Tuberculosis: an emerging health emergency
25 November 2010
PNG IS LOSING its struggle to control tuberculosis three years into a five-year, $20 million plan to reach 80 percent of the country.
“In comparison with other countries, PNG is lagging behind," said Marcela Rojo, spokeswoman for the Global Fund to Fight AIDS, Tuberculosis and Malaria.
With 16,000 new cases a year, PNG has the highest TB prevalence rate in the Pacific - and someone dies from TB every two hours, according to the Department of Health.
Health officials blame the country’s disorganised and ill-equipped health system. “Unless the national government provides funding and resources to deal with this issue, we are faced with a serious health problem,” said head of the National TB Task Force, Paul Aia,
When asked if the $20 million grant is enough to fight TB in an endemic country of 6.9 million people, Ms Rojo explained that countries request funds according to their assessed need.
But PNG’s 80 percent coverage goal by the end of 2012 excludes some of its most remote and sparsely populated areas.
This places PNG behind other high TB countries like Vietnam and the Philippines, even though the Global Fund has paid out $15 and $53 for every 100 people in Vietnam and Philippines against $118 in PNG.
About two percent of newly diagnosed TB cases are drug resistant in PNG.
Mr Aia and World Health Organization representative in PNG, Egil Sorensen, characterised multiple drug resistant tuberculosis TB as an emerging “health emergency” in PNG.
Mr Aia blames drug resistance not only on patients who do not keep to their treatment regimes, but also on drug shortages.
“The situation is so bad, even our health workers fear for their lives,” he said.
Source: UN Office for the Coordination of Humanitarian Affairs
I write on behalf of South Fly Health District of Western Province. South Fly has a population of 60,000 people. The land mass is huge and about 60% of the land is swampy. The main transportation is motored dinghies.
About 25 % of tuberculosis diagnosed in Western province is Multi drug resistence. Multidrug Resistant TB is a type of TB that is hard to treat using the four common drugs normally used when you are first diagnosed with tuberculosis.
Those diagnosed with MDR TB are crossing the international border for treatment and follow up at the Torres Strait Island clinics. The medical outreach clinics from QH have been treating PNG nationals since 2002.
The follow up and ongoing management of these patients have been made challenging with the lack of transportation to transport these patients timely to clinics.
If we go back 20 years, I remember a health boat that comes around to community schools to update children on their BCG vaccination and make oral and dental checks. This business has ceased fron 20 years now.
I strongly fell all maritime provices should be equipped and provided a boat for that purpose.
MDR TB is a huge public health issue in Daru and resources are required to address this before it is blown out of proportion and Government support is highly anticipated.
Posted by: Dunstan Peniyamina | 06 July 2011 at 04:38 PM
Peter and Lydia - Thank you for your comments and for what you are doing in the settlements.
I teach at the medical school in Taurama (UPNG). Could you tell me if Kaugere clinic is still functioning?
I wonder if you could contact me by email and we could discuss possibilities where we could involve medical students in the some of the screening process for TB etc. particularly if Kaugere clinic still runs.
Unfortunately we do not have adequate funding and resources but we do have students and the mandate to extend our activities to the communities in which we live.
We are currently trying to get students exposure to the rural and remote communities but it seems their exposure to the urban poor is somewhat limited to only those who present to PMGH. It may be an area to explore (though much of our constraints are due to manpower shortages).
My email address is [email protected].
Posted by: Paulus Ripa | 29 November 2010 at 12:57 PM
Peter and Lydia - You have effectively pinged the problem. What were the responses you received when you wrote to all the aid agencies, service clubs and most importantly, AusAID representatives at the High Commission?
I'm sure taxpayers and contributors down here would be very interested. Nothing like closing the two loose ends of a thread to end up with a connection.
_______________________
I'd like Lydia and Peter to write an article for PNG Attitude on how they assess the AusAID response to the life threatening problems they describe - KJ
Posted by: Paul Oates | 25 November 2010 at 01:47 PM
Kaugere Settlement has a population of 10,000 men, women and children. The section where we live and have our school is called "14 Street" and would have a population of 2,000-3,000.
We have been advised by health professionals that 14 Street Kaugere has the highest incidence of TB infection in the whole of PNG.
We have witnessed for ourselves far too many children who "die in the haus" from TB, because they have not been immunised and do not have the necessary two kina (80 cents) to go to the haus sik and get treatment.
These were children that were vibrant and healthy in every other respect, except that they contracted TB and because of their virtual starvation their little bodies are weak and can't fight off the disease.
We have personally carried too many children in the back of the school truck to the morgue and later for burial.
The General Manager for Ela Motors in PNG is a lovely man by the name of David Purcell. It is a personal passion of his to eradicate TB. During a meeting with him we spoke about the high incidence of TB in 14 Street and our concerns for our CUMA school children.
He stated that Ela Motors had just donated brand new vehicles to World Vision and told me to contact a specific doctor at World Vision and tell him that David from Ela Motors had referred us to him.
We immediately did so and several weeks later a World Vision representative arrived at 14 Street driving one of the brand new donated vehicles.
We discussed the situation and asked that they run an immunisation and TB check program at our school; for our school children and others in the 14 Street Community.
The World Vision representative told us that "we do not have the money to do this". We asked him how much it would cost so that we could find the funds ourselves to pay for it.
That was the last we ever saw of him or anyone from that organisation.
Please don't think we are whingers or negative because of our comments about AusAID and now World Vision.
All of the aid organisations are the same - most of the money is spent on self-sustenance of the organisation.
Our point is this: we live with the majority of the population of PNG on the bottom of the food chain.
Those wonderful people in their lofty clouds who think they are helping the people with their billion dollar organisations are sadly misled.
At the end of the day there is nothing to show for it once it filters down to the grassroots. We know because we are down here and can see if there is anything coming through or not. Ad there isn't anything hitting the ground.
It is the same story: numerous and massive reports and studies on the problem, media coverage of the problem, expensive workshops at Holiday Inn and Crowne Plaza to discuss the problem, millions spent on the best advisers and their opinion of the problem, NOTHING done to FIX the problem.
We could save these organisations (and their wonderful and generous donors) all that money and trouble if they would only listen.
Give us the TB vaccination drugs and syringes for about 800-1,000 children and we will get a group of nursing sisters to volunteer a day to the Kaugere Community and give the children a quick jab in the bum and the problem will be fixed.
Is it really so hard? Is it really so complicated? Get down to the basics and get on with the job; all this other crap is just unnecessary and is literally killing the children of Papua New Guinea.
Posted by: Peter & Lydia Kailap | 25 November 2010 at 01:18 PM