Community Health Workers helping people with TB to return to care
Since the decrease in COVID-19 cases, Community Health Workers (CHWs) have been actively searching for people who have contracted tuberculosis (TB) and who are no longer accessing healthcare facilities for their monthly check-ups or maintaining their TB treatment plans.
In the Public Interest (IPI) and Philani are two non-profit organisations contracted by the Western Cape Government Health and Wellness to conduct contact tracing of TB people who are no longer maintaining their TB treatment and attending healthcare facilities for their monthly check-ups. These two organisations operate in the Klipfontein and Mitchells Plain area as part of the Department’s Community Orientated Primary Care (COPC) initiative.
These organisations use Community Health Workers (CHWs) to conduct home-based care to bedridden people who are unable to access services at their nearest healthcare facility. Apart from home-based care, they deliver medication to people on chronic medication, conduct household assessments of families with illnesses or in need of care, trace people who have contracted HIV/Aids and TB and who have stopped taking their medication, and help families whose children require their catch-up immunisations due to the challenges created by the COVID-19 pandemic.
The CHWs work in partnership with healthcare facilities and receive a list of people not adhering to their checkup appointments and TB treatment plans to trace and recall people back to care and treatment.
Faeza Goerge, Professional Nurse, and Portia January, HIV/Aids and TB Supervisor for In the Public Interest, work in the greater Athlone area and deploy the CHWs into the community with a list of TB patients received by either Silvertown Clinic or Dr Abdurahman Community Day Centre who require assistance to return to care.
“We get a list of TB patients who require follow-up or must be encouraged to return to care from the healthcare facility. W then conduct three visits to find the patient and if we cannot find them, the nurse at the healthcare facility will conduct the fourth visit at the address provided and eventually mark the person as someone who are not maintaining their TB treatment if the person is not found,” says Portia January, HIV/Aids and TB Supervisor at In the Public Interest.
“We track the patient by finding them by their nicknames. Some people are on drugs, and we trace them to the drug den. We also have people who are in gangs and leave their original homes to hide, which makes it difficult to find them. We go out of our way to find the patient and because of our relationship with the community, we leave messages, and sometimes the patient does come to the clinic to be placed back on treatment,” says Portia.
“If we do find the patient, we explain to them why it is so important that they stay on treatment, take their medication, and go for their follow-up appointments. We tell them that TB is curable, and we are here to help them and not judge them and then we help them with their journey to complete their TB treatment successfully,” says Portia.
“Our CHWs know the community because they have worked in these areas for a long time, especially with the tracing of people who are not staying on their treatment plan,” says Faeza Goerge, Professional Nurse from In the Public Interest.
“We conduct street-based and door-to-door outreach to educate people on TB. When conducting these outreaches in communities, we find people with TB symptoms and then refer them for a test to the nearest healthcare facility by issuing them with a referral form from our ‘catch and match’ referral book,” says Faeza.
Philani’s Community Health Workers work in Crossroads and Phillipi, and they often have to brave dangerous areas to trace TB people who are not on treatment.
Phelisa Bajisi, a staff nurse for Philani, coordinates 14 CHWs. Our CHWs operate in pairs of two for safety purposes.
“The challenge with tracing patients is that people give the wrong addresses at the clinic, or they moved and don’t update the contact information at the clinic,” says Phelisa.
“We trace people living with TB from children under 5 years old to adults. We trace 10 – 15 people daily who are not maintaining their treatment of did not come to their follow-up appointment,” says Phelisa.
We want people to know that TB can be cured, and people must support each other and become TB treatment support buddies to help the person with TB complete their treatment plan.
“COVID-19 has created challenges for our CHWs, but we continue to adapt and care for our people as we want a healthy community. We also need the community to help us by supporting people living with TB without judgement. Together we can make our communities healthier,” says Portia.