tuberculosis

Grace Tsawe owns a prayer camp in Ghana's Lower Manya Krobo District. She recovered from TB, and uses her experience to encourage others to be tested and treated medically for TB. {Photo credit: B. Adusei/MSH.}Photo credit: B. Adusei/MSH.

Tuberculosis (TB) control in Ghana is challenging: detection of TB cases is low, and TB mortality rates high. In many communities, like Lower Manya Krobo District, these challenges are compounded by the popular belief that TB is a spiritual disease. Many Ghanaians who contract TB seek healing in prayer camps and shrines, rather than going to health facilities for testing and treatment. By the time these patients seek medical care, it often is too late to recover and avert death.

Lower Manya Krobo District has over 93,000 residents, and a high incidence of TB (209 cases per 100,000 people in 2011). The district is also home to many of the nation’s mushrooming prayer camps, where local healers provide daily services for ill residents. There are 50 prayer camps in Lower Manya Krobo District---and only 18 health facilities.

Grace Tsawe owns a prayer camp in this district, and she usually sees over 100 patients on her main clinic day.

Unpublished
Unpublished
 {Photo Credit: Abel Helebo/MSH.}Silenat with her three-year-old child, her husband Yirga, and Tadele, a TB focal person at the Keraniyo Health Center.Photo Credit: Abel Helebo/MSH.

Silenat Yihune, a 40-year-old woman, mother, and housewife, lives in a remote region of Huletejuenesie District, Ethiopia, which is approximately 20 kilometers from the closest health facility. For nine months Silenat suffered from a cough, chest pain, fever, and weight loss, but was unable to receive treatment. As is common among Ethiopian families, Silenat was economically dependent upon her husband. He refused to pay for her travel to the distant health facility. Several months later, Silenat’s husband, Yirga, started to show similar symptoms and visited the Keraniyo Health Center, where he was diagnosed with tuberculosis (TB).

Keraniyo Health Center is one of the health facilities in Huletejunesie district supported by the PEPFAR-funded, USAID project, Help Ethiopia Address Low TB Performance (HEAL TB), led by Management Sciences for Health (MSH).

Dr. Quick discusses Myanmar’s health system with Dr. Pe Thet Khin, the minister of health. {Photo credit: Myanmar Ministry of Health.}Photo credit: Myanmar Ministry of Health.

In Myanmar, 50 years of military dictatorship left behind a seriously underdeveloped health system, serving barely one in twenty of the country’s 60 million people. You might expect that the first minister of health under civilian rule would be despondent. But on my recent trip I found the opposite: Dr. Pe Thet Khin and his team are aligned around an ambitious vision for building a strong health system for the country.

2012 World AIDS Day event in Port au Prince, Haiti. From left to right: Pamela White, Ambassador of the United States to Haiti; Michel Sidibe, Executive Director of UNAIDS; Sophia Martelly, First Lady of Haiti; Florence Duperval Guillaume, Minister of Public Health and Population; and Guirlaine Raymond, Director General of the Ministry of Public Health and Population. {Photo credit: C.Gilmartin/MSH.}Photo credit: C.Gilmartin/MSH.

In recent years, Haiti has endured some of the greatest misfortunes in its history, including hurricanes, floods, the devastating 2010 earthquake, and the cholera epidemic that followed. These natural disasters and public health crises have added to the harm already caused by the country’s widespread poverty, social and political unrest, and under-resourced health system. Haiti’s fragile population is further plagued by the highest HIV prevalence in the Western Hemisphere at 1.9 percent, which translates to roughly 120,000 HIV-positive individuals and 93,000 children who have lost their parents to AIDS (UNAIDS, 2011).

http://www.youtube.com/watch?feature=player_embedded&v=joX9cq692Wc

Michel Sidibé, Executive Director of UNAIDS, discusses the new UNAIDS World AIDS Day report: Results at a press conference today in Geneva.

 

 

 

Children in Yogyakarta, Indonesia, a community supported by TB CARE I volunteers. {Photo credit: D. Collins/MSH.}Photo credit: D. Collins/MSH.

Each year, as many as 64,000 people die from tuberculosis (TB) in Indonesia. Although the Ministry of Health’s (MOH) National TB Program (NTP) has made great progress over the last few years, the country is still one of twenty-two high TB-burden countries in the world. Indonesia is also one of the twenty-seven countries considered to have a high burden of multi-drug resistant TB (MDR-TB). In 2011, the nation reported 6,100 cases of MDR-TB.

Donor funding has been a major factor in the success of Indonesia’s TB program over the last few years, especially The Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) grants.  Indonesia has, however, progressed economically and is now a relatively low priority for Global Fund grants, which are expected to end or reduce significantly by 2015.

Despite Indonesia’s economic growth, the sustainability of the TB program will be a major challenge without support from this critical donor, especially during the funding transition period.

Unpublished
Esther manages commodity supplies with meticulous record keeping {Photo credit: Y. Otieno/MSH.}Photo credit: Y. Otieno/MSH.

This is the advice that Esther Wahome, a registered community health nurse in a Kenyan health facility, gives to her clients when they come to the tuberculosis (TB) clinic. Within a short time, Esther dispenses the drugs to the patient, provides health care advice and updates her records.

Esther’s TB clinic clients are usually referred to Kayole II sub-district hospital from Toto Bora and other smaller health care centers. Kayole II, located on the outskirts of Nairobi, provides free health services and receives nearly 300 outpatients each day.

During a routine supervisory visit conducted by the USAID-funded, MSH-led, Health Commodities and Services Management (HCSM) Program, Esther, a mother of two, spoke about her work at the Kayole II TB Clinic, which she has been running for the last three months.

“I like serving in the TB clinic because I get to see patients who are weak regain their strength. Sometimes the patients come in when they are so weak and close to skin and bones that at times I wonder where to inject them. Seeing patients thrive fulfills me and is my joy,” says a smiling Esther.

Pages

Subscribe to RSS - tuberculosis