Thailand

Launch of TB patients’ health discussion group

On 4 July and 19 August, 15 TB patients, registered at Health Care Center 41 in Khlong Toei, attended BE Health’s first “TB patients’ health discussion group”. The discussion was initiated by our Community Health Volunteers, because they noticed that TB patients often lack knowledge about their disease. To avoid transmission of infection, treatment default and drug resistance, it is important that they know how to protect themselves and their relatives. One contagious TB patient can actually infect up to 15 people every year if left untreated or poorly adherent to his/her medical treatment. Including patients’ education into TB case management is powerful. Patients not only learn more about the causes of their symptoms and the importance of their regular treatment, they will also better understand the impact of their illness on their family and direct environment. In addition, they are taught about the importance of treatment adherence to stop the spread of the disease and how to take care of their health once they are cured. In short, making TB patients knowledgeable about their own disease contributes to making health contagious.

Improve TB treatment outcomes through social protection

This month, we are eager to start our social protection programme for extremely impoverished tuberculosis patients in Bangkok. It is sometimes difficult to understand why TB continues to flourish despite easy access to diagnosis and availability to effective medical treatment. But health is more than mere absence of illness. If poverty leads to weakness and therefore to disease, tuberculosis often creates a spiral of life-threatening poverty. With no income, proper sanitation facilities and lack of food, tuberculosis patients are simply not in control of their own health.

In partnership with Bangkok Metropolitan Administration (BMA), we want to ensure adequate support to TB and MDR-TB patients by delivering financial, food and psychosocial support to improve poor patients’ treatment outcomes. Until the end of the 2017, our active TB case finding will be ongoing in Khlong Toei and, at the same time, we will provide social support to 34 patients.

World TB Day in Khlong Toei

On Sunday, 19 March, we celebrated World TB Day on the 70 Rai’s square in Khlong Toei. With the help of six BE Health community health volunteers and two peer educators, we joined the Bangkok Metropolitan Administration (BMA) to raise awareness of the disease among its dwellers. Although the population of this neighbourhood live with it, people do not “think tuberculosis”. There is a low level of knowledge about tuberculosis, and people are not aware of how the disease is transmitted. They may even play down the importance of symptoms or choose self-medication. And because of this, people don’t immediately seek medical assistance, which causes a delay in diagnosis and the spread of the disease.

In order to meet its commitment, the BMA sent that day a mobile X-ray van, parked at the side of the square, offering people the chance to get screened. A little more than 20% of all those who were screened were referred to the local healthcare centre as they were suspected of having TB. Such an outcome proves that tuberculosis remains a public health concern in Khlong Toei. That is why the work of our community health volunteers is crucial when they are tirelessly crisscrossing the narrow alleys of 70 Rai and Lok 1 to screen households for TB, bring knowledge and urge people with suspected TB to attend the healthcare centre for further medical investigation.

Unite to end TB

World TB Day was initiated to build public awareness about TB on every 24 March. It is a special day for all those who strive to end this disease. That is why World TB Day is a meaningful day for us too. Every year, we celebrate with our partners and members the date in 1882 when Dr. Robert Koch announced his discovery of Mycobacterium tuberculosis, the bacillus that causes tuberculosis (TB). Thanks to Koch’s discovery, TB is diagnosed and cured in most of the cases. Though still 1.5 million people die from the disease every year.
On 13 March and in front of the press, BE Health was invited by Thailand’s Ministry of Public Health and Bangkok Metropolitan Administration (BMA) to present its activities and to launch together TB raising awareness activities in the country. Hand in hand with BMA, our peer educators and community health volunteers will mark the day by organising special awareness activities on 19 March in 70 Rai, Khlong Toei.

Siam Kempinski Hotel makes a difference for more than 40 TB patients in Khlong Toei.

Together with 400 invitees, Siam Kempinski Hotel Bangkok celebrated its sixth anniversary on 7 October. Since six years, the hotel successfully receives famous and less famous guests from all around the world. However, its management team also wanted to associate the nearby communities during that evening and organised a successful silent auction for the benefit of BE Health’s activities in Khlong Toei. In solidarity, 13 Kempinski hotels donated each a voucher of a three-night stay. Bidders were generous as a total amount of EUR 18,900 was collected in a few hours. This amount will be spent to provide social support to more than 40 TB patients and their families during their illness.

 

From left to right: Suriyont Arunwattanakul –Thai actor; Setthawut Naruemityarn – highest bidder; Samir R. Wildemann, General Manager Siam Kempinski Hotel and SVP Operations South East Asia; Sutanya Prodtayakul.

