My first time encountering TB this year was in Port Moresby… a boubou (gran-ma) was taking her 3yo grand-daughter to the clinic for TB relapse. Her mum had died from TB when she was a baby. Having no one left to care for her, she was placed in the care of her grandmother. Not long after, the baby girl was diagnosed with Pulmonary TB. Boubou helped the child to take about half of the prescribed TB treatment, and then the child got better, and Boubou ended up stopping to enforce the treatment. The day she came to clinic, she had no symptoms… but 3 weeks prior, she had a relapse; strong cough and started coughing up blood. They came to the clinic then but were too late and didn’t get seen. That day she was prescribed the Category-II treatment, which include an injection everyday for the first two months and then switching to oral treatment for the following 4+ months. She’s three years old, It’s NOT OK! There needs to be a deeper understanding of the ramifications of untreated TB. People need to know that TB IS TREATABLE!
Another one was a 50ish years old man with Pulmonary TB laying in the rest hut attached to the house. He was not allowed inside due to his sickness. His family thought that they would get TB if he lived in the house with them. Then man had already been on treatment for 2 months. One of the greatest things about the TB treatment is that once you’ve been on treatment for 2 weeks, the infection isn’t transmittable anymore! Unfortunately he had been suffering from TB for a very long time prior to diagnostic and the disease had damaged his lungs so much that it was difficult for him to practice any kind of motion without becoming extremely short of breath. Apart from sending him for review at the hospital, we were able to show him how to do some easy physiotherapy for bedridden patients. We’re hoping he’ll regain strength and be able to walk inside the house and out to the toilet without as much difficulty.
Last but not least… during the last week of the IPHC outreach, I came across this girl.
Her mother said that she had fallen out of her bed five years ago and that the lump on her back had been growing ever since.The only thing I could think of was “OMG, OMG, OMG, how bad does it need to get before people realize that it could be serious!” This is definitely TB of the spine, and if nothing is done, she could become paralyzed. I took a deep breath and got started with the examination and looked through her health book. Major findings:
A 10 years old girl with a deformed Spine +++
Growth development, for height and weight, of a 6 years old
History of TB in the family, yet never screened for TB…!
And never put on any treatment despite typical presentation of TB of Spine!
She’s had a growth for 5 years, getting worse and worse… nobody suspected TB!
The mother did take the child to a “private doctor” who charged K300, and did not perform any test… no x-ray, no sputum test, simply diagnosed with “bent back”.
When I showed this to the health worker assigned to accompany us throughout our travels, he couldn’t believe it! We wrote a reference letter for the child to get treated and also informed the family as well as the local community health worker about the seriousness of the case and the need to seek treatment.
Sad day for our team to see such a lack of knowledge about a very prevalent and curable disease. But also a happy day for the mother, finally getting an answer to what seemed to have started 5 years ago. And hope that it can stop spreading as her daughter gets treated.