Access to health care services among rural, resource-poor people in low-income countries remains a major obstacle to TB control efforts. A critical factor is the need to improve access to diagnostic facilities, which in many rural areas double as TB treatment initiation and registration centres for TB patients. It is common for patients to travel over 50 kilometers to access TB treatment initiation services. Thanks to the USAID TB CARE II project, more than 31, 558 people living near the Chilipa Health Centre can now access TB diagnosis and treatment close to their communities.
One such person is 46 year-old Catherine Pelani, from Pphika village. She had this to say during a TB CARE II-organized open day in Chilipa: "Ndikanafa ine kupanda anthuwa" - "I would be dead if it were not for TB CARE II."
In 2010, Catherine was diagnosed with pulmonary TB at Chilipa Health Centre, which is located 3 kilometres away from her village. At that time Chilipa Health Centre was only a microscopy centre, lacking the ability to start patients on TB treatment. As a result, Catherine had to go to Mangochi District hospital, which is more than 56 kilometres away from her home village to start TB treatment. After two months of intensive in-patient treatment, Catherine was discharged.
Unfortunately for Catherine, in early 2012 she fell ill again. A TB CARE II community volunteer visited her and offered to take her sputum to Chilipa Health Centre for smear microscopy. The results from microscopy confirmed Catherine had a relapse of TB. Catherine recalled her trip to the district hospital and worried about the time and resources it would take to again travel the long distance to Mangochi District hospital. However, thanks to TB CARE II, Catherine was able to start treatment the same day at Chilipa Health Centre, just a 20 minute bicycle ride from her home. She was cured six months later.
Judith Kabichi, a TB CARE II community volunteer, escorted Catherine to the Health Centre on a bicycle provided by the project. She continued to provide support throughout the treatment period and even transported sputum samples to the health centre for follow up testing. TB CARE II supports its community volunteers, like Judith, with bicycles, training in TB control, sputum transportation boxes, and other resources to help them help members of their community such as Catherine. These TB volunteers enjoy their work and take pride in helping their communities.
Catherine is grateful to TB CARE II and had this to say: "anthu amenewa agwira nthito ndipo sindakwanitse kuthokoza. Pano ndili bwino ngati wina aliyense mumudzimu." - "these volunteers are so invaluable I am now cured of TB and live like any other person in the village". Catherine encouraged her community to support the work of TB CARE II while advising those who suspect that they have TB to utilize TB services in their area.
There are many people who still cannot access TB health care services closer to their homes. TB CARE II is working to improve access to TB diagnosis facilities and access to TB treatment. TB CARE II is helping to launch new TB initiation and registration centres by training health care workers, providing start up materials, and conducting mentoring support visits to the new centres. TB CARE II also supports TB diagnostics and facilitates community linkages to health care services through a network of community volunteers. Chilipa Health Centre is one of 13 new TB initiation and registration centres that TB CARE II opened in 2012. Through this model, TB CARE II has been able to reach out to many communities. In the past year, a total of 3051 TB cases were detected and patients notified in the six targeted districts of Neno, Ntcheu, Machinga, Mangochi, Mulanje, and Phalombe.