Niu Way for Faet Againstim Tuberculosis
TUBERCULOSIS (TB) hem oldfala sik wea savvy killim dae man, and hem stap yet olsem wanfala serious health problem wea World Health Organization (WHO) say hem olsem wanfala bomb wea ready for bursta. “Mifala resis withim taem,” hem nao warning wea WHO talemaot abaotem TB. Sapos olketa man fail for stopem disfala bomb, maet olketa face-im wanfala sik wea “man savvy kasem thru long air, but no eni medicine savvy stopem olsem AIDS.” WHO hem say, distaem iumi need for luksavvy long way wea TB savvy fit for barava spoelem. “Evriwan wea breathim air, from [New York] go kasem [China] . . . , mas worry abaotem disfala danger.”
Waswe, toktok hia hem ova tumas? Nomoa nao. Tingim hao full world bae lukluk sapos olketa no savvy kontrolem wanfala sik wea danger tumas and fit for finisim evri pipol long Canada insaed tenfala year! Maet diswan hem olsem story nomoa, but danger hia hem tru samting. Long full world, TB killim dae moa pipol winim AIDS, malaria, and olketa tropical sik tugeta: 8,000 pipol evriday. Klosap 20 million pipol suffer from TB, and maet 30 million bae dae from diswan insaed next tenfala year—namba wea winim olketa pipol long Canada.—Lukim box “TB Kasholem World,” long page 24.
Gud Nius
But, hope hem stap distaem. Bihaen tenfala year bilong olketa test, olketa wea duim research garem plan wea maet daonem TB from samting wea savvy killim man dae go long samting wea olketa savvy kontrolem. Dr. Hiroshi Nakajima, wea director-general bilong WHO bifor, hem kolem disfala plan “wanfala barava important samting bilong pablik health insaed last tenfala year.” And Dr. Arata Kochi, director bilong WHO World TB Program, hem say diswan givim first chance for “finisim disfala TB sik wea kasem evriwea.” Wanem nao reason for hapi olsem? Wanfala treatment wea olketa kolem DOTS.
DOTS hem meanim directly observed treatment, short-course. Hem wanfala health system wea savvy healim klosap evri TB patient insaed six go kasem eitfala month and man no need for stap long hospital nomata for wanfala day. DOTS hem depend long faevfala part for win. WHO hem talem, sapos wanfala long olketa part hia no stap, way for healim man wea garem TB “hem lus from finger bilong mifala.” Wanem nao olketa part hia?
● 1. Directly: TB wea danger tumas hem nao wan wea olketa no savvy sapos man garem or nomoa. WHO hem strongim point olsem, hao olketa wea work withim health-care mas directim strong bilong olketa for luksavvy hu nao garem TB long komuniti.
● 2. Observed: Mek-tu part bilong DOTS hem mekem health system—no datfala patient—garem responsibility for healim hem. Olketa wea work long health care or olketa volunteer wea kasem training, olsem olketa man wea garem stoa, teacher, or pipol wea garem TB bifor, observe, or lukluk gud, taem olketa patient tekem evri TB medicine. Olketa “patient observer” hia barava important tumas for winim diswan bikos wanfala main reason why TB hem go ahed distaem hem from olketa patient les for tekem full treatment. (Lukim box “Why Nao Hem Kamap—Moa?” long page 24.) Bihaen samfala week bilong treatment, olketa start for feel gud and stop for tekem treatment. But, olketa mas tekem disfala medicine for six go kasem eitfala month mekem disfala TB germ hem aot evribit from body.
● 3. Treatment: Insaed disfala six go kasem eitfala month, olketa health worker mas lukim result bilong treatment and raetem card abaotem datfala patient. Long way olsem, olketa mek sure olketa patient heal evribit and no savvy givim go datfala sik long narawan.
● 4. Short-Course: Way for iusim stretfala and inaf medicine for TB, wea olketa kolem short-course chemotherapy, for stretfala taem hem nao mek-foa part bilong DOTS plan. Olketa medicine hia strong and fit for killim dae disfala TB germ.a Supply bilong disfala medicine mas stap evritaem mekem treatment nating savvy stop.
● 5. !: WHO talemaot mek-faev part bilong DOTS plan taem olketa iusim disfala mark long end bilong datfala nem DOTS! Hem meanim selen and olketa stretfala idea. WHO encouragim olketa health system for kasem help saed long selen from olketa gavman and narafala organization and for mekem TB treatment kamap part bilong health system long datfala kantri.
