Meranaw mayors, NGO unite in fight against tuberculosis

MARAWI CITY (MindaNews / 28 September) — Twenty-three year-old “Ben” (not his real name) wanted to work abroad to help support his family in Saguiaran town, Lanao del Sur.

He prepared his travel documents after a restaurant accepted his application to work as a waiter in Abu Dhabi, United Arab Emirates in February 2020.

After he completed all the requirements, Ben went to Manila to take the final medical checkup for his departure.

“My family had to borrow money to buy my plane ticket for Manila. We are not rich. I needed the job to support them,” Ben said.

Ben is one of the thousands of Meranaw residents still struggling to survive the squalid conditions in temporary shelters after the 2017 Marawi siege drove them away from their homes. The five-month urban warfare between government troops and the Islamic State-inspired Maute Group uprooted over 350,000 civilians and destroyed the core of Marawi.

Displaced Marawi residents live in squalid conditions in temporary shelters. As of May 31, 2021, some 17,446 families (87,230 individuals) remained displaced due to the Marawi siege, data from the United Nations High Commissioner for Refugees showed. MindaNews file photo by Froilan Gallardo

As of May 31, some 17,446 families (87,230 individuals) remained displaced due to the Marawi siege, data from the United Nations High Commissioner for Refugees (UNCHR) showed. The UNHCR said the COVID-19 pandemic heightened the health risks of the internally displaced persons (IDPs) and their communities because of limited access to health care.

When the medical findings came out, the world came crashing down on Ben. The clinical tests found him to have mild pulmonary tuberculosis, a contagious, airborne disease that mainly affects the lungs.

In its 2019 report, the World Health Organization (WHO) said that about one million Filipinos were afflicted with tuberculosis.

It is the number one global killer among the infectious diseases before the COVID-19 pandemic reared its ugly head in December 2019 in China, which spread and continues to ravage many countries around the globe, according to the WHO.

The Department of Health (DOH) said that tuberculosis kills an average of 70 Filipinos a day despite it being a preventable and curable disease.

Data from the Lanao del Sur provincial health office showed that there are 171 residents afflicted with tuberculosis while another 3,319 in 11 towns have early signs of the disease.

Mayors, NGO unite

Johayma Diama, project manager of Maranao Development Center (MARADECA) Access TB program, said they have been helping address the tuberculosis problem in Lanao del Sur with the assistance of the Philippine Business for Social Progress, the largest business-led non-government organization in the country that operates at the nexus of corporate citizenship, sustainable development and poverty reduction.

Diama said that what they did first was to hire mobile X-ray clinics and deployed them to 10 of Lanao del Sur’s 39 municipalities to detect individuals afflicted by the disease.

She said the people were surprised because this was not done before.

“Our tactic was to bring the X-ray clinics to the towns rather than ask the residents to come to Marawi,” Diama said.

Diama said they meet initial stiff resistance from some residents, who feared that they would be stigmatized if found that they are sick with TB.

She said they sought the help of the town mayors in asking the residents to avail the X-ray clinics.

“The situation changed when the town mayors help in asking their residents. More people came to the clinics because their leaders asked them to do so,” Diama said.

Diama said the results were encouraging, with some 6,000 residents availing of the mobile clinics and have themselves X-rayed.

She said that 171 residents were suspected to have TB and these are mostly from ages 60 to 80 years old.

Of the 171 residents, Diama said 47 elderly Maranaos were confirmed positive with TB when their sputum was examined using the GeneXpert machine for tuberculosis in Marawi.

‘Lucky Ben’

Ben went home dejected after the restaurant owner no longer wanted to hire him because of his medical condition.

Back in his hometown in Saguiran, he went to the municipal health office to seek treatment.

The municipal health office in Saguiaran had Ben X-rayed, and was able to confirm that he was indeed sick with pulmonary tuberculosis.

Ben has been taking daily medication of anti-tuberculosis drugs that was made available for him free of charge.

Dr. Apasrah Macumbal-Mapupuno, of the Lanao del Sur Provincial Health Office, said that Ben was “lucky” that the municipal health office still have anti-TB drugs to treat him.

She said the province had already ran out of anti-tuberculosis drugs for TB patients, which were supposed to be readily available and given free of charge.

Mapupuno said most of the budget of the provincial government for treating tuberculosis has been realigned  to combating the COVID-19 pandemic.

“The treatment for tuberculosis has taken a back seat because of COVID-19,” she said.

Mapupuno said the GeneXpert machine for tuberculosis molecular laboratory at the Amai Pakpak Medical Center in Marawi City was also used for testing COVID-19 cases since the pandemic emerged in 2020.

“Most of the money for the early detection of tuberculosis and other diseases also ran out as the money went to the fight against the coronavirus,” she said.

Due to lack of funds, Mapupuno said the salaries for the drivers of motorcycles who collected the sputum tuberculosis samples from Lanao del Sur’s 39 municipalities were not paid.

Treatment of tuberculosis involves taking antibiotics medicine for a minimum of six months. A patient must complete the medication, otherwise he or she could develop drug-resistant TB.

Treating and curing drug-resistant TB is complicated. Inappropriate management can have life-threatening results. Drug-resistant TB should be managed by or in close consultation with an expert in the disease, according to the Center for Disease Control and Prevention.

Because of the COVID-19 pandemic, TB disease treatment by the Lanao del Sur government has been side-tracked for a year now, Mapupuno reiterated.

She said they are especially concerned of the cramped houses in temporary shelters in Marawi City where thousands of IDPs like Ben have been staying, as such situation could worsen the incidence of COVID-19 and tuberculosis in the province.

For her part, Diama expressed optimism that with the public and private sectors working together, addressing health issues such as tuberculosis “won’t be a hard battle to win.”

Diama urged the mayors and other local officials to continue supporting the fight against tuberculosis, noting that their influence will help a lot in the campaign to eliminate tuberculosis in the country.

(This story supports the #TBFreePH campaign of the Department of Health and was produced under the 2021 TB Media Fellowship in the Philippines. With the help of the United States Agency for International Development, #TBFreePH aims to increase and improve conversations about TB and help address stigma and discrimination experienced by persons with TB.)