Eradicating TB in Daru requires everybody’s help

By ELLEN TIAMU

THE Mayor of Daru Samuel Wingu has big plans to change the outlook of his town which currently leads the national statistics for having the most number of people with tuberculosis (TB). Not only are the numbers the highest, there also exist the more dangerous forms of TB, MDR-TB and XDR-TB. The former is way more expensive than the first line TB drugs, and means longer stays in hospitals- all costing loads more money. The latter is a rare type of multidrug-resistant tuberculosis (MDR TB) that is resistant to the most potent TB drugs and is extremely difficult to treat.
TB is a disease that is mainly spread through the air, thus initially affecting the lungs.
The majority of the 17,000 population of the colonial township are people who migrated down from Fly River due to their livelihoods being destroyed by Ok Tedi. Daru is in the South Fly District and is the capital of Western province. It is still an emergency area as the struggling Daru hospital and provincial health care facilities battle to contain TB.
Prior to TB, cholera swept through the province with the South Fly area also the hardest hit. Three years ago, just as Cholera was dissipating, TB showed its ugly head.
Mayor Wingu joked about his town hitting the headlines for all the wrong reasons when he addressed officials of the National Department of Health and Daru hospital, who, together with their partners, were in the island town last week for the launch of new equipment to be used to quickly test people for the disease, once thought to be an illness of the past.
Overseas partners such as World Bank, World Vision, Australia’s DFAT, WHO, Burnett Institute, Australian High Commission, and HSSIP are all working with the National Department of Health, Daru Hospital and Provincial Health Office in the fight against TB.
The mayor strongly urged Western province MPs in parliament to speak up to get more attention to their plight, “bang the tables if they have to.”
He commended all the partner organisations for chipping in try to alleviate the problem. He himself fell victim to TB and has recently completed treatment.
“Our MPs must talk and fight to assist Dr Dakulala to fight TB. Our politicians need to go out in a bigger way.”
Wingu lamented that while the Government has no problem spending hundreds of millions of kina on infrastructure around the country, he quipped that there will soon be no one left to enjoy these structures because everyone would be dead from TB.
He said the government was not contributing enough towards the plight of the people of Daru and the town which has been left to suffer all kinds of ills including lack of basic development.
Even the provincial government, he said, was doing very little, and he wants to see the number of those affected to be brought down to a manageable level. ”
The mayor is hoping that a mega project he has planned to shakeup and cleanup the town will be approved by the provincial assembly as this will compliment what the stakeholders are doing in the fight against diseases in his town.
Daru, last Thursday received a new mobile clinic to assist in the ongoing fight to subdue and eradicate TB in South Fly. The launch also kick-started a nationwide campaign, Kick TB Out, featuring rugby league star Ase Boas.
The mobile clinic consists of a truck and shipping containers that hold special computer-generated TB testing and x-ray equipment that will be used to go around the island, or the mainland if necessary, if the roads allow, to conduct public screenings.
The sensitive equipment was procured in the Netherlands and brought to PNG by the National Department of Health, costing K1.3m.
The mayor was pleased with the first-of-its-kind equipment.
“Everybody must make him or herself available, every child must make themselves available for systemic screening.”
He also called on the local people to take care of personnel and equipment on the island.
According to the town’s TB program coordinator Lucy Morris TB sufferers in the past travelled to Australia, through Torres Strait, to seek treatment in Australia. It was sometime in 2013-2014 that Multiple Drug-Resistant TB (MDR-TB) showed up in Daru after patients returned to Daru and skipped medication or failed to make follow-up visits to the Daru General Hospital.
The problem started worsening in 2014 and a visit to the island by Dr Dakulala in 2014 confirmed that the worst- drug-resistant TB was a major problem and an emergency situation was declared.
As of October this year, hospital records showed the number of Drug Susceptible – TB (DSTB) cases at 193 and Drug Resistant (DR-TB) numbers at 193. The figures haven’t changed much with CEO of Daru Hospital Orpah Tugua. She estimates five new cases every month. The other cause for real concern for health authorities and people fighting against the disease is the XDR-TB numbers which currently stands at around 20. Extensively drug-resistant TB is a rare type of multidrug-resistant tuberculosis (MDR TB) that is resistant to the most potent TB drugs and is extremely difficult to treat. Let’s not forget that the drugs that all TB patients take can have side effects.
Assistant Health Secretary Paison Dakulala, who heads the fight against TB around the country, estimates that for every person that contracts the disease, 15 others become infected.
He said this might mean that the battle against TB in South Fly could take as long as 10-15 years before the results start to get better.
He also pointed out that the Health Department and its partners can only contribute so much but the bulk of responsibility lies with the people of Western if they want to see changes in their health and lives.
Most of the partners in the fight agree that a balanced diet, cleanliness, improved hygiene and sanitation as well as patients completing their required “first line” TB medication will see the numbers of patients drop.
According to the TB programme coordinator in Daru Lucy Morris, TB is not the only issue they have to deal with, an increasing number of leprosy and malaria patients are also posing a problem.
From what it is currently, Daru can be turned into a beautiful seaside town. The place can be cleaned up and consequently, diseases eradicated or subdued. As they say, a healthy town is a happy town.

what is Tuberculosis (TB)?
Tuberculosis (often called TB) is a bacterial infectious disease that usually attacks the lungs, but can attack almost any part of the body. TB can be an active disease or latent infection.

How is Active TB Spread?

• When people with TB in their lungs or throat cough, laugh, sneeze, sing, or even talk, the germs that cause TB may be spread into the air. If another person breathes in these germs there is a chance that they will become infected.
• It is not easy to become infected with TB. Usually a person has to be close to someone with tuberculosis disease for a long period of time.
• Even if someone becomes infected with TB, that does not mean they will get active TB disease.

What are the Symptoms of Active TB?

People with latent TB do not have symptoms and are not infectious. A person with active TB disease is infectious, and may have some or all of the following symptoms:
• a cough that will not go away
• feeling tired
• weight loss
• loss of appetite
• fever
• coughing up blood
• night sweats

These symptoms can also occur with other types of lung disease so it is important to see a doctor and to let the doctor determine if you have TB.

What are the Risk Factors for TB?

Anyone can get TB, but for many reasons, some groups of people are at a higher risk of being exposed to tuberculosis. Some of these groups include:
• People in close contact with those known to be infectious with TB
• Immigrants from countries with high TB rates such as China, Philippines and Brazil. Other countries with high tuberculosis prevalence rates can be found here
• People who work in, or are residents of long-term care facilities or correctional facilities
• People affected by poverty, malnutrition or poor housing
Some people who are exposed to TB are at an increased risk of having the infection develop into active tuberculosis if they have medical conditions that make their body less able to protect itself from disease. Some of these medical conditions include; HIV infection, chronic kidney failure or diabetes. – Source; healthunit.org