tuberculosis (TB) blitz event, Sasolburg, Fezile Dabi District
8 December 2006
Programme Director
Honoured guests
Ladies and gentlemen
During the month of December our focus as far as health issues are concerned
falls on HIV and AIDS but today we are meeting here in Sasolburg to draw
attention to the provincial tuberculosis programme and more so, the need to
trace defaulters, especially in the Fezile Dabi district, and motive them to
come back to the TB programme. Our theme is 'A call for action, Stop TB'.
Programme Director, in July of this year we launched the Provincial TB
Crises Management Plan. This provincial plan has been developed for
implementation in the Fezile Dabi district as a matter of priority to
strengthen the management of TB in this district. We have targeted this
district specifically as it has the lowest cure rate in the province and a high
proportion of TB cases that is not evaluated. Today whilst joining health
workers in the door to door campaign, I realised again that we need to call on
every member of community to take action to stop the spread of
tuberculosis.
Ladies and gentlemen, the Free State TB Control Programmeâs crisis plan aims
at:
* flooding the communities with messages and activities to increase
awareness
* implementing emergency strategies from the crisis plan to control the
worsening tuberculosis epidemic
* rapidly improving tuberculosis case detection and treatment success
rates
* expanding provincial partnerships for TB control, especially with the mining
sector
* implementing strategies to reduce patient default and transfer out rates to
10% or less.
The programme also faces some challenges as patients present late at our
health facilities as a result of a lack of awareness about the disease and the
stigma associated with TB. There is also a poor adherence to treatment, which
is a result of a lack of understanding of the importance of complying with the
treatment prescribed. We have also found a low conversion rate of the positive
smears at two or three months and some patients do not utilise the local health
facility in their area, especially workers working far from home such as the
mineworkers or farm labourers, and this causes patients to miss out on their
follow-up visits and medication.
There has been significant progress in the detection of TB cases in the Free
State after the implementation of the active case-finding campaign in 2005. The
TB Control Programme at district and provincial level still have a problem in
ensuring that people with confirmed TB adhere to treatment until
completion.
One of the achievements in 2006/07 is the training of managers and doctors
from both the public and private sectors in the control and management of
tuberculosis. This includes also the doctors and nurses from the mining
industry.
Programme Director, today's event was preceded by TB screening and sputum
testing in Sasolburg. This morning there has been an active case-finding
campaign whereby people who have signs and symptoms of TB can present
themselves for sputum testing. This will be ongoing throughout the event.
Ladies and gentlemen, I have to mention the important role of the Directly
Observed Therapy (DOT) supporters. This group of men and women:
* Conduct continuous awareness within communities through door-to-door
campaigns. I joined a group of supporters this morning and have great
appreciation for the hard work they are doing.
* Supervise the TB patients when taking the medication; and most of all
* Give support and encouragement to the TB patients until they complete the six
months' treatment period.
In March this year we launched our Provincial Campaign of tracing back
defaulters into the programme known as âOperation Khuthlelaâ. With this
campaign we would like to encourage people who have been diagnosed with TB to
complete their treatment. Failure to do this will result into a serious
condition known as Multi-drug Resistant TB (MDR TB). MDR TB takes longer and is
more difficult and expensive to treat. A person is expected to take MDR TB
medication for up to two years and should this fail to happen and a person
defaults MDR TB medication, he/she is in danger of having an even more serious
condition known as Extreme Drug Resistant TB (XDR TB). The unfortunate part is
that this condition can lead to death. I am pleased to announce that since the
implementation of Operation Khuthlela, more and more treatment defaulters were
traced and are now back on the programme all over the province.
Programme Director, the media constantly reminds us of the new strain of TB
called Extreme Drug Resistant or XDR. I would like to briefly touch on this and
would like to make you aware of the new strain. XDR was discovered in
KwaZulu-Natal and has also been found in other provinces including the Free
State. Let me take this opportunity to explain to you what is XDR TB and how it
happens. It all starts with the ordinary TB that we are familiar with. A client
is diagnosed with TB and is expected to take treatment for six months or eight
months and if he/she does not complete the treatment as required, then he/she
develops Multi Drug Resistant TB. This client then has to take treatment longer
than the previous time (up to two years), as the TB bacteria has now developed
a much stronger resistance against treatment.
If this client still fails to take treatment as required, he/she will
develop XDR TB which at this point cannot be treated with any drugs available
in South Africa as it is resistant to all. This is an extremely dangerous form
of TB. It is therefore important for those diagnosed with TB to take and finish
their treatment as informed by the health institution they attend.
As communities it is our responsibility to support those on treatment, to
advise those coughing longer than two weeks to go for sputum tests, and to
report to our healthcare workers anyone who refuses to go for tests or whom you
know is refusing to go for treatment. As individuals we are the only ones who
can stop all TB. TB is preventable and can be cured free of charge with the
resources offered by the government.
Ladies and gentlemen, government does not forget its responsibility but
realises that it must involve the ordinary man and woman on the street in the
control and management of tuberculosis. Furthermore, non-governmental
organisations must also complement the Provincial TB Programme (PTCP)
activities by carrying out awareness-raising, education, and outreach
programmes of their own, in close consultation with the PTCP.
Today we call upon every member of society to help encourage those people
that are known to have stopped taking their TB medication before they complete
the six-month period. They are the ones who will in future develop complicated
forms of TB or multi drug resistant TB and the extreme drug resistant TB which
are difficult to treat.
Ladies and Gentlemen, TB is not merely a public health problem, but a
broader socio-economic issue. It is for this reason that the Department of
Health is strongly considering the involvement of the district health
councillors in an effort to put TB on the table of decision makers and policy
makers for the sole purpose to win co-operation, support, and to ensure the
involvement from other government sectors, the private sector, big business as
well as the youth. It is necessary for all of these organisations to adopt a
more effective partnership approach to social mobilisation activities. The
partnership approach requires that public participation is a fundamental
principle, provides for access to TB treatment as a right and a provision of
treatment as an obligation, and to reach out more aggressively to the poor, who
are most affected by TB.
Finally, today I would like to acknowledge men and women who saw the
importance of completing their TB treatment. The people standing in front of us
today were diagnosed with positive smears and entered the programme by starting
to take their medication. Today they were discharged from their clinics after
they gave the last sample of the sputum. This group of fine individuals is a
testimony that TB can be cured.
Programme Director, in conclusion, elements of poverty such as poor living
conditions and malnutrition predisposes people to being infected with TB and
the rapid development of infection to disease as a result of depressed immune
system is a real reality. I would therefore like to encourage members of the
community and community structures to form support groups in Fezile Dabi.
Government cannot fight the battle alone â we need the help of each individual
to ensure a healthy and self-reliant Free State community.
I thank you.
Issued by: Department of Health, Free State Provincial Government
8 December 2006
