Story and pictures by PAULA KARI
TB partners in Daru, including World Vision, have welcomed the TB Mobile Clinic, recently unveiled by the Deputy Health Secretary Dr. Paison Dakulula in Daru. The TB Mobile Clinic hopes to boost the National Department of Health (NDoH) and partner efforts to ‘ACT Now!’ and ‘Kick TB out’ of Daru, Western Province.
The TB mobile clinic boasts a computerised system for screening TB including a digital x-ray and a systematic process of referral for diagnosis and treatment at the Daru General Hospital. Upon enrolment, treatment will be commenced and completed at the five treatment (D.A.R.T.) sites on the island, including one at the World Vision compound. Featuring the PNG SP Hunters Skipper Ase Boas’ image kicking a ball, the red and white painted Mobile Clinic is an eye-catcher relaying the National Department of Health’s national campaign to “ACT Now!” and “Kick TB Out of PNG!”. With the SP Hunters, specifically Boas’ performance in the recent Intrust Super Cup, the Hunters’ skipper is an inspiration to many Papua New Guineans, even in Daru, where the population is not so much into rugby league, but rather rugby union and touch football.
The fight against TB presents many challenges still for Daru’s 18,000 populace and TB partners, especially as Daru Island is the heart of business and services for the South Fly District (SFD).
Daru General Hospital (DGH) is the only active Basic Management Unit (BMUs) for screening, diagnosing and treating TB in the South Fly and one of five BMUs in Western Province (pop: 243,238 – 2017 est.). In the last three years, it has treated 1,432 people for TB. In October 2017, DGH was treating 193 Drug-Susceptible (DS-TB) and 166 Drug-Resistant (DR-TB) patients, according CEO Sr. Orpah Tugo. DR-TB patients from Balimo and Kiunga BMUs also receive treatment in Daru.
While the DGH has expressed concerns on the extra strain the Systematic Screening Initiative (SSI) for TB in Daru might have on the hospital’s current processes, systems and staff, TB partners believe now is the time for this next phase to finally eradicate TB in this hotspot island.
“…we are moving towards getting through the process of eliminating TB on the Island of Daru and in Western Province. How long it will take will depend on our partnership and what we have been doing. We are encouraged by the work that’s been done right at the ground level with leadership in the community, with our people, as well as with our partners, including the Government of Papua New Guinea, Burnet Institute, HHISP, and World Vision, thanks to the Australian Department of Foreign Affairs and Trade (DFAT) and new support from the World Bank,” said Dr. Paison Dakulala, Undersecretary for Health, National Department of Health (NDoH).
Dr Mark Jacobs, Director of Communicable Diseases, WHO Western Pacific Region, who visited Daru to witness the occasion of the unveiling of the TB Mobile Clinic said that while there has been big improvements in TB all over the world, reduction in deaths and in the number of people getting sick with TB, it is still the number one infectious disease in the world. “It is still causing ill health than any other diseases. So there’s still a lot the world needs to do to come to grips with TB.”
On a positive yet challenging note, Dr. Jacobs said the efforts in Daru and PNG were also discussed during a recent high level global meeting in Moscow.
He said this indicates that the efforts so far in PNG in terms of the emergency response and particularly, the efforts and the achievements so far in Daru, are not just important for Daru, but also important for PNG, for the region and for the rest of the world.
“That really shows how important the work here is and also means there is a big responsibility for all of us to really finish the job. There’s a lot that has been done already, there’s a lot of support from different donors, but now is the time to push on and really ‘Kick TB Out of Daru’, and really show the way for the rest of PNG and for many other countries in the world,” said Dr. Jacobs.
According to Dr. Sonia Madjus, World Vision’s Technical Lead for TB (Western Province and NCD), World Vision’s role has now moved from community mobilisation, education and awareness to taking care of patients in the community.
“Our role is to educate the communities and our health workers, including our volunteers (treatment supporters) from the community on how to identify presumptive TB in the community. Then they are enabled to better refer these patients to the health centres/aid posts so they are referred back to the BMU (hospital). The hospital does the proper screening and diagnosis of the patient. And as soon as possible, the patients are returned back to the communities,” explained Dr. Madjus.
She said they have been working with patients and treating them but cases are still coming up. She welcomed the TB Mobile Clinic saying it will really help the Government and partner efforts to find, treat and hopefully eliminate TB on Daru Island.
“We hope that we’ll be able to screen at least 85% of the population so that we’ll be able to detect most, if not all, the TB cases on the island. Of course if we do that then we’ll be able to put them on treatment and stop the transmission of TB in the community – and that’s the most important part that needs to be undertaken right now. And we look forward to making Daru Island healthy and TB free,” said Dr. Madjus.
About 87% of patients are receiving continuation of care and treatment in the community DART sites on Daru Island while another 11% are receiving treatment in communities outside of Daru.
World Vision provides nutritious meals for both DS-TB and DR-TB patients in Daru, boosting patients to continue receiving treatment to completion. Patients also receive food vouchers of K100 for DS-TB patients and K150 for DR-TB patients, 60% used to purchase food items and 40% to purchase items to further sustain their livelihoods for instance, for further income generation activities.
- Paula Kari is Senior Communications Officer, World Vision.