Hope Rises in the Midst of a Stigmatizing Disease: Tuberculosis

By Grace Adofoli

In the midst of dark clouds, a bright light shines through. The dark clouds are a reflection of the stigma that surrounds TB. The bright light is the patients who endure the disease, and the health workers who put their lives on the line every day to support these patients. During my visit to a health center in Adama (Oromia Region), I experienced one of the most wonderful things about working in the health field; the health workers. Ethiopia is a high TB and HIV burden country, but over the years, fighters of TB and HIV have seen a decrease in the number of individuals contracting TB and HIV. One of the main issues with adherence among patients is the inadequate communication between the patients and the health workers. The fear of contracting TB is not only present within the community, but also among health workers interacting with TB patients. Due to this fear, some patients often feel isolated and do not want to cooperate with health workers to receive their treatment.

Workers like her make things move. Delivering food to TB patient. Photo: Grace Adofoli.

Workers like her make things move. Delivering food to TB patient. Photo: Grace Adofoli.

As a USAID intern working on a Master’s in Public Health and Social Work, I was assigned to work with Help Ethiopia Address the Low Tuberculosis Performance, a USAID-managed activity implemented by the Management Science for Health. I was tasked with helping to develop a national TB videography script that would allow patients to receive preliminary and critical information before starting their treatment. To fully grasp the activity, I wanted to visit various TB health centers to observe and meet patients and workers, which would help me to write a script that was reflective of their experiences. Oftentimes, one can get caught up in just doing the work and not thinking about how the work will affect people, but I wanted to be inspired and believe in the work I was going to do. That is exactly what happened during my visit to a multidrug resistant TB treatment center in Adama. I was completely moved by patients and the health workers that were present

Earlier, I mentioned that there is a high fear and stigma around treating TB patients, but that was not the case here. During my visit, I had to wear a respirator mask to protect myself while meeting patients. I sat next to an Ethiopian doctor and observed as he treated, informed, and comforted patients on their monthly follow-up visits. These patients were from all walks of life—medical students, children, women, men, husbands, wives and young adults. Even though these patients were stricken with TB, they smiled, complied with treatment, saw results, and often shared about how grateful they were to be some of the lucky ones to receive treatment. The road for these patients is not swift, but they know that without their treatment, they would not have the same opportunity for a better life.

I realized quickly that it takes lots of people to make opportunities possible for these patients, who oftentimes do not have the means to get the treatment themselves. As I sat there next to the doctor, a car pulled up and an Ethiopian lady with a beautiful floral print came out of it and headed to a table to drop a basket full with food, and the next thing she did was truly beautiful. She walked to each individual patient and greeted them closely and gave them their food. The beauty about this interaction was the fact that she did not care about their illness, but wanted to make them feel comfortable and valued (she did have a mask on for safety precaution).

Money does makes a difference in making sure that these patients have the right facility, and in this specific location they did have the medications and necessary equipment to get well. However, without the everyday people who are committed and risk their lives to make this happen, it is absolutely impossible. To personally witness the collaboration between external funders like USAID, international non-governmental organizations like Management Sciences for Health and the Ethiopian people at this health center was truly great, but to see it work and benefit people was magical.

To change infrastructure, to create sustainability and to witness a positive outcome can feel impossible at times, but when people are willing to sacrifice, learn, listen and collaborate, it is possible to bring these dreams to reality.

