Stopping Tuberculosis, One Patient At A Time

Guest blog by Sisca Wiguno and Natalia (DOTS program coordinator)

The DOTS workers who help TB patients stay on the path to wellness.

The DOTS workers, who help TB patients stay on the path to wellness! Photo courtesy of Sisca Wiguno, March 2013.

Natalia, the ASRI DOTS Program Coordinator, interviewed one of the community health workers for TB treatment (DOTS workers), called Pengawas Minum Obat (treatment adherence supporter) in Bahasa - and one TB patient. In this interview, they shared their impressions about ASRI’s TB treatment program, their motivation to continue their work (for the DOTS workers), and to finish TB treatment (for the patient). Here are their stories:

Interview with a DOTS worker:

From left to right: Ase (Nurlinda’s husband); Natalia or "Lia" (DOTS coordinator)

From left to right: Ase, who with his wife Nurlinda volunteers for DOTS; and Natalia, nicknamed Lia, the DOTS coordinator at ASRI. Photo courtesy of Sisca Wiguno, March 2013.

Nurlinda is an elementary school teacher in Lamang Satong Village. As a local in this area, she recognized ASRI's work on reforestation in her village. She got acquainted with some of ASRI's staff, and it was from them she received information about ASRI's programs, which also cover health related activities. Since she desires to contribute to improving the health of her community, she was eager to know more about ASRI's health activities. In 2011, she joined ASRI as one of the community health workers for TB. Within a short time, Nurlinda's husband, Ase, became interested in supporting her in her TB work and began to share the responsibility with her to follow up with patients and pick up the patients' medication from the ASRI clinic. Both of them are perceived well by the patients and ASRI staff as a model "TB treatment couple." Their main role is ensuring patients’ adherence to TB treatment, which takes at least 6 months’ therapy. As Ase said, it takes a lot of patience to support the patient. Ase and Nurlinda fully understand the importance of finishing TB treatment, so they always try to encourage the patients by listening to their complaints of the drugs’ side effects [Tuberculosis treatment drugs can have strong effects on the liver] and communicate with the TB coordinator whenever it is necessary. They also try to boost the patients’ spirits with ongoing follow-up and support. As he said in the interview, Ase hopes ASRI can improve the documentation of TB patients. He also suggests ASRI broaden the coverage of the DOTS worker program, so more TB patients can benefit from it. Certainly Nurlinda feels this work is a heart fulfilling job when she said "I am proud to be part of the program which give me a chance to help other people, especially when I see my patient finish their treatment and become healthy."

Interview with a TB Patient:

From left to right: Lia (DOTS Coordinator); Sisca (author and TB program researcher); Lina (TB patient); Ronald (doctor at ASRI).

From left to right: Lia (DOTS Coordinator); Sisca (author and TB program researcher); Lina (TB patient); Ronald (doctor at ASRI).

Lina, age 26 years old, is a category-2 TB patient. She was treated in another health facility before and did not finish her treatment because she developed side effects from the TB medications and the medication was stopped. Her incomplete treatment resulted in recurrent TB. Upon her first visit to the ASRI clinic, she had lost most of her weight, and was suffering from severe symptoms of TB, including bloody cough. One of community health workers named Emi was assigned as her treatment adherence supporter. During the first two months of treatment, Lina experienced several side effects of drugs again, which caused her to be hospitalized several times. Though she almost gave up on her medication, Lina received encouragement and continuous support from Emi and the medical staff at the clinic. With just one more month to go out of the total of 9 months therapy, Lina is feeling much healthier now and already gained 7 kilograms. She confessed that Emi's commitment to support her and even sit by her side to ensure the medications are taken, is crucial to help her move forward. She appreciates ASRI's commitment to the community and she hopes one day ASRI can build a hospital in Sukadana.


About Sisca Wiguno, MD

Sisca is an Indonesian masters’ student in Public Health Management at a Japanese university. She visited ASRI briefly in 2009 and is fascinated with ASRI’s commitment to the community and way of combining programs to protect the forest and providing health care to the needy. Particularly, she is interested with ASRI’s work with the TB program and decided to return to Sukadana to conduct a research on community based TB care.



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