Community based research for improved TB services

Esau Kekeubata1, Rowena Asugeni1, Peter Massey 2, John Wakageni 1, Tommy Esau1, David

MacLaren3, Rick Speare3,4.

1 Atoifi Adventist Hospital, Malaita, Solomon Islands

2Hunter New England Population Health, Tamworth, Australia

3 James Cook University, Cairns, Australia4 Tropical Health Solutions, Townsville, Australia

TB in East Kwaio

• TB is an important public health issue in Solomon Islands and especially in East Kwaio.

• Communities around here are concerned about TB

• The national TB program are also concerned about TB in Kwaio.

Background

• Risks with TB– Spreads through families

and communities– If TB treatment is not

completed properly there are risks of developing resistant TB like in PNG

Background

• There no health resources in Kwaio language

• DVDs are a new thing in East Kwaio and are of great interest to people.

• A number of the staff at Atoifi have skills in making videos.

Methods

• DVDs developed with Chiefs, community leaders and hospital staff.

DVDs

• 2013 (complete & distributed)– TB awareness– Story about TB– ai’ imae

• 2014 (complete bot not yet distributed)– TB treatment: takin medicin go go for 6 months

Methods

• DVDs were shown to more than 400 people at villages, hamlets

Family watching the DVD (very closely)

TB DVD at Market house

Survey before and after video

Also talked with Chiefs and community about DVDs

The survey and discussions showed…

• TB awareness increased because of DVD• Following the DVD more people said they

would get health checked if 3 weeks of cough.• Sorcery is still an issue for many people

especially in mountains• Stopping taking medicine too early is common

and why this was the focus of the DVD in 2014

Comment from a Chief about language• “Inau nga le`anga ngai ai inau ku madafia ai na fatalana nga arikwao,

ngai lo`oo gwa`a ka agea ma gwa`a inau me le`a agu. Gwaa `ua taa `ola ka iria ma nau ku “Fatanga lo`oo ku su`ai.” Ngai lo`oo nau ku laenia `akui su`ai. Gwa`a `ola imooru moru agea mai, ma moru agea fana tee `Ingelesi, ma gwa`a inau ma taku boobolosia mola. Ma alata imoru moru agea maka leka mola na languisi, gwaa `ola `uutaa ma inau taku bi`i fata i suria te`e bi`i le`a agu te`e wataga agu. Ngai lo`oo nau ku laenia ai. Na fui`ola agu lee `ilo`oo, suria `ola gurui arua fana languisi [inaudible: `ola agu lo’oo?]… ku madafia e le`a.”

• [Me, what I think is good about what he said, if he [puts it into Kwaio] I like that. Anything he says [if put into Kwaio], I’ll say, “This is a language I understand.” I like that because I want to understand it. Anything you guys do here, if you do it in just English, even I won’t grasp it. But if you put it all in [Kwaio] language, then anything you talk about I’ll be able to talk about, and only then will it be satisfactory for me, be clear to me. That’s why I like it. That’s what I think…]

3 research articles published with many authors AAH and community

Next steps

• Community suggested the videos should be on mobile phones

• Other communities and language groups have asked for the DVD.

• Ongoing work this year will look at ways that women with TB can be better supported or how to better support women who care for someone with TB.

Conclusion

• Local language is important• Cultural understanding is important• Big difference can be made in the control of

TB when we work with community

Bao lea baita