In Uganda and in Madagascar with two highly experienced partners: Medici con l’Africa Cuamm and RTM Volontari nel mondo
Tuberculosis is considered the “disease of the poor” because it reaches vast proportions, especially in Africa, when living conditions are extremely precarious. It manifests mainly in rural areas and is exacerbated by the difficulties that the population has in accessing information on prevention, treatment at health centres and in finding medicines.
It is exactly in this context that Medici con l’Africa Cuamm and RTM Volontari nel mondo have been working successfully for many years.
The FAI decided to support their work, particularly in the fight against tuberculosis in rural settings, because of their professional skills and excellent values.
CUAMM – DOCTORS WITH AFRICA:
Medici con l’Africa Cuamm is an Italian organization that has been engaged in the promotion and protection of the health of African populations since 1950.
Cuamm has been operating in Uganda since 1958 and to date has sent over 300 health workers and administrative/logistics staff, with an average of 3 years’ service per person.
During the last 40 years, the organization has supported 16 hospitals, in particular in the Northern region, the West Nile and the Karamoja region, with the support of the Matany, Moroto and Abim hospitals.
The FAI started supporting CUAMM’s work at the St. Kizito Hospital in Matany (Karamoja region) in 2014.
The planning activities carried out by CUAMM, in collaboration with the St. Kizito Hospital , the Ugandan Ministry of Health, the local authorities of Jaramoja and the Diocese of Moroto, aim to strengthen the Hospital in order to be able to guarantee adequate assistance for childbirth and new-born children, training for new midwives and nurses and the diagnosis and treatment of tuberculosis, especially resistant tuberculosis.
Regarding the fight against tuberculosis in particular, the aim, which has been achieved, was to increase the rate of identification of new cases in the area and improve the offer of treatment at the hospital and in the health centres in the surrounding area.
Due to the good results achieved by the hospital in terms of diagnosis, treatment and follow up, with a low anti-tuberculosis therapy abandonment rate, the national programme to control tuberculosis asked the St. Kizito Hospital in Matany to become a reference centre for the whole region for the diagnosis of resistant tuberculosis. The hospital would use the new diagnostic equipment recommended by the WHO, the MDR-TB Xpert, which makes it possible to perform a certain diagnosis on the mycobacterium DNA and the diagnostics of the resistance to rifampicin. The equipment is proving reliable and easy to use.
Given the danger associated with handling biological samples with a high risk of transmission, a safe area to work in had to be set up next to the laboratory. The same building also has an area that has been set up for the equipment that produces oxygen and nitrogen, which is soon to be installed and can then start to be used.
While the staff of the Matany and Moroto hospitals were receiving training on how to use the MDR-TB Xpert equipment, training sessions were held for the Village Health Team on the symptoms of tuberculosis and on when and where to report suspected cases from the areas outside the towns to the health centres that are equipped to identify and treat the disease.
The treatment of patients with resistant TB is carried out at their home.
The treatment of resistant TB weakens the organism and in order for the treatment to be effective, the patient has to eat properly. The patient cannot work until after the virus tests negative and cannot therefore provide for their family’s needs. The treatment therefore includes the distribution of food for the patient and their family.
RTM – VOLUNTEERS IN THE WORLD:
RTM Volontari nel mondo is an Italian NGO that carries out development projects in Africa, Latin America and the Middle East. It has been present in the country since 1973, it is recognized by the Malagasy government and it operates in rural, healthcare, food security and fair trade areas.
The FAI established its first contact with the RTM in 2010 in Kosovo, during a monitoring mission. Over time, through interviews and by exchanging ideas, FAI identified RTM, in terms of its actions and its values, as a valid organization to collaborate with.
Tuberculosis is very widespread in the Vatovavy Fitovinany region, as well as in many other Malagasy regions. According to the National Strategic Plan to fight Tuberculosis 2009-2013, tuberculosis is the second cause of mortality (3.8%) in the Regional Reference Health Centres.
RTM is active in the fight against tuberculosis thanks to the “Global Fund to fight AIDS, Tuberculosis and Malaria” (www.theglobalfund.org), which is supported by governments and private donors. The NGO has worked in 11 health districts in the country, including 6 in the Vatovavy Fitovinany region. Tuberculosis is a highly contagious infectious disease and if left untreated, it kills over 50% of infected people.
With the drugs that are available today, over 95% of patients recover completely. The therapy is effective if taken every day for at least 6 months. In Madagascar, the treatment for tuberculosis is compulsory and free of charge.
RTM fights tuberculosis by providing food support for the people who have this pathology. In collaboration with the WFP – the World Food Programme, they distribute food supplements to the people who are in treatment so they can follow their therapy regularly and maximise its efficacy.
RTM also works to strengthen the social capital, which is represented by the Health Committees in the Vatovavy Fitovinany region. In January 2009 the Ministry of Health drew up the National Community Health Policy guidelines, which involve strengthening the participation of grassroots communities by establishing a network of community health agents as a link between families and the national health system and local health centres.
The health committees are to all effects “basic national health care organizations and an interface between the community and the health system”. Strengthening the community health agents and their network makes it possible to achieve a widespread presence throughout the country, also in the fight against tuberculosis.
This in turn makes it possible to identify people with the disease early on, carry out the clinical tests that are necessary for a certain diagnosis and look after the patients throughout the whole treatment cycle, thus ensuring that the patients are treated in the smaller and isolated communities as well.