Women as agents of change in DR-TB management
“Nothing makes me happier than to see people live healthier lives by simply adhering to the instructions that I give them in the clinic. I am a community health worker and I love my job. I consider it the most rewarding job any human being can wish for because it’s an opportunity to serve the underprivileged”.
These were the candid words of Hajiya Binta from Utai Village in Wudil Local Government, Kano State, North West Nigeria. Everyone knows her because she coordinates antenatal clinic, immunize children, treat malnutrition which by the way is very common there and also serve as a DOTS provider. In fact she is often referred to as a “doctor”. She gave a vivid narration of how she discovered Maikudi in the story below.
One patient I will never forget is Maikudi. A well-known young man in this village whom I once treated for tuberculosis and later commenced on CAT 2 drugs because he had started coughing again. Despite all the treatment he wasn’t improving. I watched him deteriorate from an active person to a bed ridden “sac of bones”.
Maikudi would often ask me if he was going to die. It was heartbreaking. I gave him hope even though I knew that the chances were slim. This is sad because he is poor and he lives in a village. He can’t afford care in big hospitals. When the Local Government TBL Supervisor told me that Maikudi had been diagnosed with what is called Drug Resistant Tuberculosis, I knew it was something very serious, judging from the tone of his voice and the fear and disappointment on his face. He had to be taken to the city for treatment and would have to wait as admissions are made in cohorts. At the time, I didn’t even understand most of what the Local Government TBL Supervisor was saying because I had virtually no idea what drug resistant tuberculosis meant.
Everything changed in December 2013 when a team from FHI360 and the State Tuberculosis Control Program visited me in my place of work. They quickly informed me that they came because of Maikudi and they were going to provide his treatment right at home with no cost to him or myself if I was ready to support him. We all visited him together and I was amazed at how the doctor counseled him about his diagnosis, adherence to treatment, possible adverse drug reactions, adherence to ARVs, and general health education among others. We all knew that a great task lay ahead but most empowering was the determination from Maikudi and his family.
Shortly afterwards, I was invited to the city for a training on how to manage patients with drug resistant tuberculosis. I came in as a novice and in just three days I was already feeling like an expert. I also met other health workers like me and we shared experiences. It was a really rewarding experience. As at this moment, I am the one treating Maikudi at home and he has improved significantly. I can’t express how happy I am. “I am an agent of change” to everyday people in my community.