On Tuesday, 05 March, TB HIV Care (THC) received a notification of award for an exciting new community project to be implemented in the Eastern Cape from 01 April 2019.
The Eastern Cape Community Collaborative Cancer Initiative, as the project is known, is the second THC project to be funded by Bristol Myers Squibb Foundation (BMSF) and marks a notable diversification of the scope of services offered by THC. The overarching goal of the project is to support improved patient outcomes for lung cancer and other common cancers affecting people living in the catchment area of the Nelson Mandela Academic Hospital, by raising community awareness of lung cancer, promoting and linking people to screening, supporting navigation through the health system as well as supporting palliative and survivorship activities.
This community-based project will link with and support the activities of the Nelson Mandela Academic Hospital Oncology Centre of Excellence, which is being supported through a separate funding agreement with BMSF.
You may be wondering why THC, an organisation that has historically focused on two of the most prevalent infectious diseases impacting South Africans (TB and HIV) would be branching out into lung cancer, so here are some interesting facts:
Lung cancer is the leading cause of cancer-related deaths in South Africa, accounting for around 16% of all cancer deaths, followed by cervix, breast and prostate cancer.
Lung cancer is the second most common cancer affecting South African men and the fourth most common in women.
People living with HIV who have access to effective antiretrovirals are living longer lives and co-morbid non-communicable diseases such as diabetes, heart disease and cancers are becoming an increasing health burden to this group and others. Yet many South Africans have limited awareness of cancer.
There is evidence that TB, either active TB or successfully treated TB with resultant lung scarring, is a risk factor for the development of lung cancer.
Lung cancer can present with similar clinical symptoms and X-ray changes to TB (incl. unexplained weight loss, a persistent cough, blood-stained sputum) and diagnosis may be delayed if health workers are not aware of the possibility of an alternate diagnosis to TB.
In light of this, we believe that it is important that links between TB and cancer service providers are strengthened and community awareness raised. TB HIV Care is therefore partnering with four community-based organisations (CBOs) in OR Tambo and Alfred Nzo districts to raise community awareness and support endeavours to equip community-based and primary health care providers with the necessary knowledge and skills to assess risks for lung cancer and refer patients for early screening.
TB HIV Care, led by Mandisa Mona (Advanced Clinical Care Facilitator), joined a team of ten delegates, including representatives from TB HIV Care’s Chris Hani district office, SEAD and the Chris Hani District Department of Health (DOH), on a four-day visit (26 February – 01 March) to Durban. The trip was organised by CAPRISA.
The purpose of the visit was to benchmark best practices in viral load monitoring and recognition of treatment failure; learn strategies to increase viral load coverage in ART clients; share Advanced Clinical Care (ACC) tools utilised for improved patient outcomes and share M&E tools for reporting purposes. All of which contribute to moving closer to achieving the third target of UNAIDS’ 90-90-90 goals (that by 2020, 90% of all people receiving antiretroviral therapy will have viral suppression).
The best practices will be piloted in the Chris Hani health district, with relevant stakeholders prioritising 10×10 facilities and escalated to other facilities supported by TB HIV Care in Amathole and OR Tambo.
The team also visited Clairwood Hospital (Thusong ARV Clinic) where ART patients with complications are managed. They were taken step-by-step through the management process of these patients.
The Informal Settlements Programme (IS) provides the comprehensive prevention package (CPP), including TB screening and testing, HIV testing and counselling and STI screening, to contacts of TB cases and community members in three informal settlements in the Eastern Cape: Dimbaza, Duncan Village and Reeston.
TB HIV Care, in partnership with the Pedal Power Association (PPA), is piloting a bicycle project in Dimbaza Informal Settlement (Buffalo City Metropolitan Municipality). The PPA donated three bicycles to carry out the pilot project, with hopes of expanding the programme should it prove to be a success. TB HIV Care is hoping that the introduction of bicycles will make a significant difference in increasing the number of households reached and assist with the distance that HAST Counsellors can cover (in order to reach far-flung households).
The idea was initiated when the IS Programme received funding from dhk thinkspace to allocate to an area described as a ‘limited services area’ – such as Dimbaza. TB HIV Care used these funds to purchase suitable walking shoes for the team (who often walk great distances), and will also support the bicycle project with accessories needed for safety.
The bike handover ceremony took place at Dimbaza Community Health Centre on Friday, 08 February 2019. The event went extremely well, with TB HIV Care staff, Dimbaza CHC staff and community members overjoyed and excited about the project. What excites them most is that Dimbaza CHC is the first facility in the Eastern Cape to pilot this kind of project. If the project is a success there is every chance that it will be rolled out to other areas in the province. Everyone present was singing, sharing traditional songs of praise and rejoicing in the donation of the bicycles. It is worth noting that while the event was happening, delivery of health services to community members continued as normal.
Many thanks to Nomgcobo Puta (Team Leader: Informal Settlements) who acted as programme director for the day, Zimkhitha Mphati (Project Coordinator: Informal Settlements) who shared the purpose of the day and the background to the project, and all the guests who made it such a special and meaningful occasion.
The ceremony concluded with HAST Counsellors visiting homes in Polar Park – demonstrating exactly how they trace and follow-up with household and close contacts of TB index clients. Thank you!