Virudhunagar, Tamil Nadu, India – International charity Target TB, with local partner Blossom Trust have developed an initiative that increases the sustainability of education, prevention and treatment of TB programmes. With a further three years of funding from the Big Lottery fund, the good work is set to continue – even beyond the life of the project!
Up until now, most TB programmes have relied upon staff and volunteers for implementation, requiring remuneration, stipends, and transport costs to be paid.
But in Virudhunagar district, through a very organic initiative, cured and current patients of TB have formed TB Associations. These associations are involved in awareness raising activities and supporting the community based management of TB patients. They are able to support these activities themselves through a livestock income generation project.
Since 2009, Target TB and the Blossom Trust have implemented a successful community based TB project, funded by the Big Lottery Fund that has contributed to significant improvements in levels of TB testing, identification and treatment completion.
The TB Associations grew very organically as an offshoot of the project. “At first, may be five or so people would get together in someone’s house and have a chat. But this wasn’t some kind of local gossip group. The group would talk about the challenges they had faced before they were cured of TB, or are facing as people currently being treated for TB” explains Mercy Annapoorni, Director at Blossom Trust.
Many people with TB face stigma and discrimination. These groups provide vital emotional support to people with TB. “When I was diagnosed with TB I cried. I thought of the social repercussions. I thought I was going to die.” recalls Citradevi. “At work people would cover their mouths when they spoke to me and I had to wear a mask. People stopped sharing their food with me. But the greatest struggle was at home. I was given a separate plate and had to sit separately at meal times. I heard them say “let her die, it doesn’t matter”. The discrimination by my family was worse that the severity of the disease”.
“We came together to share our feelings, as TB patients we face stigma in the community” explains another TB association member. “Here we can share something that we would usually have to hide, and we are able to counsel and consol each other. Free medicine satisfies only the needs of the body but we also need to satisfy our emotional needs. Together our confidence grows.”
And the Associations quickly grew too.
Through Blossom Trust, Target TB has supported the TB Associations to enable members to increase their knowledge of TB and develop their skills in community mobilisation and networking. The associations meet monthly and leaders from each association form a district level rainbow group, meeting quarterly for experience sharing and learning, mentoring and support from project staff.
This has been a really important development in running of TB control activities. By the end of last year there were 11 TB Associations providing invaluable peer support to people affected by TB throughout the district.
Moreover, the associations have been able to bridge the gap between TB patients and government services, tackle issues of stigma and discrimination, and at a grass root level, using community participation process, create awareness about the effects of TB.
“The TB Associations have been an enormous success so far. This is because TB patients get to meet their peers and they realize that they are not alone and they can share their inner thoughts and experiences with other TB patients. Since it is a community run by TB patients for TB patients, they get their voice heard and they are treated as human beings and not only patients” states Mercy Annapoorni of Blossom.
The project has funding for a further 3 years of implementation in Virudhunagar and Kanchipuram Districts of Tamil Nadu. By the end of the project it is expected that the TB Associations will lead on the delivery of health education and TB patient identification and referral activities, with mentoring and support from project staff. They will support these activities themselves through a livestock income generation project, which means that they will be able to successfully sustain their community led TB control activities beyond the term of the project.
India has the highest number of TB cases in the world. According to the recently published WHO Global Tuberculosis Report 2013, India also has one of the highest burdens of Multi-Drug Resistant TB (MDR-TB). In the southern state of Tamil Nadu people are more vulnerable to TB due to high levels of poverty, poor working and living conditions, combined with social-economic and physical barriers that delay, reduce, and prevent the already limited access to health information and facilities.
TB Associations provide a voice for people and communities affected by TB and play a crucial role in the identification of issues and challenges affecting people with TB, particularly women, children, and people living with HIV/AIDS. At district level the TB Associations communicate their needs to health service providers and district officials, and advocate for better and equal access to services for the communities they represent.
In this way the TB Associations work side by side with local government TB service providers, influencing them to provide a better quality of service to beneficiary communities. Target TB is now looking at replicating the model throughout our programmes in both Asia and Africa.
Notes to the Editor Target TB stops vulnerable people in Africa and Asia dying from TB by improving their access to information, treatment, care and support. Our vision is a world free from TB.
There are 9 million new cases every year. TB kills nearly 1.5 million men, women and children every year – needlessly, because TB is preventable and curable.
Target TB tackles the causes AND effects of TB. The bedrock of our approach is training local people in Africa and Asia to help themselves and others around them by becoming volunteer health workers. We ensure people living in poverty receive the right diagnosis and treatment to regain their health quickly and effectively, which also helps to reduce the spread of the disease. We inform people about TB so they can recognise its symptoms and know where to get help quickly and safely. We tackle myths and misconceptions too, reducing stigma & fear. We train local people as volunteer health workers giving them the lasting skills to find, treat and care for people with TB. They also raise awareness about TB in their own communities.
We work in India, Malawi, Zambia, Uganda, Timor-Leste, and South Africa.
Target TB works partnership with local organisations in India, Malawi, Zambia, Uganda, Timor Leste, South Africa to develop truly appropriate and sustainable solutions to TB prevention and treatment. We target countries these countries as they have the highest numbers of TB cases.
The Big Lottery Fund, the largest distributor of National Lottery good cause funding, is responsible for giving out 40% of the money raised for good causes by the National Lottery.
The Fund is committed to bringing real improvements to communities and the lives of people most in need and has been rolling out grants to health, education, environment and charitable causes across the UK. Since its inception in 2004 we have awarded close to £6bn.
The Fund was formally established by Parliament on 1 December 2006.