Driven to deliver hard facts on good health

“It is quite ironic that we wear masks eight hours a day while we’re on duty, but when we go home we don’t have those masks,” says Zamani Dlamini, a nurse with Jhpiego, a nongovernmental health organisation affiliated to Johns Hopkins University in the United States. “When I leave work and get into a taxi I may end up sitting next to the same person I was protecting myself from in the ward.

“The people who are in a tuberculosis ward or clinic are actually less infectious because they are on treatment. But you may end up in the same bus or taxi as someone who has defaulted on their treatment, and get infected that way.”

Thinking back to the days when he was a taxi driver, Dlamini shakes his head and laughs: “You know sometimes people would refuse to open the window in the taxi because they didn’t want to mess up their hairstyles, as if that is more important than your health.”

Before becoming a nurse, Dlamini spent four years driving minibus taxis in the village of Hlabisa in rural northern KwaZulu-Natal where he grew up. He also ferried passengers between his hometown and Johannesburg.

After graduating as a nurse in 2011 he started working at Hlabisa hospital, where he quickly developed a special interest in tuberculosis.

“When I was at Hlabisa I was confronted with a lot of TB cases — but I was not prepared for the scale of the problem. To deal with this disease we need to educate not just the community but also nurses on issues such as infection control.”

KwaZulu-Natal has the highest HIV prevalence rate in the country. A report last year by the Human Sciences Research Council estimates that nearly 17% of the province’s population is HIV positive.

The provincial Aids council says KwaZulu-Natal has the most tuberculosis infections in the country and that tuberculosis is the leading cause of death in the province.

In the uMkhanyakude district, where Hlabisa is situated, nearly 40% of pregnant women at government clinics tested HIV positive in 2012, the fifth-highest prevalence rate in the country, according to the District Health Barometer, which also says that more than 71% of people with tuberculosis in the district are HIV positive. The tuberculosis cure rate in the district is 75.7%, below the national target of 80% according to the publication.

Dlamini conducts regular training for patients on treatment for multidrug-resistant tuberculosis to help them stay on their medication. He has also trained injection and tracer teams, which provide treatment to patients in their homes, and provides support to nurses working in tuberculosis programmes in the Hlabisa area.

When Dlamini joined Hlabisa’s tuberculosis programme as the coordinator in 2013 the cure rate was between 60% and 70% — by mid2015 this had gone up to 83%.

But he is not complacent: “People still don’t realise TB is a killer disease. We need more education about it so people can understand how it’s spread and how to protect themselves — that way we can avoid many deaths.” —