Children account for 26 per cent of detected TB cases in PNG, according to figures from the PNG National Department of Health, although this is likely just a fraction of the real story. Dr Welch is convinced that malnutrition “absolutely” plays a substantial part in the disease profile. “In PNG, 43 per cent of children are too short, they are stunted, because they don’t have proper nutrition. That’s almost half of the population of children.”
This is supported by UNICEF, which states that malnutrition is the underlying cause for the majority of deaths of children under the age of five in PNG.
Dr Welch adds: “TB is one of those social diseases. The medicines for TB really aren’t that difficult – we’ve got that figured out. But it is really about treating the social problems behind the disease … it’s a disease of poverty.”
ChildFund’s health project coordinator Olive Oa has both professional and personal experience of the potentially lethal obstacles facing children with TB in PNG. This includes growing evidence of diagnosed and undiagnosed TB in children in the communities she visits in Central Province as part of her work.
“Because adults are not getting treatment, you will then see children with large lymph nodes. The parents think it is normal until the child starts to lose weight and becomes tired, then they get diagnosed as having TB.”
Ms Oa was convinced that a 10-year-old family member had tuberculosis. She told health workers her suspicions, but he was misdiagnosed at two clinics in Port Moresby, and again at a hospital. When a chest X-ray came back clear, she pushed hard for a referral for more tests. Her determination meant the boy eventually had a CT scan, and was diagnosed immediately. The TB was in his stomach.
By this time, the boy was gravely ill. But within a week of treatment his health had improved dramatically. “He ate a lot of food. He gained back weight. He took the medicine for nine months,” Ms Oa reports. Today he is in his second year at university.
ChildFund Australia CEO Nigel Spence says: “It is shocking that globally more than 140,000 children die each year from TB, and that one million become sick, from an entirely curable and largely preventable disease.
“The luckiest recover, but at substantial cost to their education, their prospects and their families, whose fragile livelihoods are eroded by the effort to provide care, medication and nutrition to sick children over months and even years of treatment. This feeds into a generational cycle of disadvantage.”
Mr Spence adds: “We continue to urge leaders to find the will, resources and strategies to win the war against TB. In the meantime, ChildFund remains committed to equipping communities at the frontline with the means to win their battles, to save lives and livelihoods, and protect children’s futures.”