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End TB Inform the Population

 

“It is where she was working as a maid for Indians that is where she got the problem. When you are cooking their food you have to put a lot of chillies in it,” explained Mother of how she believes her teenage Daughter got infected with pulmonary tuberculosis (TB). This was April 2017, during an interview with CPAR Uganda Ltd (CPAR).

Shortly after Daughter returned home from town, according to Mother, “one evening she vomited a lot of blood at around 5:00 p.m.” On seeing his granddaughter vomit blood, he apparently cried out in resignation: “she is finished, she is going to die.” Mother said that she remained strong and that she re-assured her father: “In the name of Jesus, she is not going to die.”

They went to the “main government hospital”, where, according to Mother, a medical doctor told them that there was no cure, but for surgery to remove a “hernia in the heart.” Unable to afford heart surgery they returned home, but someone advised Mother to get Shs. 30,000/= and take Daughter to see a visiting doctor. He worked in a referral hospital in town, but periodically run clinics in rural areas.

Mother said she borrowed money from a village group and took Daughter to the visiting doctor, who was running a clinic within the district.  The doctor gave Daughter some medicine, according to Mother, “syrup and then some tablets which stopped the vomiting. Then he gave her two injections and told me to take her home and return the following day so he could give her some more injections, which I did. She got better, the vomiting of blood stopped, but she continued to cough.”

Eventually, mother said, she took Daughter back to the “main hospital” and this time she was tested and it was confirmed that she had TB; was put on anti-TB drugs; and cured.

A two-year study that CPAR conducted in Uganda in 2016-2017 finds that Daughter is among the few of thousands of TB patients in Uganda whose story has a happy ending. Albeit her flawed knowledge of how TB is transmitted, Mother took the initiative and sought medical services.

Like mother, the CPAR Study finds, thousands in Uganda have a flawed understanding of how TB is transmitted. Some, like mother, think it inhaled while cooking food with chillies. Some think it comes through witchcraft. Others think it is those who “sexually misbehave” who get it and also get HIV and AIDS.

For those who think witchcraft, chances are high that they will not bother seeking medical services, but will resort to witchcraft, religion, or will resign and wait for death. Those who think TB transmitted through “sexually misbehaving”, if afflicted will likely opt to hide their illness for they fear they could be ostracized and so are less likely to actively and openly seek medical services.

As can be deduced by Mother and Daughter’s experience, the CPAR Study finds that TB patients may be discouraged to seek medical services by questionable practices of medical personnel; the cost of services; or the quality of services.

TB is a highly infectious airborne disease, transmitted by airborne droplets during sneezing, coughing and contact with sputum. One gets TB from being in close contact with an infected person, as Daughter likely did.

Seemingly, therefore, in Uganda, the weapon of mass destruction that is rapidly spreading TB, a deadly disease, is the flawed knowledge that a significant proportion of Ugandan’s have of how TB is transmitted. Time is now for Uganda to rollout a multi-pronged TB awareness campaign. A well informed population will end TB.

 

About the Author:

Ms. Norah Owaraga is the Managing Director of CPAR Uganda Ltd, a not-for-profit development organisation. CPAR Uganda Ltd was part of a consortium code named: “Tuberculosis: Working to Empower the Nations’ Diagnostic Efforts (TWENDE)” that implemented the TWENDE research and advocacy project on tuberculosis; a consortium for which Ms. Owaraga, a cultural anthropologist, was the sole Social Scientist.

This article is among the products of the TWENDE project that is part of the EDCTP2 programme supported by the European Union.  Whereas, the EDCTP Association and the European Union provided funding for the TWENDE Project, the views herein expressed are not necessarily those of the EDCTP Association or those of the European Union.