ALOIS YOBA BAI
An entry in the Crocodile Prize
PNG Chamber of Mines & Petroleum
Award for Essays & Journalism
TUBERCULOSIS (TB) is a contagious disease that over the centuries has killed millions of people worldwide.
The lack of a reliable cure prior to the 20th century and TB’s perceived randomness in selecting its victims made it a common theme in literature and a metaphor for larger social and political ills.
Today, TB has re-emerged as a major public health threat in Papua New Guinea.
After its incidence decreased in the country for many decades, TB is again on the rise. In some communities, TB rates are particularly high, Karkar Island in Daru are two cases in point.
Recent trends in the incidence of TB have been linked, in part, to decreases in public health investment by successive governments. Another factor associated with its resurgence is the HIV epidemic. An important complication is the emergence of drug resistant TB strains.
These recent trends in TB represent a serious threat to communities already saddled with poor health, poverty and other social problems and the disease could become an additional major burden on the nation’s healthcare system.
Despite tuberculosis being both preventable and curable, it is one of the most serious health problems facing PNG today. According to the World Health Organisation, since 2009 there has been a steady increase in the number of patients.
In 2011 close to 1,000 patients were undergoing TB treatment and the disease was beginning to present a major health crisis as well as being a heavy drain on public resources.
Tuberculosis is an archetypal disease of poverty. It has been all but eradicated in the developed world yet remains a real threat particularly amongst those suffering from malnutrition or HIV/AIDS, and in areas where public goods such as access to healthcare are limited.
Eradicating the disease from Papua New Guinea will require concerted and multi-faceted efforts.
TB interventions have typically focused on issues such as healthcare, malnutrition and HIV/AIDS, however recently the role-played by rural-urban population drift to overcrowded settlements has also been in focus.
Poor access to clean water and sanitation is also a catalyst to the steady increase of the disease and research has shown that a significant cause of tuberculosis increase in PNG is poor living conditions and hygiene practices.
In urban settlements especially, accommodation is often cramped and of low quality, providing an ideal environment for the spread of airborne strands of the bacteria.
However, there is another important factor.
In socio-economic terms, the imperative to address TB in the government sector has been very weak and diluted by mass corruption.
This political influence is very important since it underpins the social economic problem that give rise to the increase of TB.
In some, communities, the problem is very serious as other social ills, including AIDS, hopelessness, drug abuse, and poverty, are compounded by a disease that is worsening in its impacts.
Particularly disturbing is the emergence of multidrug-resistant tuberculosis (MDR-TB), esepcially in Daru. MDR-TB has been directly linked to inappropriate and incomplete treatment, which in turn has been linked to a lack of resources to ensure the proper delivery of TB services.
It is now time that the government shift the national focus on healthcare reform. Too much attention is given to the lessening problem of HIV/AIDS compared with TB.
The lifestyle, culture and practices of communities in PNG is very favourable and conducive for a TB explosion.
Alois Bai is a trained nurse and a post-graduate student in health promotion at the University of the Sunshine Coast in Queensland, Australia