Swaziland Health Workers – Making a Difference

Swaziland Health Workers – Making a Difference

Johan Viljoen

Swaziland has the highest prevalence of both TB and HIV in the world. The SACBC’s “Early Detection of TB” program has made a difference in reducing morbidity levels. Patients are detected during the early stages of the disease, are placed on TB treatment, and are monitored by community health workers for adherence to treatment. The program operates in 16 places. Two of them are in Swaziland – Good Shepherd Siteki and Regina Mundi Piggs Peak. In both places the program is being run by parish based home based caregivers. The program is currently being evaluated by Drs Ruth Stark and Marisa Wilke, under the auspices of the University of the Free State. Dr Stark is visiting implementation sites, interviewing project coordinators, care givers and beneficiaries. It has been a heartening experience. Siteki and Piggs Peak were visited during the week of 21-24 July 2014.

The two sites are amongst the five best performing in the program. In both places, patients described care givers as “their friends”, in whom they confide and with whom they discuss all their problems. This is in contrast to South Africa, where many patients do not want to see a care giver near their houses. In both places the poverty is acute, with starvation being common. The situation in Siteki is exacerbated by the fact that it is at the epicentre of a cholera epidemic, which has claimed more than 30 lives so far. However, the program is having an impact. Fr Mandla Makama says that he used to bury around 25 people per year who died of TB. Since this program started in August 2013, he has only buried three.

The photo shows Mangcobo Mabuza with his daughter Thandolwethu, and their care giver Janet Dlamini. Mangcobo has four children. The oldest is 11. Thandolwethu is 8. Their mother died in 2011. Mangcobo is in Manzini during the week, looking for employment. The children are then alone at home. They have no money and no food, and rely fully on what they receive from Janet. Thandolwethu was found to have TB three months ago. She is on treatment.