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Battling TB on the frontline in PNG

For Papua New Guinean health worker Celestine, tackling the tuberculosis (TB) epidemic in her country has become somewhat of a personal crusade, after losing both of her parents to TB and contracting the disease herself. More than 9,000 people have died from TB in PNG over the past three years – including hundreds of children – and it is people like Celestine working on the frontline who urgently need support to tackle this terrible but treatable disease.

“I always wanted to help sick people get better, but I never wanted to work with TB patients. I was afraid I would catch it,” says Celestine I’Ova.

Celestine is a health worker at a small rural clinic in Papua New Guinea`s Central Province. The clinic is a basic shack, typical of many across PNG. There are just six staff to provide support for around 15,000 people, some of them travelling six hours by boat for medical attention.

Despite having over 20 years of frontline experience as a community health worker, TB has always held a particular terror for Celestine. Both of her parents died from the disease, and she admits avoiding TB patients for years afterwards.

“I did not want to learn how to treat TB patients,” she says. “Also, with the deteriorating health facilities and lack of resources at our health centre, I felt it was not safe for us. When TB patients came, I never stood in front of them or spoke to them; I always moved away from the patients.”

In PNG, however, TB is a growing epidemic. Over the past three years, it has killed 9,000 people in the Pacific island nation, with children particularly susceptible to the most disabling forms of the disease. By comparison, the Ebola virus, which galvanised such international fear and concern, killed 11,300 people globally in the same period.

 

10-year-old Grace is battling TB for the second time in her life.

ChildFund Australia – which has launched a report on the TB epidemic and its devastating impact on children – has been working in Papua New Guinea for the past 20 years, stepping up efforts to reduce the spread of TB since 2013.

“Tuberculosis is an entirely preventable and curable disease,” says ChildFund Australia CEO Nigel Spence. “It is absolutely critical that health workers in rural areas have the right tools and knowledge to prevent and treat the disease, and to raise awareness about the importance of early medical intervention.”

ChildFund is among several organisations playing a critical role in training and equipping health workers to detect TB early and ensure patients complete their full course of treatment.

“Three years ago, ChildFund selected me to attend a TB workshop. I accepted because, at that time, nobody was trained on TB at my clinic,” Celestine recalls. “After the training, I completely changed my negative thoughts about TB and wanted to help.”

Tragically, the first patient she treated after her training died from the disease. But for Celestine, his death only highlighted the importance of the new work she was undertaking.

“I could not help but think about his family and his community, and how many of them are out there and not treated until it’s too late. I did not want to witness another death and from that day worked hard to monitor my patients and quickly get them tested.”

Celestine checking Grace’s weight for her record card.

Working in such close quarters with infected patients has put Celestine’s own health at risk.

“After four months of treating TB patients, my sputum test confirmed I had TB too. I stayed at home but it is just few metres away from the TB lab,” she says.

“Every Tuesday, I saw my patients queue up and they were referred to other health centres because the other officers could not treat them. It broke my heart seeing them leave.”

Knowing she was no longer contagious after three weeks of medication, Celestine asked if she could return to work. She got the OK and resumed her duties while remaining on medication for the next seven months.

Now, ensuring better healthcare for TB patients in her remote community has become somewhat of a personal crusade. Celestine is very concerned that the incidence of TB is on the rise.

“The increasing number of patients coming in for TB tests shows that there could be more untreated TB cases out there,” she says.

“Many communities do not know how to live a healthy lifestyle. If someone is coughing in the house for weeks, it does not worry the other family members unless that person is bedridden. Only then do they feel the need to take that person to the hospital.”

She adds: “I would like to go out to villages and educate them about TB and about how important it is to take their medicine every day and on time.”

It is essential that people with TB complete their full course of treatment to cure their illness.

Celestine is also advocating for improved facilities at her clinic, including a TB-only ward to provide better support to patients requiring admission, and more trained staff. Currently, Celestine and her team of three treat as many as 60 patients a day, and provide support for emergencies at night.

More community outreach is also vital, she says, however: “Our vehicle runs only when we have enough funds to buy fuel.”

The immense challenges in tackling TB are none too steep for Celestine, who has completely overcome her early trepidation and is now committed to fighting this disease on the frontline.

“We never turn a TB patient away,” she says. “In spite of everything, what keeps me going is the patients. When I see the smiles on their faces after they recover, I am so happy.”

ChildFund Australia has launched a fundraising appeal to help children and communities battling TB in Papua New Guinea. Donations will help train and equip local health workers, like Celestine, in PNG’s remote villages.

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