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Aurum tackles TB in Western Cape farmlands

Aurum tackles TB in Western Cape farmlands

Jacobus Engelbrecht had been living with TB symptoms for some time, hoping it was a passing flu as he could not afford to be off work on a farm, to go to the clinic.

“The clinic is very far, so it was a great relief to have the team from Aurum come to us on the farm for TB screening,” he said.

Engelbrecht is now a month into his TB treatment. He is one of many farm workers who have been screened for TB by Aurum in Malmesbury, as part of the USAID-funded TB Local Organizations Network (LON) project.

TB LON is a USAID funded project which supports organisations implement locally generated solutions to improve TB diagnosis, treatment, and prevention services.

Marinda Bouwer, Managing Director of Aurum’s Public Health Division said the Malmesbury outreach teams had visited more than 100 farms in the Western Cape.

“The seasonal nature of farming makes TB case finding and contact tracing, challenging. Many farm workers are employed through agencies or labour brokers, which find them work for three to six months at a time. They move from farm to farm for the next job, depending on what produce is in season,” she said. This results in people being lost to care and follow up TB treatment, risking developing drug resistant TB. “Having outreach teams which go to the farms where people work, means we can trace them and ensure they get medication from the clinic they are close to at the time,” added Bouwer.

Established in June last year, the outreach teams have helped 89 people start treatment after being diagnosed with TB.  Through these people, the outreach teams have raised awareness on TB in the respective areas and assisted with contact management by treating their families. The team focuses a on the Department of Health (DoH) TB Recovery Plan and contact management- including children under the age of 5 years- of index patients to find more presumptive cases.

Each team consists of 10 community health workers, a linkage officer who is an enrolled nurse, and a driver. They travel the vast farmlands of the West Coast District, conducting TB screening, contact tracing and raising TB awareness in farming communities at large. They do outreach in the Swartland sub-district, Malmesbury, Cederberg sub-district, Citrusdal and Matzikama sub-district, Vredendal. Another team is based at the DoH clinic in the Saldanha sub-District.

They screen the farm workers and when TB is suspected, collect sputum samples for testing. They then link those who test positive for TB to the nearest clinics for treatment.

Jean Pierre Alias, Aurum Project Coordinator in the Western Cape said that it is important to establish a good relationship with the farming community, which includes the workers, farm owners and the public living around farms.

“As a result of social and environmental circumstances, farm workers within the Western Cape farming districts are at high risk for TB. Poverty, lack of knowledge and overcrowded living conditions, all play a role. As an at-risk community who live and work far from healthcare facilities, we cannot forget them or afford for them to be lost to care, if we are to curb the spread of TB,” he added.

The partnerships with DoH and other government organisations offices such as home-based care service, Thusong Centres and the West Coast TVET Colleges, across the district are also key to the success of the project.  

Sarie Cloete, who is the linkage officer of the Cederberg outreach team said she was glad to be part of the collaborative TB case finding effort. “We can’t keep losing people to curable diseases like TB. This work on farms is very important to me because we are working to save lives, like that of Jacobus, who is now on treatment and well on his way to a recovery,” she said


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