 

Active case finding by BE Health’s Community Health Volunteers

Tuberculosis is a common disease in Khlong Toei, where about 100,000 people live in poor living conditions, squeezed in an area of around a square mile. Active case finding is vital to prevent TB from spreading amongst the most vulnerable in this area. That is why BE Health trained eight Community Health Volunteers living in Khlong Toei’s quarter 70 Rai to identify people with suspected active TB. Since September, they have been relentlessly crisscrossing the narrow alleys of their neighbourhoods and going door to door in search of suspected active TB cases. Each outing, they identify eight to ten suspected cases, who are sent to Healthcare Center 41 to undergo diagnostic tests. It will take them until the end of the year to cover every household in 70 Rai before screening the next quarter.

Khun Pongsakorn: the importance of treatment monitoring and social support

Khun Pongsakorn is lion-hearted. As a day-labourer, earning THB 380 a day (approx. EUR 10) at Bangkok’s harbour, he makes a living for a family of six. He works in flip-flops too small as he cannot afford to buy himself a pair of sneakers that fit, which have given him a pressure ulcer in both feet. But most of all, Khun Pongsakorn is a recurrent TB patient and started his medical treatment last month for the second time. Although TB treatment is free, Khun Pongsakorn needs THB 60 for his daily transport to the healthcare centre to receive his medication and THB 120 for dressing his wounds. Deeply weakened both by the disease and the ulcers, he was forced to stop working. This also means no income for the entire family which amplifies the risk factors, such as under-nutrition, for TB transmission within the household.

BE Health’s peer educators noted furthermore that Khun Pongsakorn was seriously lacking knowledge as he randomly put all his pills and tablets from eight different regimens in the same box, seriously compromising the success of his TB and ulcer treatments. Besides monitoring his treatment, the peer educators were determined to prepare precise drug packages so that he could take the correct therapeutic doses every day.

Khun Pongsakorn received financial support from his neighbourhood and social support from Healthcare Centre 41 (Khlong Toei). BE Health will take care of him until he is cured. His case shows that TB treatment monitoring, social support and empowerment are crucial to the success of tuberculosis care and prevention.

Stop smoking reduces the spread of tuberculosis

Smoking tobacco increases the risk of TB disease. It even doubles the risk that people who have been successfully treated for TB will develop TB again! This is why BE Health decided to conduct a quit smoking campaign, which demonstrated that bringing knowledge and counselling to the workplace can effectively help employees to cure their addiction. On I June, one year after its first campaign against tobacco smoking, BE Health joined Bangkok Metropolitan Administration’s Health Department in their campaign to encourage people to stop smoking. More than 400 people attended the event in the middle of Bangkok’s busiest shopping area, Siam Square. Our peer educators, Saphon Udomwongrattana, Thitima Tanmanee and Anan  Leelawat, had the chance to present their actions to Dr. Pusadee Tamthai, BMA’s Deputy Governor and chair of the event. Under the supervision of Pakhin Chanthathadawong, BE Health’s public health expert, they counselled 15 of their colleagues, having decided to give up their smoking; eight employees succeeded three months later, while the other seven employees succeeded in their effort after six months. Saphon, Thitima and Anan showed that their commitment and altruism made a difference at the workplace.

Khun Ood’s story

Khun Ood is homeless. A bench on a wooden bridge over Khlong Toei’s market is where he lives. Over the past 15 years, he has been treated two times for TB already. BE Health met him at the beginning of his third treatment.

“I felt so ill, I was in agony throughout my whole body. I wanted to die. I put a rope around my neck and waited to make the final decision under a tree when a sudden breeze reminded me of my father. It made me realise that it had taken my father a long time to raise me. This thought changed my mind. I went to the doctor and, during the first two months of my treatment, I received daily injections and pills. Because of the daily shots, I couldn’t sit on my bicycle any more and had to walk five kilometres to and from the Healthcare Centre. Walking made me breathless and I had to pause many times. I had no choice other than to keep up with my medication because I didn’t want to spread my illness to my neighbours. So I told myself that receiving TB treatment was easy. Just go ahead! I believe that living is easy, but it’s the thinking which makes it difficult.”

BE Health celebrates World TB Day in Bangkok

A railway station is like a beating heart in town. In Bangkok, thousands of people use Hua Lamphong train station daily. This is the reason why BE Health’s team set up their booth on such a busy crossroads on World TB Day, together with Thailand’s BMA. Enticing people is key to making them aware that tuberculosis is still a major health problem in the country and city. However, people are not aware of the disease, do not recognise the symptoms, nor do they know that everyone has access to TB treatment. But how do you make busy commuters knowledgeable about the disease and its prevention in a minimum of time? Like giving them a quizz, ask them to read a short script about the disease and question them afterwards. A small present rewarding an accurate response will make the exercise worthwhile!

 

A few days prior to this event and in the presence of Dr Amnuay Gajeena, Director General of the Department of Disease Control, as well as the Director of Thailand’s National TB Programme and the Vice President of BMA Health Department, BE Health and Siam Kempinski Hotel hosted the World TB Day Press Event, focusing on raising awareness and advocating better TB control. More than 120 people attended the meeting.

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