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Ken loads the dinghy in preparation for TB outreach services in the South Fly District of Western Province.
It takes a lot of courage, sacrifice and determination to do what Ken Tal does for a living. As the senior tuberculosis (TB) outreach officer with the Western Province Health Office, he often travels long hours across rough seas and wetlands to reach TB patients in the South Fly District.
When diagnosed TB patients do not present themselves at Daru General Hospital or Daru Accelerated Response for TB (DART) sites for regular treatment, they are referred to as ‘lost to follow-up’. The outreach team is then dispatched to go out and find the patient, and investigate why they did not turn up to take their medication.
Maintaining continuity of treatment helps prevent the development of drug-resistant strains, which are harder and much more expensive to treat.
“We sometimes go as far as Balimo and even Saibai to retrieve loss to follow-up cases, but most of the time we go up the river. Even though we are from the South Fly District Health Services, we also go as far as Middle Fly, because they are our patients too,” explains Ken.
“We find them, find out why they have not come back to the hospital for the due reviews, get them to give a sputum specimen, then we return to the hospital and give in the sputum for testing which takes about two to three days.
Once we get their results, we return with drug supplies, but if some patients have tested positive to multi-drug resistant TB, then we isolate them quickly and arrange for them to return with us to do further testing, counselling and treatment.”
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Ken carries TB medication onto the dinghy to treat patients unable to attend Daru Accelerated Response for TB (DART) sites.
Daru, the capital of Western Province, has one of the highest rates of TB and multi-drug resistant TB in the country. Local health authorities are concerned that cases of extensively-drug resistant TB have also been diagnosed in the area.
The Australian Government is in partnership with the National Department of Health, World Health Organization, World Bank, Burnet Institute and World Vision to support the Western Province Health Office and Daru General Hospital in managing the emergency response to TB. Australia’s assistance in Daru began in 2013 with the construction of the current drug resistant TB ward building.
Outreach services are a critical part of the response to ensure TB patients in remote South Fly villages take their medication and complete their treatment.
“We have 67 treatment supporters across the district that submit reports. From these reports, and also a list of lost to follow-up cases from doctors and nurses with patient records, we are able to make plans to travel to the patient’s village and bring them back for further testing and treatment,” explains Ken.
Tracking these patients and getting them back on their medication through patient care and counselling have contributed to Daru having one of the lowest TB patient drop-out rates in the world, at just two per cent.
A nurse by profession, Ken graduated from Kudjip School of Nursing in Jiwaka, 1998 and worked in various provinces, including West Sepik and Manus, before transferring to the South Fly District Health Office. Despite the risks of his job, Ken is committed to reducing high rates of TB in the region through patient outreach.
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Ken (right) with ‘skipper’ Dobin, both members of the South Fly TB Team, supported by Australia in partnership with the National Department of Health.
“I owe a lot to my family – my wife and four kids. My colleagues here too are the best people to work with. I would not be able to have the courage to continue in this job if not for them,” said Ken.
For further information, including access to related materials, please contact the Australian High Commission media team: +675 7090 0100