Tuberculosis (TB) kills more people than any other infectious disease in the world – 3,800 people die from the disease every day. It causes more deaths than AIDS and Malaria, but it is preventable. VSO volunteer Dr Simon Blankley spent one year in Uganda sharing skills and setting up systems to help reduce the unnecessary burden of this major health problem in the developing world.
At death’s door
“I wouldn’t be around now, I’d be dead…that’s the truth,” recalls TB survivor Misi.
As a single father of three young boys, staying alive was even more important to Misi, who could barely breathe or walk by the time he was admitted to hospital. Living in a slum in the Ugandan capital, his TB diagnosis would have gone unknown were it not for Dr Simon Blankley’s work to invigorate the city’s TB outreach project. Misi was initially identified by a community volunteer trained to recognise TB symptoms who immediately brought him to a clinic. “Misi unfortunately is a typical TB patient that we deal with; he lives in cramped, confined space with many members of the family living in the same room, poor ventilation and poor access to food,” Simon adds.
Ignorance is not bliss
One of the major challenges in tackling TB in sub-Saharan Africa is dispelling ignorance about the disease. “People don’t know what the symptoms of TB are so they don’t seek appropriate healthcare so they don’t get treated and they die,” says Simon.
The stigma falsely attached to TB in Uganda is also very high with patients often locked away in cupboards and forced to leave their home villages. The problem is not confined to the general population but also exists amongst healthcare workers. “We’ve had instances where nurses have been in tears, afraid of catching the disease because we want to admit TB patients to the wards,” explains Simon.
Tackling TB in a sustainable way
As the third in a series of VSO volunteers based at the IHK hospital in Kampala, Simon was able to build upon the work of his two predecessors by improving the quality of TB care at a clinic they had set up. Getting TB patients from nearby slums to complete their eight month treatment was a challenge, but Simon’s input drastically increased completion rates.
He also expanded the outreach service in the city’s slums, adding TB to the community health education already in place. The outreach programme in Kampala now reaches 25,000 people each year.
In addition, Simon adapted the TB outreach project model to a rural setting, taking it from Kampala to Lira, an area devastated by civil war in the north of Uganda, where work has kick-started to educate people about TB; as well as its signs, symptoms, treatment, and how to keep people in treatment.
He’s trained local health worker Tom Okello to independently manage the clinic and community outreach work in Lira and equipped him with diagnostic skills such as interpreting X-rays.
Through his work in the community, Tom is convinced of the value of tackling preventable disease through education, “People in Africa don’t die because they are poor but people die because they are poor and they don’t have information,” says Tom.
After just two months, the TB clinic set up by Simon in Lira has diagnosed and put 50 people on TB treatment, 50 people who would have probably died without access to the clinic.
A lasting legacy
Simon anticipates the outreach work in Lira will educate around 20,000 people about TB, which is 1 in 5 of the local population.
There is a lot more work required to tackle TB in Uganda and indeed across sub-Saharan Africa, but Simon’s work has undoubtedly saved many lives. As TB survivor Misi says, “I got the treatment, extra care and support from Dr Simon…now every time I see him or think of him, I take him to be my real father, as I have no parents.”