Saed long selen, olketa wea bae disaedem hu nao kasem selen, laekem tumas disfala DOTS plan. World Bank hem say DOTS hem “wanfala gudfala way wea no kostim staka selen for faetem . . . sik.” WHO hem say, full kost for iusim disfala plan long olketa poor kantri hem olsem $480 for wanfala patient. “Planti taem diswan no winim 30 cent for wan man long olketa poor kantri, wea evriwan fit for peim nomata living hem hard tumas.” But, nomata kost hem small nomoa, hem savvy givim bigfala reward.
Waswe, Hem Work Gud?
Long March 1997 WHO talemaot hao nomata fewfala nomoa iusim DOTS plan “diswan kosim TB for katdaon long world winim planti year bifor.” “Taem olketa iusim DOTS, way for heal hem klosap double.” DOTS plan wea olketa traem long samfala area showimaot hao diswan hem work gud. Lukim samfala example wea WHO talem abaotem olketa wea win long diswan.
Long India olketa “traem DOTS plan long olketa area wea garem winim 12 million pipol. . . . Tuberculosis hem finis long 4-fala long evri 5-fala patient.” Long disfala program wea kavarem wan million pipol long Bangladesh, “87 percent [long olketa TB patient] heal nao.” Long wanfala island long Indonesia, disfala DOTS plan “hem healim 9-fala long evri 10-fala patient.” Taem olketa traem long China, plan hia “hem barava win nao,” and 94 percent kamap gud. Long wanfala taon long South Africa, “winim 80 percent [long olketa TB patient] wea kasem treatment barava win nao.” No longtaem go nomoa, olketa startim DOTS long New York, and hem gud tumas.
Samting wea kamaot from olketa test long samfala kantri, showimaot disfala plan “hem gud for iusim evriwea and savvy healim winim 85 percent bilong pipol,” Dr. Kochi hem talem.
No Big Tumas—But Hem Muv Ahed
Maet iu tingsay from DOTS plan iusim wanfala treatment wea fit for finisim wanfala nogud sik bilong man long easy way wea iusim small selen nomoa, hem mas barava big tumas. “But, iumi sapraes from samfala kantri nomoa iusim disfala TB treatment bilong WHO wea olketa pruvim finis and kost bilong hem small tumas,” wanfala bigman bilong WHO hem talem. Tru tumas, long start bilong 1996, 34 kantri nomoa startim disfala treatment.
Nomata olsem, hem muv ahed. Bifor long 1993, taem WHO kolem TB wanfala emergency long world, 1-fala nomoa long evri 50-fala sikman garem DOTS. Distaem hem 1-fala long evri 10-fala sikman. Report hem say, long 1998 samting olsem 96 kantri iusim DOTS plan. Sapos samfala moa kantri supportim DOTS, namba bilong olketa TB patient evri year ‘bae katdaon long haf insaed tenfala year nomoa.’ Dr. Kochi hem say: “Iumi garem wanfala ansa long health care but iumi mas iusim long planti ples.”
From man garem savvy and olketa tul for faet againstim TB and win, samting nomoa wea no stap hem nao ‘pipol wea bae mek sure olketa iusim gud medicine hia long full world.’ Dastawe insaed wanfala pablikeson for olketa doctor and narafala health worker raonem world, WHO hem ask: “Wanem nao iumi waitim?”
[Footnote]
a Insaed olketa medicine hia hem isoniazid, rifampin, pyrazinamide, streptomycin, and ethambutol.
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Evri second, samwan long earth kasem tuberculosis
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‘Olketa medicine wea sevem laef hem stap but planti million dae.’—Dr. Arata Kochi
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“Disfala DOTS plan bae kamap barava important pablik health ansa bilong olketa year hia.”—Report bilong WHO
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Why Nao Hem Kamap—MOA?
Olketa faendem way for healim tuberculosis (TB) winim 40 year wea go finis. Start long datfala taem, winim 120 million pipol dae from TB, and klosap 3 million moa pipol bae dae long disfala year. Why nao planti pipol go ahed for dae from TB sapos way for healim olketa stap? Threefala main reason hem stap: pipol no care, HIV/AIDS, and TB wea medicine no stopem.
