On the move

I recently visited for the first time ward 4 (TB ward) of the Port Moresby General Hospital (POMGH).
I have been writing about TB (Tuberculosis) and this was an opportunity to see for myself how the disease is affecting our people.
I was told that the patients in the ward were all multi-drug resistant TB (MDR-TB) patients. MDR-TB refers to patients who were put on treatment when first diagnosed but discontinued and became resistant to the first line of drugs and were now on the second line of drugs. It would take an MDR patient 18 – 21 months to be cured, where as a normal TB patient would have six months to be cured if faithful to the treatment.
I spoke to Haro Sarea from the Gulf province, who had been a patient in the ward for almost a year.
Haro was first diagnosed with TB in 2007 at the Malalaua health center back home. He was put on treatment but could not keep up the consistency because he had to travel to and from his village and the health center to get the drugs. The drugs did not work for him and he became very sick and was referred to the POMGH.
After starting on the second line of drugs he began regaining his health and strength and is now a ‘positive’ TB advocator in the ward, encouraging other patients to keep up with their treatment.
“I feel better now and I encourage other patients to complete their treatment on time. The drugs are working (for me) because of my faith in God, he blessed the medicine and so I encourage the others to complete their treatment,” he said.
TB is one of the killer diseases in PNG. The National Department of Health, the World Health Organisation and other non governmental organisations like World Vision International and Hope Worldwide have joined hands to fight TB by increasing awareness and advocacy through community volunteers, setting up labs in the urban clinics run by the NGOs and rolling out the drugs to selected provinces in the country thanks to funding from the Global Fund.
The battle gets tougher every year as they see an increase in the number of TB and MDR-TB cases not to mention the number of people who die from the disease. TB is 100% curable and it can be prevented from spreading. To prevent it requires simple habits like covering your mouth and nose when you cough or sneeze because it is an airborne disease it spreads quickly when an infected person does not practice these habits.
The environment in which an infected person lives is also a contributing factor to the spread of TB. Overcrowding in houses, poor water and sanitation also contribute to the spread of TB.
At the beginning of this month the 9 Mile clinic run by Hope Worldwide recorded 74 confirmed cases of TB from January to February and its likely the number could have increased now.
TB nurse Sr Nimai Derevi said they were detecting four cases a day from all age groups of both Pulmonary TB (TB of the lungs) and Extra Pulmonary TB (TB affecting other organs).
Sr Nimai said the defaulter rate of TB was also rising. Defaulter rate refers to the number of patients who have discontinued their treatment and this is a common trend in other clinics. The increase in TB cases recorded at the 9 Mile clinic is bad news but given the clinic’s excellent record of managing drug supplies and the turn around time in obtaining test results from sputum samples, patients are diagnosed and put on treatment right away.
It is the patient and family’s responsibility to ensure that the treatment is adhered to for the period given. There are a number of reasons why patients discontinue their treatment and they are; the side effects caused by the drugs ( itchiness), lack of support from family members and financial constraints in having to travel from a village to an urban health facility.
The national TB programme in PNG aims to increase the TB case detection rate and cure rate to global targets of 70% and 85% respectively. This is being implemented through the Directly Observed Treatment Short Course Strategy (DOTS). DOTS has been rolled out in NCD, Morobe, Eastern Highlands, Madang, Milne Bay the Highlands provinces excluding Enga. 
With this strategy in place the Government aims to cut down on the number of people dying from TB by 2015.
A Papua New Guinean dies from TB every two hours-the equivalent of nearly 38, 000 every year. Every year 16, 000 new cases of TB are detected including 2, 900 people who are
co-infected with HIV. Almost 25% are children.