Stop TB Partnership

Feature: Nurses help to drive MDR-TB and HIV care in South Africa

By Jeane Garcia Davis

27 April 2012 - KwaZulu-Natal province, South Africa - They wipe the sweat from their brows and drive deftly over unpaved dusty roads far from any health clinic to reach their last patient living with multidrug resistant tuberculosis (MDR-TB) and HIV at home for the fifth day this week. Treading slowly behind them, it is impossible not to be impressed by their dedication.

These nurses and TB workers operate in a region of the world hit hard by MDR-TB and HIV. Nurse manager Marge Govender-Singh and MDR-TB doctor Dr Simmi Lachman have worked with the Department of Health since 2007 to tackle rising cases of MDR-TB in Ugu district. Their programme, one of six in KwaZulu-Natal province, provides treatment and care at Murchison District Hospital, as well as mobile care and outreach in the surrounding communities.

With help from the South African Medical Research Council, Johns Hopkins University School of Nursing and other partners as part of the Co-INFECT study, the nurses have grown their local programme and currently manage over 300 patients with MDR-TB.

In January, the nurses added a clinical nurse practitioner to their team. ‘Kaya’ Mlandu, is the first nurse in South Africa to help doctors start patients on MDR-TB treatment and monitor their response to the medication.

As you walk through the wards at the hospital or join them as they visit communities, the nurses share countless stories detailing the complex needs their patients face. MDR-TB patients have to take as many as 22 pills a day for two years and face side effects including hearing and sight loss. One newly admitted patient says, "We just need hope and more people in our community to know about MDR-TB. I didn’t know anything until I got diagnosed and admitted here."

In response, nurses are implementing activities designed to bring down the MDR-TB death rate, especially among people living with HIV. These include referring patients for diagnosis, following up on test results and helping patients to complete their treatment.

"We are all educators and nurses and parents, and one of us here may have had TB or has HIV," said Nurse Singh. "Only together can we fight and win this war against TB."

For further information about the project please write to Jason Farley at coinfectproject@gmail.com