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Tuberculosis, a community approach

1,909 views · Published 23 March 2011 · 2:56 · Indexed 22 September 2026

Channel: Doctors Without Borders / MSF-USA · 2011 · Nonprofits & Activism

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Khayelitsha is one of the biggest townships in South Africa; it has a population of about half a million and is located about 30 or 40 kilometres outside of Cape Town. It has one of the highest rates of TB (tuberculosis) and HIV in the country. Here MSf has established a decentralised model of care, whihc is based around the patient and aims at improving outcomes through diagnosing more people and starting them on treatment earlier. This is enabled by the model where patients are able to get treatment from their local clinics with a better treatment regiment, better diagnostic technics and more support for the patient.

Shot: March 2011, Khayelitsha township, South Africa

Transcript:

DOCTOR JENNIFER HUGHES, DRUG-RESISTANT TUBERCULOSIS (DR-TB) COORDINATOR: Khayelitsha is one of the biggest townships in South Africa; it has a population of about half a million and it is located about 30 or 40 kilometres outside of Cape Town. It has one of the highest rates of TB (tuberculosis) and HIV in the country. So the decentralized model of care in Khayelitsha, is based around the patient and it aims at improving outcomes through diagnosing more people and starting people on treatment and that is enabled by the model where we allow patients to access treatment from their local clinics with a better treatment regiment, better diagnostic techniques and more support for the patient.

TEMBINKOSI QONDELA, SUCCESSFULLY TREATED PATIENT: I had a first test and I was told I had normal TB. Then I was put on treatment for a month. Then I was told later on that I had drug-resistant 

DOCTOR JENNIFER HUGHES: We see different types of TB, apart from the regular drug sensitive TB, we also see drug resistant TB, which can be divided into multidrug-resistant TB, MDR TB, and extreme drug resistant TB, which is EXDR TB. 

Mr. QONDELA: To take the MDR treatment. I could decide to go to the hospital, I chose to take the treatment from the clinic and then I was referred to the support group which is a drug-resistant support group run by MSF. For me being home was much better then being at the hospital, I was still there for my children, I was still there for the things that I had to do. So, even though I was sick, it did not affect me in a way that I felt paralyzed and not able to do anything. I think, being at hospital would have meant that I could not do the things I was able to do.

DR. HUGHES: One of the main aspects of our program is support for the patients while they are taking their DRTB treatment. So we have a social assistant and we also have counsellors. The counsellors see patients on a one on one basis when they start their treatment, to provide intensified counselling for them. They also carry out home visits where they visit their home and they give infection control advice to the family, they educate the family and they reiterate the messages they gave in the first counselling session, and they are also used to track defaulting patients, if they have stopped taking their medicines for what ever reason. So by decentralizing drug resistant TB treatment, people have access treatment sooner and they are able to stay in the communities where they can get support from their families to continue their treatment.

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