No Care. Full world luk go long olketa nogud sik olsem AIDS and Ebola. But, long 1995, long evri man wea dae from Ebola, 12,000 dae long TB. Tru nao, from TB hem staka tumas long olketa poor kantri olketa pipol tingim disfala sik olsem part bilong laef. Long semtaem, long olketa rich kantri, olketa letem TB go ahed nomata gudfala medicine stap wea savvy healim. Disfala way for no care wea kamap long full world hem bigfala mistek. Taem interest long world abaotem TB hem weakdaon, disfala TB germ hem kamap strong. Distaem hem attackim moa pipol long moa kantri winim enitaem long history bilong man bifor.
HIV⁄AIDS. TB hem savvy join withim HIV and AIDS. Taem pipol kasem HIV—wea mekem olketa weakdaon—olketa 30 taem moa fit for kasem TB. From HIV hem kasem evriwea long world distaem hem mekem namba bilong olketa TB patient kamap moa big tu! Olketa tingsay 266,000 pipol wea garem HIV olketa dae from TB long 1997. Peter Piot wea director bilong Joint United Nations Program long HIV/AIDS hem say, “olketa man and woman hia no kasem help from olketa medicine for TB wea no kost hae tumas and wea savvy healim tuberculosis bilong olketa.”
TB Wea Medicine No Stopem. “Olketa strongfala germ,” wea no savvy dae long olketa medicine, hem luk olsem mek-ap story nomoa, but long saed bilong TB, hem kwiktaem start for kamap tru. Winim 50 million pipol maet distaem garem TB wea medicine no stopem. Olketa patient wea stop for tekem medicine bihaen fewfala week nomoa from olketa feel beta, from medicine hem finis, or from komuniti feel shame long disfala sik, olketa no killim dae olketa germ long body bilong olketa. Example, long wanfala kantri long Asia, 2-fala long evri 3-fala TB patient stopem treatment kwiktaem. Taem olketa kamap sik moa, sik hem moa hard for treatim bikos olketa germ wea laef yet faet moa and winim evri medicine for TB. From diswan, olketa patient garem wankaen TB wea olketa no savvy healim—for olketa and eniwan wea olketa givim long hem. And taem disfala danger TB hem go aot, wanfala nogud kwestin stap yet, Waswe, man savvy stopem diswan?
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TB Kasholem World
Sik bilong tuberculosis (TB) hem kamap moa big, kost moa selen, and garem moa danger evri year. World Health Organization hipimap evri report abaotem disfala danger wea go ahed. Samfala example long hia: “Pakistan hem bin lusim war againstim tuberculosis.” “Tuberculosis hem go back long Thailand and hem moa strong.” “Distaem, tuberculosis hem wanfala main reason bilong sik and dae long Brazil.” “Tuberculosis hem go ahed for kasholem pipol bilong Mexico.” Long Russia “TB start for kamap big tumas.” Long Ethiopia “tuberculosis hem go ahed long evri part long kantri.” “TB long South Africa hem hae winim eni narafala kantri long world.”
Nomata 95 long olketa 100 TB patient stap long olketa poor kantri long world, TB hem kasholem olketa rich kantri tu. Long United States, start long olketa year bilong 1990 TB kamap moa big. Wanfala woman for raet Valery Gartseff long U.S. hem talem hao TB “hem kam back moa for spoelem pipol long America.” Olsem tu, Dr. Jaap Broekmans, director bilong Royal Netherlands TB Association, hem say hao sik bilong TB hem “kamap moa worse long Eastern Europe and samfala part bilong Western Europe.” Hem no mekem man sapraes hao magasin Science, bilong August 22, 1997, talem hao “tuberculosis hem go ahed for kamap main health problem.”
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Olketa Faendem Plan Bilong TB
No longtaem go nomoa olketa wea duim research faendem way for lukim full genetic plan bilong tuberculosis (TB) germ. Disfala samting markem “wanfala niu taem insaed long faet againstim disfala nogud samting wea spoelem man,” Dr. Douglas Young, bilong Imperial College Skul Bilong Medicine long London hem talem. World Health Organization reportim hao samting wea olketa faendem “maet kamap barava important insaed research long future saed long medicine and nila for TB.”—The TB Treatment Observer, September 15, 1998.
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Olketa medicine hia tugeta savvy killim dae TB germ
[Credit Line]
Photo supplied by WHO, Geneva
Photo: WHO/Thierry Falise
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Hem needim $480 for healim wanfala patient
[Credit Line]
Photo: WHO/Thierry Falise
Photo supplied by WHO, Geneva
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Photo: WHO/Thierry Falise
Photo supplied by WHO, Geneva
Photo: WHO/Thierry Falise