The recent decrease in Covid-19 cases has seen Western Cape community health workers take to the streets to actively search for tuberculosis (TB) patients who are no longer accessing healthcare facilities and defaulting TB treatment plans.
Faeza Goerge, a professional nurse, and Portia January, an HIV/Aids and TB supervisor for the non-profit organisation In the Public Interest, work in the greater Athlone area of Cape Town. They deploy health workers into the community with a list of TB patients who need 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. We 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 January.
Seek out and assist
In the Public Interest, along with another non-profit organisation, Philani, are contracted by the Western Cape department of health and wellness. The organisations run their base of operation in Klipfontein and Mitchells Plain.
Health care workers are tasked with tracing TB patients who have defaulted treatment.
“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,” explains January.
Goerge adds that community health workers have worked in these areas for a long time, especially with the tracing of people who are not staying on their treatment plan.
“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 Goerge.
Braving the risk
Philani’s Community Health Workers work in Crossroads and Phillipi, and they often have to brave dangerous areas to trace TB sufferers who are not on treatment, says nurse Phelisa Bajisi. “Our [workers] operate in pairs of two for safety purposes,” she says.
“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.
“We trace people living with TB from children under five years old to adults. We trace 10 to 15 people daily who are not maintaining their treatment or did not come to their follow-up appointment,” says Bajisi.
“Covid-19 has created challenges for our community health workers, 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 January.