Community Health Warriors Battle TB; in an Area Where Poverty Is a Breeding Ground for Tuberculosis, Care Workers Form the Front Line against It, Writes Vusumuzi Ka Nzapheza
NTOMBEKHAYA Mhlekwa hates the poverty, the filth, the stench that permeates the squatter camps of Khayelitsha, and which allows tuberculosis to thrive. As a community-based treatment supporter, she sees the squalor at SSD section of the township from her shack, which doubles as a dispensary for TB patients under her care.
Mhlekwa believes the bucket system has worsened the health of her TB patients or clients – as she refers to them in the language of TB Care South Africa, the NGO she works for.
“You look around and all you see are cramped shacks and the filthy surroundings. TB is difficult to cure in this environment,” Mhlekwa said.
Khayelitsha has the highest number of people with TB in the Cape metropole.
Mhlekwa is responsible for 16 of the estimated 1 000 people who have the lung infection in the township. Every weekday they come knocking at her shack to take their treatment.
Unemployed couple Sindiswa Siyoko and her husband Zwelisha Gwabeni walk together every day to Mhlekwa’s shack for their treatment. Gwabeni said he was diagnosed in September and Siyoko on February 14 when she visited the local clinic.
“I was feeling tired and sweating all the time,” she said, adding she noticed the TB symptoms because she had seen her husband go through the same.
Their poverty is evident, and Gwabeni said they depended on a stipend Siyoko’s sister sent them for their upkeep.
Ria Grant, the director of TB Care Association, said patients whose weight fell below 45kg used to be supplied with protein-enriched milkshake (PEM), but this had been stopped.
“We refer patients to soup kitchens in their communities because supplying PEMs did not work out,” she said.
Gwabeni said the lack of food was his family’s biggest problem. The need for food has never been greater with both of them on TB treatment.
“The treatment makes you hungry,” he said.
Mhlekwa gets a stipend of R30 per month for every patient who comes to her shanty between Monday and Friday.
“Saturdays and Sundays, their bodies need to relax from the tablets,” Mhlekwa said. Treatment for pulmonary TB includes popping four pills every day for six months.
Mhlekwa said if any of her patients failed to come for treatment, she personally went to their homes to ask about the absence.
“It is very important because sometimes a person is just absconding, but sometimes they have genuine reasons. I impress upon them to realise nothing should take precedence over their treatment.”
Those who work can visit her in the evening while the unemployed come in the morning.
The work of a treatment supporter is more than just being a dispenser: they are trained to be counsellors as well. Mhlekwa said when the client arrived, she took the trouble to ask about other aspects of their lives apart from the lung disease.
“I try to take their minds off the tablets they have to pop every day,” she said.
Nothing pleases her more than a client finishing the treatment in the prescribed six months.
“Seeing them pick up weight and getting better makes me realise that the work I do is not in vain.”
Similarly, when for some reason, a person fails treatment, it gets her down.
“To tell someone that they have to start afresh is not something I relish. It is hard to look at their face and say: ‘We did not succeed and we have to do it all over again.’”
The TB Care Association, founded in 1929, operates throughout Cape Town and makes treatment accessible to patients on the streets where they live. It is one of the non-governmental organisations which helps the government in the fight against TB. …