The Covid-19 pandemic has had a huge impact on the way normal health services are provided to patients in the province.
Some chronic patients have experienced changes to the way they obtain their medication. Due to safety reasons, many avoided going to clinics for chronic health care.
Other challenges include patients who did not adhere to their TB treatment or who defaulted on their treatment.
To address this, health workers are actively working to track down patients who defaulted on their treatment to ensure they are placed onto treatment again.
Zanele Ndibongo is part of the team that works to get people back onto their treatment.
They also track patients and keep them from defaulting, and monitor them for six months. She says getting defaulters back on treatment can be a huge and difficult task, but it has its rewards.
“Patients sometimes give us a lot of attitude, forgetting that it is their lives that we are trying to save,” she says.
Ndibongo is a community healthcare worker for Philani, based in Khayelitsha Site B Community Health Centre (CHC).
Lwando Cengani has also seen the success of his team’s work through patients who successfully complete their treatment with no interruptions.
“Those are our good clients. It is tough, but if they manage to complete their treatment, they live normal and healthy lives,” he says.
Cengani is a professional nurse working with TB patients and is also based in Site B CHC.
They enrol and record new TB patients, provide medication and refer them to counselling and treatment.
They also do follow-ups to support their patients and to prevent them from defaulting on their medication. They work with a number of NPOs, one of them being Philani.
Philani works closely with Western Cape department of health and provides home-based care in and around Khayelitsha, doing door-to-door community services and deliver chronic medication to patients. Similar services are offered throughout the province.
“The two biggest issues faced by staff members is the stigma and non-disclosure, which is a stumbling block to all efforts made to deal with TB in the community. People fear being stigmatised, so they do not disclose their TB status, not even to their family members and partners,” she explains.
“They sometimes believe that they do not need us and don’t want anything to do with us. Those are often the defaulters.”
Cengani adds that not disclosing that they have TB plays a big role in patients not adhering to their prescriptions.
“Fear of stigmatisation is a very big issue. We want to support our patients with their recovery and we want to build a good relationship with them. They need to trust us and believe that they will get well if they continue to take their medication. We find ways of making people comfortable with us and we have to be creative about it and show lots of support,” says Cengani.
Cengani says teams continued to work throughout the lockdown and did not make it easy for people to default as services were always available.
If someone is on TB treatment or suspect they may have TB, it is best for them to visit their nearest clinic.
A community health worker in their community will be assigned to them to support them with their treatment and to follow up on them.
Community health workers work with demarcated areas allocated to their local health facilities.
Adherence to treatment is very important to cure TB, control the spread of infection, and minimise the development of other serious forms of TB.
“If anyone has defaulted on their medication for whatever reason, they are welcome to visit the facility as soon as they can and we will assist them to get back on it. We give them guidance on maintaining good adherence by taking treatment on time every day,” Ndibongo says.