The TB project is taking off!!

CMMB Fieldworker giving HIV test results to a
client in Phakamisa 

While I realize that we are currently halfway through April, this post is going to be dedicated to the month of March, which was absolutely hectic!! As I have said before, the TB project I am working on has really taken off since January.  Each month our fieldworkers are reaching more and more clients with HIV and TB testing services and we couldn’t be more excited! 

Last month was spent trying to keep up with the pace of the project by making sure that as soon as testing was completed in one community, the teams had another area ready and waiting for them.  Aside from the fact that coordinating the movements of 5 teams is a daunting task in general, starting to work in a new area isn’t as simple as pointing to a place on the map and showing up.  Community entry has been one of the most difficult challenges of this project.  It involves working with community leaders as well as other stakeholders to spread the word about CMMB and what services we are providing and, ultimately, getting permission from each community to work in their area. 

Homes in "TB crisis" area of East London

As I am sure you can imagine, each community is vastly different.  They all have their own power structures and politics that play a role in their final decision.  Most communities are simple: we explain what we are providing, they like the fact that we are offering our services, so we start working in their area, no problem.  Other places have created a myriad of hassles causing us to start working, then getting chased away, then asked back because other community members really want our testing services, and then chased away again... leaving you feeling like you are in an endless cycle. 

On top of trying to keep up with all community entry struggles, it was decided that we should try and expand our project to the East London area. 

Homes in "TB crisis" area of East London

Many of the communities surrounding East London are what the department of health deems “TB crisis areas.”  They are densely populated and most have extremely substandard living conditions, which is only contributing to the problem.  I think this is a really great opportunity for the project to have a huge impact in an area that is truly in need of an intervention.  The process of getting everything set up and teams in place to offer door-to-door services is definitely not going to be a picnic but I’m excited for the challenge and to see what will happen over the next couple of months.

I think what I really love about this project is that even though its only been fully operational for 6 months now, we are able to see an impact.  The department of health has seen a dramatic impact on their TB indicators (the factors they use to measure the effectiveness of TB services in a given area) and they are

extremely pleased with our progress.   The communities are grateful as well.  Whenever I get to go out into the field, it is very apparent that most people really just don’t know anything about TB.  They don’t know how you get it, they don’t know how to prevent it and they don’t understand the importance of treating it.  The plus side is that, at least in my experience, many of our clients become extremely engaged in the conversations about TB.  They always have so many questions and by the time they are finished with the testing and education process it seems like they are walking away with a lot more knowledge then they had before.  The project may not be perfect, but at least something is clearly working, and that makes all the stress of work and being far from home totally worth it.

Young clients learning about HIV and TB