Community action against TB in Timor-Leste
IOM Dili April 18 2019
Cecilia MCINTOSH, IOM Dili.
UN Agencies in Timor-Leste are working with the Ministry of Health to end TB through community screening with people on the move – such as university and school students; police and defence forces; border communities; and other highly mobile populations including agricultural workers, market vendors, bus and truck drivers.
Timor-Leste has the highest TB burden of countries in Southeast Asia. TB can be spread from person to person through the air, and for people living or working in large groups and small spaces, it can spread more easily. However, TB is curable and preventable.
Finding the source of TB is not easy, but the UN’s Migration Health team (IOM) has been working with communities to increase TB awareness and provide TB symptom screening and access to mobile x-ray machines.
“To end TB in Timor-Leste, it is important to understand the linkages between TB transmission and human mobility. People on the move are affected and need to be involved TB prevention and control efforts,” says IOM Chief of Mission, Mr. Wonesai Sithole.
“Having TB is both a health and a migration issue which has significant consequences for the well-being and livelihoods of people on the move within Timor-Leste and overseas including their communities of origin, transit and destination,” explains Mr. Sithole.
The IOM´s successful TB control efforts have surpassed their targets in many countries. The sustained high treatment success rate is largely attributed to early detection.
The UN is an impartial, rights-based and strategic partner supporting the Government of Timor-Leste as a member State to fulfil its commitments to advance the 2030 agenda for all.”
There has been a clear break with the peace keeping and political leadership of the past and the UN in Timor-Leste is now entirely focused on sustainable development.
It’s Time! World Tuberculosis Day Screening for TB in Atauro
“The TB screening was very beneficial for me and the community. This is the first time I have been screened so I’m very happy. It’s very good opportunity for all of us to have access to early diagnosis for TB,” says Ernesto Alves, describing his experience of the Ministry of Health’s ‘World TB Day 2019’ house to house screening activity in Atauro supported by the International Organization for Migration (IOM), World Health Organization (WHO) and local non-governmental organization, Caritas.
“It is very difficult to access health services. Patients often have to travel long distances to reach health posts. As a result, many TB cases are missed which puts the community at risk. Therefore, it is very important that our community see’s the benefits of TB screening,” says Sr. Januario D. Cabecas Soares, Health Director of Atauro.
“This screening is a really good opportunity because we live in rural areas and all the facilities are far away. It’s very good to have door to door screening and have access to the mobile x-ray. We usually have to walk far to go to the health post and go to Dili by boat for x-ray examinations,” says Mr. Alves.
For his household and many others, the house to house screening provided easy access TB information and services. “Today, I learned a lot of new information including the basic symptoms of TB. I want to continue to share this information and if I see someone with symptoms I will tell them to come to the health post for treatment.”
Over the five-days of screening, health teams of national and local health staff, community health volunteers, Caritas and IOM visited four villages and three hundred households to conduct TB awareness and symptom screening using the screening questionnaire developed by WHO. When a household member indicated that they were experiencing TB symptoms, a sample was collected for testing, followed by an x-ray examination using IOM’s mobile x-ray machine.
''This is also a good opportunity for Atauro’s local health staff supported by the MoH, WHO and IOM to achieve the main objective of elimination TB in Timor-Leste” says Sr. Matheus Belo, Atauro Administrator.
IOM has been supporting the MoH to provide systematic screening of TB for high-risk groups living in congregated settings including rural communities, universities, schools, prisons, and police departments in Dili, Ermera, Bobonaro and Covalima municipalities since 2017, with the aim of ensuring early access to diagnosis and the initiation of treatment services.
This year’s World TB Day theme “It’s time” calls for a coordinated approach to ending TB by 2030. The Timor-Leste MoH’s ‘World TB Day 2019’ house to house screening activity supported by IOM, WHO and Caritas has contributed to increasing public awareness and case detection among vulnerable and hard to reach communities. And that, for World TB Day is an important step towards meeting Timor-Leste’s commitments to Sustainable Development Goal 3 to ensure healthy lives and promote well-being for all at all ages.