Fighting TB in the Community


August 4, 2009
Jen Maurer, senior policy associate

In a very poor area of Lusaka known as Chazanga, we visited the Bwafano (“helping each other out”) Care Project, which provides TB and TB-HIV testing, counseling, and treatment, as well as care and support to orphans and vulnerable children (OVC) and their caregivers. Bwafano has created many programs in order to respond to the community needs, such as income generating activities (selling crafts made by their members), life skills (12-month course in sewing and business), living wills to protect property of OVCs should their care-givers die, child nutrition counseling and supplements, and a community school for with a school-feeding component. We were impressed to learn that Bwafano adjusts their programs and activities if they realized that the current approach isn’t working.

Bwanfano receives support from PEPFAR (U.S. President’s Emergency Plan for AIDS Relief), the Global Fund to Fight AIDS, TB and Malaria, the Ministry of Health, as well as contributions from other donor countries and some private support.

We then went into the community and visited Precious, a bed-ridden TB-HIV patient. She is 22 years old and started anti-retroviral therapy (ART) for AIDS two months ago. She is still very weak and confined to her mattress on the floor, so a volunteer community health care worker from Bwafano visits her three times a week to make sure she is adhering to her medicines and is doing okay. Precious told us the first thing she wants to do when she gets better is sing again at church. We brought her food parcels to thank her for letting us visit.

TB is the number one killer of people living with HIV/AIDS in Zambia, where the TB-HIV coinfection rate is 70 percent, meaning that 70 percent of TB patients have HIV. The government and NGOs like Bwafano are aggressively trying to implement policies to test all TB patients for HIV and vice versa. If Precious wasn’t tested for both diseases, and if programs like Bwafano didn’t exist thanks to PEPFAR and the Global Fund, Precious would never have the chance to sing at church again.

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