The Philippines ranks #4 in the world for reported incidences of tuberculosis. And yesterday Jerry become one of those statistics. Children who grow up in poverty and experience malnutrition are especially vulnerable to TB, as they often live for years with infected parents or grandparents who transmit the disease.
Like many western countries, Australia has extremely low rates of TB infection and the World Health Organisation has actually pinpointed Australia as a country that could completely eradicate the disease. So a lot of the people reading this newsletter will never have had a paediatrician tell you your child is at high risk for the TB and should be tested.
And I didn’t get Jerry’s test done right away when she filled out the TB request form. What with floods and new-school enrolment and my western non-exposure to TB I didn’t give the test the importance I should have. I’m still a little shocked.
Getting a TB Test
Jerry’s TB test was conducted at a hospital in Iloilo City. His forearm was injected with a small amount of tuberculosis and a circle drawn around the injection site with a ballpen. He was told not to touch or scratch it, and to return in exactly 48 hours for a check.
By the time we returned two days later Jerry had developed a lump on his arm and it was very painful to touch. I thought he was going to have another injection until the nurses got out a tape measure and recorded the dimensions of the swelling. They also asked me a lot of questions about his background and possible exposure to TB.
Yesterday was Jerry’s final check and the swelling had grown even more. It was a positive result with the affected area measuring 20mm so we marched directly to the office of his paediatrician and were able to get an appointment after about an hour or so.
Because Jerry’s test reaction was extreme he’ll be having up to nine months treatment. The first two months are intense and every morning he must take 2½ of those great bit capsules (cut in half) plus some sort of anti-allergy stabiliser to protect his liver. He has to drink milk every day and I’m to monitor him for stomach ache and yellowing eyes (which could indicate a liver problem). On September 15th (exactly one month along) he’ll undergo a liver test to make sure the medications aren’t causing any organ damage. He’ll be tested every following month too.
Telling Jerry about TB
This morning it took Jerry about 30 minutes to get down his tablets. There was a lot of spitting out, rescuing the pills, pleading, mopping up spit, and finally swallowing. Jerry doesn’t know what tuberculosis is (he thinks he had a TV test) and I haven’t yet created any narrative around what we’ve just done and what he has in front of him. All he knows is he’s terrified of pills and he doesn’t want to die.
I wrote a blog only a few days ago about the stories we tell children to persuade them into varying behaviours — like inventing a snake to keep them out of a spare room. Now I’ve got to tell him a new and important story, so he understands that he’s sick and why it’s so important to take his meds. But without scaring him so he lives with TB constantly on his mind for the next 9 months.
The Story of TB
Jerry’s paediatrician is wonderful lady who adores Jerry. She is so kind and gentle you can tell she is living her purpose in every way possible. She donates 4 full months of every year to providing free clinics for children in the poorer barangays and provinces. Administering TB tests and providing free medication is one of the key activities of the doctors.
She tells me that one of the biggest problem here is the older people selling their meds instead of taking them. The disease then lives on into another generation as they infect their children and grandchildren through the coughing and sneezing.
Tuberculosis (TB) is still one of the world’s deadliest diseases and it’s no surprise that the countries most affected also have high incidences of poverty. Here in the Philippines almost 27 million people live in poverty and don’t get enough to eat.
Ending poverty is completely achievable and within the reach of us all. If we all did something imagine what we could achieve? Like a doctor who donates 4 months of her year to helping impoverished children.