In the war against tuberculosis in Papua New Guinea, getting patients to take their medicine can be half the battle.
Community health worker Pauline Kove has been on the frontline for 20 years and is based at a World Vision-supported TB clinic at Six Mile in Port Moresby.
The clinic has 500 cases on its books from 2014-15 and 392 for this half year alone.
Patients need to take a full drug treatment for six months to receive the all clear.
TB can become resistant to drugs if a treatment regime is not adhered to strictly.
In some cases people start to feel better after two months and then decide to hoard their medication for other family members who might become sick in the future, Ms Kove says.
Young people were among the worst offenders for not diligently taking their medication.
Health workers have to had to devise creative ways, such as a buddy system to keep track of medication consumption, to ensure patients don't miss a dose.
When Ms Kove is not at the clinic her spare time is spent wandering her neighbourhood, looking out for more patients and educating people about symptoms.
"Afternoons when I'm finished here from 5pm-6 I do that awareness, or on the weekend," she told AAP in Port Moresby.
She wishes there was more time to do such work but the clinic doesn't have enough staff.
Karlyne, a mother of three, is a newly diagnosed TB patient about to start treatment.
Shortness of breath has inhibited her ability to do domestic chores and earn money as a babysitter.
"I'm afraid I might die," she told AAP through an interpreter.
Her children are being cared for by family members in the Highlands but she is worried about her ability to financially support them.
Grandmother Mamma Kori had TB last year and completed her full medication course but now her 19-year-old son has developed the condition.
"He's a student and has been taking his medicine and is now back at school," she said.
It's safe for students to return to class after two weeks if they are receiving treatment.
WHAT IS TUBERCULOSIS?
- A bacteria that affects the lungs.
- Spread through the air via coughing and sneezing.
- Symptoms include cough, fever, night sweats and weight loss.
- The symptoms may be mild for months which can lead to delays in seeking care, and allow the bacteria to be transmitted to others.
- Curable, but without proper treatment up to two thirds of people will die.
- Each year nine million people fall ill and 1.5 million die worldwide.
- More than 95 per cent of deaths occur in low and middle-income countries.
- Globally in 2013 an estimated 480,000 people developed multidrug-resistant TB.
- Top 22 countries for TB are Afghanistan, Bangladesh, Brazil, Cambodia, China, DR Congo, Ethiopia, India, Indonesia, Kenya, Mozambique, Myanmar, Nigeria, Pakistan, the Philippines, Russia, South Africa, Thailand, Uganda, Tanzania, Vietnam and Zimbabwe.
(SOURCE: World Health Organisation)
TB CHALLENGES IN PNG
- Limited diagnostic capabilities.
- Access to healthcare with 85 per cent of the population living in remote areas.
- Difficulties with follow up.
- Lack of awareness.
(SOURCE: Medecins Sans Frontieres)
