The PIRMCCM Oversight Working Group (OWG) visited Port Vila Central Hospital to speak with staff who are working toward curbing the impact of Tuberculosis (TB) in Vanuatu. An airborne infectious disease usually affecting the lungs, TB is prevalent among urban centres throughout Vanuatu where communities live in close quarters.
Dr. Raymond Seule, TB Lab Manager at Port Vila Central Hospital, explains the process for testing patients.
“We conduct sputum tests for all patients here,” says Dr. Seule. “If a particular sample tests positive for TB, we will begin treatment immediately. If a sample tests negative, but our doctors believe the patient is showing considerable symptoms of TB, we will test further using the Gene Xpert machine.”
Gene Xpert is a new technology being utilised to diagnose TB, providing significantly faster and more reliable results than sputum microscopy and also testing patients for drug resistant TB. Currently, Gene Xpert machines are being utilised at hospitals in Port Vila and Luganville, though Dr. Seule hopes that in the future more patients will benefit from the technology.
“We would like to utilise the Gene Xpert machine as much as possible. Currently, if we run out of cartridges to conduct testing, we have to wait for more to arrive. There are still cases of TB out there but we are not testing them all … there is always more that can be done.”
Mr. Terry Sali, TB Ward Nurse at Port Vila Central Hospital, treats TB patients who travel to Port Vila from all over Vanuatu. As we enter the TB Ward, patients convene in the common-room for lunch and Sali describes what life is like for those receiving treatment.
“Many patients feel very well taken care of here,” Sali explains. “They receive treatment, along with meals and a safe place to stay. So many are motivated to remain in treatment for the full two months.”
Receiving TB treatment requires patients to spend two months at the TB Ward, though some leave early for a variety of reasons.
“Some patients come to us and ask if they’re able to leave early. Some patients experience complicated social issues, others feel the need to return to work to maintain an income for their family.”
From January to October 2016, 45 patients have received treatment at the TB Ward. The ward is fitted with 17 beds, a common-room, kitchen and bathroom facilities to ensure patients live comfortably during the two month treatment. Still, Sali believes there is more that can be done to expand the reach of TB treatment in Vanuatu.
“Some patients do find it hard to come to the hospital,” says Sali. “Some patients live very far from Port Vila and it’s also difficult to conduct follow-up treatment and contact screenings due to a lack of transportation resources.”
“I think it would be helpful to have more training for nurses, too. Having more specialised TB training for nurses here would help us in our jobs.”
Sali goes on to detail the state of stigma surrounding TB in Vanuatu, explaining that TB patients often find it difficult to reintegrate into their communities and experience social isolation after receiving treatment.
“For those in Vanuatu who have TB, some people will say things like ‘We don’t go near him, we don’t sit with him’ and if a patient receives treatment there will be stigma attached to them when they return to the village.”
PIRMCCM, UNDP and the Vanuatu Ministry of Health are working toward providing early rapid and quality diagnosis, sustaining high quality treatment for all forms of TB, and preventing TB through diagnosis and treatment for high risk groups in Vanuatu.
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