In Dar es Salaam, a former patient’s group reaches clients where they live

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Former TB patient, now president of Mukikute, Joseph Samwel Mapunda

Joseph Samwel Mapunda was 46 when he was diagnosed with TB. He was cured in eight months, but by the time the disease was through with his family, his wife and daughter were sick too, and his brother-in-law was dead.

“From that day, I felt very strongly about this,” he told us last week. He felt strongly that TB patients had a right to choose whether to be treated in a hospital or in their own communities, and he felt strongly that too many communities were missing the message that the disease is curable.

DSC02800From that impetus came Mukikute — Fight AIDS and Tuberculosis in Tanzania — the first former TB patients’ club in the country, in the Temeke municipality of Dar es Salaam, and from that something of a movement. The group has taken the message to bus stations, market places, and to traditional healers: “I am a former TB patient. I’m cured, and you can get cured as well.” It led to the formation of Mkuta, an umbrella organization of former tuberculosis patient led groups nationwide, to a focus on the deadly synergy of HIV and TB coinfection, and to the recognition that many tuberculosis and HIV patients are hidden, and that their communities must be reached too.

So last week after we met Mapunda, now 56 and president of Mukikute, we followed him and several staffers to a community based drop-in center where people who inject drugs can get clean needles and syringes, condoms, take a shower, and lie down. In addition, they can be screened for tuberculosis.

In the process they get the opportunity to save their own lives, a woman at the center told us.

“You know when you are addicted to drugs, even when you hear about TB it is not important to you,” she said. “When you use drugs you don’t think about what will happen to you. You only live for the present.”

But having a place that met her immediate needs made a difference, she said. “We drug-users, we are not considered human beings. But if you continue giving education, we can hear what you’re saying.”

She followed the instructions she was given, she said. “I thank God I am here today.”

We walked down a hall past a room with a mattress, where a client could take a rest. Across the hall a door opened onto a room where two men worked quickly and hard, squeezing juice from sugar cane. Mapunda, smiling, passed a glass of juice across the counter that opened onto the street. This is one of the sources of income for everything that happens there.

Mapunda calls it a dream, realized.

“Without TB, I wouldn’t be here,” he said.



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