Under World Vision’s Treatment Supporter Program, an estimated 2, 700 patients have successfully completed their treatment. (1569 male and 1079 female) with tuberculosis (TB) at Erima outreach site between February 2018 and February 2021. Of these, 345 are children and two cases are people with disabilities.
Six year old Anna is one of the children who completed treatment.
Anna contracted TB when she was four years old but her parents made no attempt to seek medical assistance in its early stages.
Hence, she developed a mental disability. Her grandmother says, “The parents were so busy with gambling and did not take her to the hospital. That’s why I took her away from them.”
Anna’s grandmother learnt of our community based TB program and the outreach site through an awareness activity conducted by our community treatment supporters (CTS) and brought Anna to the outreach site where signs of TB were identified.
The clinicians commenced Anna on anti-TB treatment and referred her back to the outreach site where she received medication with close observation and support from the CTSs until she completed the treatment cycle.
Anna has recovered from TB and her brief stint with a mental disability. Now cured, she says, “I want to go to school and become a teacher.”
The grandmother says, “I am so happy with World Vision. Thank you for saving my grand -daughter’s life.”
Laua is another beneficiary, an elderly women with visual impairment who lives alone.
She was once happy and well, sewing and selling shopping bags in front of Erima shopping mall to earn an income. She fell ill with TB and couldn’t continue with this activity.
Helen, a CTS, is a close friend to Laua. On a visit to Laua, Helen found her alone, very ill with signs of TB, and helped her to the hospital where she was diagnosed with TB. Laua also developed the visual impairment when she was ill with TB.
Helen provided daily anti-TB treatment and support to Laua until she completed the treatment.
Apart from anti-TB treatment, Helen and Lucy, a neighbor, helped to fetch water and cook for Laua. Laua thanked Helen for supporting her even after the treatment was completed.
Erima is a TB burden community in the National Capital District (NCD) with more than 3000 cases of TB between 2018 and February 2021.
Data show that, despite making up only 5 percent of the nation’s population, NCD contributes to 25 percent of all TB cases in Papua New Guinea (PNG). The overcrowded settlements and transient population have caused widespread infection.
Although the Gordon’s Health facility is just a five minute bus ride away from Erima Settlement, people’s health seeking behavior is still very poor.
The most common reasons given by most is having ‘no time’ to visit the facility because they are busy with street selling, gambling or going to work.
Few parents or caregivers wouldn’t want to bring their children to the health facility at the early signs of illness but have time for these activities to earn an income survival.
Other reasons are ‘no bus fare’ Community members also have concerns for their safety when travelling as petty crimes and murder are common occurrences near the Gordon’s Health facility and Erima settlement. Stigma and discrimination also affect people with tuberculosis from seeking health services. Misconceptions about the disease are very common and most people blame sorcery when they come across TB cases.
In support to the National Capital District Provincial Health Authority’s (NCD PHA) treatment supporter program, World Vision established the outreach site at Erima and trained 11 community treatment supporters (CTS) to provide support to people in the community who are undergoing treatment for TB.
With funding through the Emergency Tuberculosis Project (ETP) of the National Department of Health (NDoH), permanent outreach site facilities were constructed, including a building, VIP latrine and a 2000 litre water tank. As the outreach site was established, patients diagnosed with TB were referred from the TB clinic to the outreach site through a referral pathway. Since 2018, 3237 TB patients have been referred from TB clinics to this outreach site.
The CTS observe and monitor daily doses for the patients at the outreach site or in the patient’s home if the patients are unable to walk. That is known as directly observed treatment (DOT) as stipulated in the National Tuberculosis Management Protocol 2017.
Anti-TB medicines for the patients are stored safely in the building. Each patient has a medicine kit packed at the clinic and delivered to the outreach site. The patients are sent back to the TB clinic for review after completion of treatment, where diagnosis and doctors review take place. So far, the outreach site has received patients from, six-mile, nine-mile, Port Moresby General Hospital and Gordon’s TB clinic. Currently there are 70 TB patients within the Erima settlement, supported by three CTS.
Susan is a nurse at Gordon’s TB clinic who works closely with the CTS in the communities. She says, “I had little doubts and concern when I first referred patients to the CTS but I decided to give a try. The positive outcomes have made me to trust these people.” “This program is the way forward to ending TB in our nation.” She adds.
World Vision also conducted learning and reflection sessions with clinicians and CTSs that helped them to better understand the program. Since 2018, through this partnership, the team have conducted 52 TB awareness sessions, 60 contact tracings and 28 patient meetings.
The behavioral change awareness sessions and patient education meetings conducted have changed people’s behavior towards eradicating the deadliest disease. The patients were encouraged to come to the outreach site for medication every day except weekends. Community members were also educated on the symptoms of TB and they have since referred their family members to the outreach site for checkups. The people around the outreach site area were also supportive in encouraging patients to take their medication. Patients are now accessing the outreach site without stigma or discrimination.
Aside from serving patients with tuberculosis, Erima community also have access to clean water at the outreach site.
Alice, a community member, says, “We have no water supply to our home. Since the outreach site was set up here with the tank, we’re able to access clean water through this tank. Thank you World Vision for the tank you’ve given to our community.”
The surrounding communities fetch water and do laundry using water from the tank. Helen says, “Around 30 to 40 people come around to fetch water in a day. I advised them to have one container (20 litre each) so they have equal share of water. They respect the patients. They use the water after the patients finish taking their medication.”