With 10 million sick people worldwide and 1.4 million deaths in 2019 alone, Tuberculosis remains one of the deadliest diseases. Twenty-five percent of new cases recorded each year are in Africa, and Covid-19’s arrival in the last year has put a strain on health systems here too. This risks being a major setback for the fight against tuberculosis. For World Tuberculosis Day, on March 24, Doctors with Africa CUAMM is joining the World Health Organization (WHO) in its urgent call that the “Clock is Ticking,” if we want to put an end to Tuberculosis.

In Uganda, in Karamoja, Doctors with Africa CUAMM is working on two projects to fight tuberculosis funded by Fondation Assistance Internationale (FAI) and by the Italian Agency for Development Cooperation (AICS). Even in the year of Covid-19, there are some signs of hope, which show how the fight against the “disease of poverty” can still be won with enough determination.

Simone Cadorin, project manager of Doctors with Africa CUAMM in Moroto, says:

“With Covid-19, we were afraid that years of work would be ruined. A year ago, the government stopped public transport, imposed a curfew, and banned travel. There was the fear was that people would no longer come to the hospital for monthly visits and to get their medicine. This we why we worked with local authorities to develop, in the midst of the emergency, home-based care for patients, visiting them at home and distributing medicines in rural areas with semi-nomadic populations. We have not only kept patients in treatment, but we have also greatly improved outcomes, going from 36% successfully completed treatments in 2019 to 85% in 2020 and bringing the dropout rate down from 42% to 11%. Lockdown measures have been recently relaxed in Uganda, and patients now come themselves to health centers. We still continue to maintain contact with each of them through the “village health teams,” who see the patients at home, make sure that they regularly take their medicine, and provide psychological help and social support to families and patients.”

It is often from the community that problems arise related to fighting viruses and infectious diseases, as we hear from Paul Okala, a patient that Doctors with Africa CUAMM has followed and who has suffered the consequences of the stigma and prejudices about Covid-19.

“Because of Covid-19,” he says, “in Karamoja, unfortunately, people think badly about those who wear a mask. I found out I had drug-resistant tuberculosis before the virus came. I was treated in Matany and then I was supposed to continue taking the medicine at home for a year, using a mask when I was with other people. Everything was fine until Covid-19 came. People started to treat me badly because I was wearing a mask; they thought I had the virus and that I would infect them. Nobody wanted to come near me and my landlord was about to kick me out. It was horrible. I didn’t know how to deal with it and even thought about giving it all up. Fortunately, the Doctors with Africa CUAMM team came and helped me to show everyone that I was not sick with Covid-19 and explain the differences between the two diseases and the different ways to handle them in the village too. Luckily, no one is upset with me anymore, and I was able to complete my treatment!”

Combating fake news about Covid-19 with training for health personnel and awareness raising in the villages was one of the major focuses of Doctors with Africa CUAMM in Uganda, as well as in the other seven countries where it is active. Many people stopped going to the hospital for fear of being infected, with the result that many women were risking their lives giving birth at home, and many babies were not being vaccinated against the most common diseases. The home-based approach developed in Karamoja shows that by going the extra mile, talking to the communities, and listening to their needs and fears, we can ensure continuity to our projects and provide health care to those who need it most.

March 24th, during the event for World Tuberculosis Day, the Ugandan Ministry of Health awarded Doctors with Africa CUAMM for their tireless and extraordinary support towards  TB services delivery in South Karamoja. The award was received by Peter Lochoro, CUAMM country representative in Uganda.


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