ከአግላዩ የሳንባ በሽታ በሻገር ተስፋ ሲያንሰራራ

በግሬስ አድፎሊ

በጨለመው ደመና መካከል ብሩህ ብርሃን ይፈነጥቃል፡፡ ጨለማው ደመና የሳንባ በሽታን ያካበበው መገለል መገለጫ ነው፡፡ ብሩህ ብርሃን ደግሞ በሽታውን በመታገል ላይ ያሉ ህመምተኞችንና እንዚህን ህመምተኞች ለመታደግ በየቀኑ የሚታትሩ የጤና ባለሙያዎችን ይወክላል፡፡ በአዳማ (ኦሮሚያ ክልል) በጤና ማዕከል ባደረኩት ጉብኝት ፤ በጤና ዘርፍ መስራት የሚያስገኘውን  እጀግ አስደናቂ ነገር ለመገንዘብ ችያለሁ፡፡ ኢትዮጵያ ሳንባ በሽታና ኤች አይ ቪ ከፍተኛ ጫና የፈጠረባት አገር ነች፡፡ ይሁን እንጂ ባለፉት ዓመታት በበሽታዎቹ የሚያዙ ሰዎች ቁጥር እየቀነስ እንደመጣ በዘርፉ የተሰማሩ ባለሙያዎች አስተውለዋል፡፡ ህመምተኞች ተግባራዊ እንዲያደርጉ የተነገራቸውን ምክር እንዳይፈጽሙ ከሚያደርጓቸው ጉዳዮች አንዱ በህመምተኞችና በጤና ባለሙያዎች መካከል በቂ የሆነ ግንኙነት አለመኖር ነው፡፡ በሳንባ በሽታ የመያዝ ፍርሃት በማህበረሰቡ ብቻ ሳይሆን ከህመምተኞች ጋር ግንኙነት ባላቸው የጤና ባለሙያዎችም ዘንድ ይስተዋላል፡፡  በዚህም ፍርሃት የተነሳ አንዳንድ ህመምተኞች የመገለል ሥሜት ስለሚሰማቸው ለጤና ባለሙያዎች ተገቢውን ትብብር አያደርጉም፡፡blog

በሕዝብ ጤና አጠባበቅና ሶሻልዎረክሰ ለሁለተኛ ድግሪ ሟሟያ በዩ ኤስ አይ ዲ የምሰራ ተለማማጅ ሰራተኛ በመሆኔ፤ የተመደብኩት በማኔጅመንት ሳይንስ ለጤና ( Management Science for Health)  በተባለ የዩ ኤስ አይ ዲ ፕሮግራም ተግባራዊ የሚያደረግ Help Ethiopia Address the Low Tuberculosis Performance ለተሰኘ ፕሮግራም ድጋፍ እንዳደረግ ነበር፡፡ የተሰጠኝም ኃላፊነት የሳንባ በሽተኞች ህክምና ከመጀመራቸው በፊት መሰረታዊና እጅግ ወሳኝ የሆኑ መረጃዎች ማግኘት የሚያስችላቸውን ብሄራዊ የሳንባ በሽታ ቪድዮ ለማዘጋጀት የሚውል የመነሻ ጽሁፍ ማዘጋጀት ነው፡፡ የበሽተኞችን ተመክሮ ያካተተ መነሻ ጽሁፉ ለማዘጋጀትና ዝርዝር ሁኔታዎችን ለመረዳት በቅድሚያ የተለያዩ የሳንባ በሽታ ህክምና መስጫ ማዕከላትን መጎብኘት እንዲሁም ህመምተኞችንና የጤና ባለሙያዎችን  ማነጋገር ነበረብኝ፡፡

ብዙውን ጊዜ አንድን ሥራ ስንከውን በሥራው በመጠመድ ሥራው በሰዎች ላይ የሚያስከትለውን ተጽዕኖ እንዘነጋለን፡፡ ሆኖም እኔ መሥራት ስለአሰብኩት ሥራ እምነትና ተነሳሽነት እንዲኖረኝ እፈልግ ነበር፡፡ በአዳማ መድሃኒት የተላመደ የሳንባ በሽታ ህክምና መስጫ ማዕከል በጎበኝሁበት ወቅት ያጋጠመኝም ይኸው ነበር፡፡ በማዕከሉ በነበሩት ህመምተኞችና የጤና ባለሙያዎች በጣም ተደነቅኩ፡፡

