away. Or the person may not be well enough. The WHO Stop TB Strategy therefore encourages alternative arrangements for supporting TB patients as they take their treatment.
A friend, neighbour or community leader who has been educated about the process and demonstrated commitment can take on this role with help from health services. A variety of groups in many countries are developing their own approaches to community TB care.
This story showcases one such initiative in rural Kibaha in the United Republic of Tanzania. Members of the Upendo Disadvantaged Group all of whom have been cured of TB — support and care for TB patients in their community.
When Jane Tibihka of the United Republic of Tanzania was cured of tuberculosis (TB) in 2004, she recognised that former TB patients could be a valuable resource. “They have the understanding and motivation to help others sick with the disease,” she says. She formed an organisation of former TB patients, the Upendo Disadvantaged Group.
Upendo is now a registered NGO with branches in Dar es Salaam and Kibaha, a nearby rural district. The Kibaha group’s 31 community-based home care providers focus on primary care for more than 200 TB patients in the district.
Upendo’s office in Kibaha receives a visit from Dr David Wawa, who serves as a medical adviser to the group. Dr Wawa is on staff at Tumbi Hospital, which is seven kilometres away.
In many parts of the world, TB patients travel daily to a health facility to receive their medication. Not so for most of the residents of Kibaha, because Tumbi Hospital is too far away. Patients generally pick up their medicines monthly and learn to take the drugs on their own with support from their families and Upendo’s community health workers.
Dr Wawa provides guidance to Upendo’s community workers on primary care basics and TB care. Here he explains to Nurdinir Mayoyo how to coach people on remembering their TB tablets. “It is good to advise them to take them at the same time of day for example, when a favourite radio programme is on the air,” he says.
On a routine visit to Tatakae Selemani, who is ill with tuberculosis and living with HIV, Jane Tibihka checks a medication diary to make sure he is taking all tablets as prescribed.
Nurdinir Mayoyo delivers a package of food to Celestine Benja. TB medicines are difficult to tolerate without good nutrition. Upendo’s members supplement TB patients’ diets as often as they can.
Rajabu Saidi assists Mariam Abdala as she takes a brief walk. Abdala has been on TB treatment for nearly six months and has been bedridden much of the time.
The Upendo group organises community gatherings featuring music and poetry to educate their neighbours about TB. Here residents talk about how to recognise the symptoms of the disease.
“We will never be free of this disease if we do not make people especially youth — more aware and less afraid,” Tibihka says.
Source: World Health Organisation
Source: The Daily Star, August 15, 2009
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