Josephine no longer afraid of tuberculosis stigma

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Friday, July 9, 2021

Josephine is 19 years old and lives in Port Moresby with her adopted parents.

When she fell ill in 2018, her family thought she was under a spell. She also believed that it was sorcery because she had a very bad cough, lost her appetite and eventually began to lose weight.

Her family took her to a clinic nearby and there it was revealed that she had multi-drug resistant tuberculosis (DRTB) and it was at its worst stage.

“I was surprised when the doctor advised that I have DRTB because I thought it was sorcery that’s. The doctors told me that this type of TB is very strong.” she said.

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Josephine with her mother in their home.


Josephine was admitted at the Port Moresby General Hospital (PMGH) and commenced her anti-TB medication in September of 2020. She was later discharged to 9mile clinic in her community the following month.

She was referred from 9mile clinic to a community TB outreach site at Kerema Block near to where she lived. The outreach site was established by World Vision with the support of the community treatment supporters and community leaders.

Prescribed with a longer regiment which is the 18 months treatment, she was assisted by a treatment supporter on a daily basis.

Agatha, a treatment supporter under the NCD TB Diagnostic and Treatment services project was assigned to support Josephine with her daily dose of TB medication. When Josephine could not make it to the treatment site, Agatha would take the responsibility of visiting her to administer her medication, every day. Josephine is expected to complete treatment cycle in February 2022.

Despite the free TB services and easy access to medication in the community, Josephine experienced discrimination within her family and community due to misconceptions about the disease.

Josephine’s family were afraid of being infected by the disease when they learnt that she has DRTB. This is a common response among TB patients’ families in PNG.

“When my family and neighbors knew that I have TB they were scared of the disease. No one would come closer to me or share food with me,” said Josephine.

TB educational patient by World Vision and counselling sessions provided by health workers and Community Treatment Supporters (CTS), like Agatha has given Josephine the strength and courage to adhere and continue her treatment.

Josephine knew that TB is curable and she would return to normal life after completing medication. She has completed over eight months of medication and her health has improved significantly.

In response to the family’s misconceptions, she has shared factual information about the disease with the family but they still did not believe her.

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Josephine, masked up and waiting for doctor’s review at 9mile TB Clinic, accompanied by CTSs Agatha (middle) and Jennifer (right).

Agatha says, “Josephine’s face looks unhappy every time she comes to the DOT site.” Josephine has also told Agatha about the discrimination within the family.

In 2021, World Vision’s TB project staff with the CTSs visited Josephine and her mother.

In the process of educating the family, the team mentioned that TB does not spread through sharing of food or eating with the same utensils.

Her mother interrupted the conversation saying “I am the one who fears this. It’s good that you came and explained to me. We thought that this was sorcery and we were scared of her.”

“All of us were afraid of sharing food with Josephine because we might get sick like her. You told me the right thing so now I am happy with my daughter and we will eat together and live happily together.” she adds.

Josephine appreciated the visit with thanks saying, “I can now feel the joy I never felt before.”

Three days after the visit and TB education, Agatha could see the change on Josephine’s appearance.

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Josephine walking to the treatment site for her daily medication.

“There’s so much smile on her face as she approached the DOT site. She looks so happy.” Agatha says.

Whilst on anti-TB medication, Josephine has now resumed her high school education through distance mode while she stays at home.

Josephine is among 359 beneficiaries who received bus fare reimbursements and food vouchers (AUD 520) twice a month from World Vision since April 2020 under the project which enables her to access health facilities.

This support is provided to DRTB patients who comply with all the guidelines of the anti-TB treatment.

“The help from World Vision with bus fare and food has given me the strength to take my medication. I take 6 tablets of medicine in a day. Thank you World Vision.” Josephine says.

World Vision in partnership with NCD Provincial Health Authority (PHA) is implementing the NCD TB Diagnostic and Treatment services project in Port Moresby. The project is funded by the Emergency Response Tuberculosis (ERT) project of the National Department of Health contracted by World Bank.