ቀደም ብዬ የጤና ባለሙያዎች የሳንባ በሽተኞችን ለማከም ከፍተኛ ፍርሃትና እንዳለባቸው ገልጬ ነበር፡፡ ነገር ግን ይህ እንደልሆነ ተገንዝቤያለሁ፡፡ በጉብኝቴ ወቅት ከህመምተኞች ጋር ስነጋገር ራሴን ለመከላከል የሚያስችል የትንፋሽ መከላከያ ማጥለቅ ነበረብኝ፡፡ ከኢትዮጵያዊ የህክምና ዶክተር ጎን በመቀመጥም ዶክተሩ ክትትል የሚያድርግላቸውን ህመምተኞች ሲመረምር ፤ መረጃ ሲሰጥና ሲያጽናናቸው እመለከታለሁ፡፡ ህመምተኞቹ ከሁሉም የኅበረተሰብ ክፍል የተውጣጡ ናቸው፡፡ የህክምና ተማሪዎች ፤ ህጻናት ፤ ሴቶች፤ ወንዶች፤ አባወራ፤ እማወራና ወጣት ወንዶችን ያጠቃልላል፡፡ የሳንባ በሽታ ህመምተኞች ቢሆኑም ፤ ይስቃሉ ፤ ፈጽሙ የተባሉትን ያደርጋሉ ፤ ውጤት ይመለከታሉ፤ ህክምና ማግኘት በመቻላቸው ዕድለኞች እንደሆኑ ሃሳብ ይለዋወጣሉ፡፡ ለነዚህ ህመምተኞች መንገዱ ቀና አይደለም፡፡ ይሁን እንጂ ህክምናው ባይኖር ኖሮ ለተሻለ ህይወት ዕድል እንደማይኖራቸው ይገነዘባሉ፡፡

እነዚህ ህመምተኞች የተሻለ ዕድል እንዲኖራቸው የብዙ ሰው ድጋፍ እንደሚያስፈልጋቸው በፍጥነት ለመገንዘብ ችያለሁ፡፡ ከህክምና ዶክተሩ ጎን እንደተቀመጥኩ በአበባ ባጌጥ ውብ ልብስ የለበሰች አንዲት ኢትዮጵያዊ ሴት ከመኪና በመውርድ ፤ በእጇ የያዘችውን ምግብ ለማስቀመጥ ወደ ጠረጼዛው አመራች፡፡ ቀጥላም ያደረገችው ነገር እንደዚሁ ውብ ነበር፡፡  ከእያንዳንዱ  ህመምተኛ  ጋር ሰላምታ ከተለዋወጠች በኋላ ለሁሉም ህመምተኞች ምግብ አደለች፡፡ የዚህ ግንኑነት ቁም ነገሩ ሴትየዋ ስለበሽታው ብዙም ሳትጨነቅ በሽተኞቹ ክብርና ምቾት እንዲሰማቸው ጥረት ማድረጓ ነበር፡፡

እነዚህ ህመምተኞች ተገቢው መሳሪያ እንዲሁም ለመዳን የሚያሥችላቸው መድሃኒትና ቁሳቁስ እንዲኖራቸው ለማድረግ ገንዘብ አስፈላጊ ነው፡፡ ይህም ሆኖ ህይወታቸውን ለአደጋ ያጋለጡ ወገኖች ጥረትና ቁርጠኝነት ባይታከልበት ይህ እውን ሊሆን አይችልም ነበር፡፡ በዩ ኤስ ኤ አይ ዲና የማኔጅመንት ሳይንስ ለጤና (Management Sciences for Health) በመሳሰሉ ዓለም አቀፍ ድርጅቶችና የኢትዮጵያ ሕዝብ መካከል ያለው ቅንጀታዊ አሰራር በእጀጉ አስደንቆኛል፡፡

አንዳንድ ጊዜ መሰረተልማትን ለመለወጥ ፤ ቀጣይነትን ለማረጋገጥና አዎንታዊ ውጤት ማምጣት እማይቻል ይመስላል፡፡ ይሁን እንጂ ሰዎች መስዋዕትነትን ለመክፍል ዝግጁ ከሆኑ ፤ ከተማሩ፤ ካዳመጡና ከተባበሩ ይህንን ህልም እውን ማድረግ ይቻላል፡፡