Every second someone in the world gets infected with the bacterium that causes tuberculosis. One third of the world’s population, around 2 billion people, already has this TB bacterium in their body.
It is for this reason that health workers in western Uganda goes knocking on doors of congested slums once a week to convince suspected tuberculosis (TB) patients to visit referral hospitals and submit a sample of their sputum.
The health workers have been doing this for the past three years in a bid to fight and prevent TB in the most congested slum areas of Kisenyi in Kabarole district, Biafra in Mbarara district and Nyendo Senyange in Masaka district. They set up tents as sputum collection centers to serve and counsel people from there.
They work with local leaders in the slums to mobilize and sensitize community members the dangers of TB and urge them to diagnose for the disease. They also use local radio stations to call people to come have them tested.
“We as health workers identified this cause and recognizes the effect of TB in congested slums and we want to save the people from getting this disease,” Dr Ronald Muhame, the in charge of Kibito health IV in Kabarole district said.
He said the group gets assistance from districts and local leaders. The samples are sent to the National TB and Leprosy Program (NTLP) whose overall functions are to establish country wide quality diagnosis and treatment services for TB and Leprosy and to coordinate the implementation of TB and Leprosy control activities. It also have specialized laboratories to test for TB.
TB remains a major public health problem in Uganda. According to the 2009 WHO Global TB Report, Uganda is ranked 16th among the 22 high burden countries. In addition, the country has an emerging multi drug resistant TB (MDRTB) problem.
Dr John Muhumuza who coordinates the group says that they also offer HIV/AIDS testing and counseling services to slum dwellers, saying that TB is common among people living with HIV and is the leading cause of death among HIV positive patients.
Dr Muhumuza expressed fear that despite their intervention, the level of infection has not gone down which he attributed to lack of treatment adherence of TB patients.
“Most people do not want to test while others refuse to adhere to the treatment which results into extremely drug-resistant (XXDR) TB,” he told Key Correspondent.
Dr Rhoda Tuhaise a TB expert said that four of the 12 patients detected with totally TDR, TB recently were from Biafra slum in Mbarara district.
She said that poor ventilation, lack of sunlight, dampness in the environment that favours the growth of TB bacteria in slum areas.
Stigma and challenge TB patients face
Those people who do develop tuberculosis face an exhausting disease. Treatment takes months and in many countries like Uganda people with TB face a huge social stigma. The disease often leads to loss of income and isolation.
Among them is Ronald Tukamubona, 35 who started TB treatment last month, used to visit private clinics but his problem was not solved.
A taxi driver Mbarara, Tukamubona lost his job because of absenteeism. He was off and on at his work place and he was weak most of the time until job that was demanding.
He has no idea that what he was suffering from was TB until he met a group of medical personal volunteers who were testing slum dwellers and grabbed the opportunity to test for the disease
“I lost my job after contracting TB and I was unable to perform my duties, I would cough all and day and night, not until I took sputum test and tested positive for TB. If I had known earlier I would have lost my job”, he said.
"The kind of discrimination I faced from my neighbours made me regret sharing my condition with them; I could not even share the communal toilet with them,”Kabakumba Annette a business woman in Fort Portal said.
Eight months into her marriage, Jolly Nampija was diagnosed with tuberculosis in January. She was hospitalized for a week at Masaka hospital but when she was discharged, her husband asked her to stay at her parents’ place in Kyotera in Rakai district saying he and his family had to travel to Kampala for a wedding and there was no one to take care of her.
For two weeks, her husband did not call to check on her. When her mother took her to her husband’s home, her mother-in-law said they didn’t want her in the house because she had TB.
“My husband wasn’t even ready to face me. My mattress, bed sheets and other belongings had been burned,” Nampija said.
Six months on Nampija has completed her course of TB treatment and was given the ‘all-clear’ by her doctor. “I don’t know if my husband and his family will ever take me back,” she said.