Rural Healthcare Challenges in the Spotlight: Dr Mphothulo Discusses TB at #RHC2024
Healthcare expert Dr Ndiviwe Mphothulo, who has worked in tuberculosis (TB) management for over 20 years, discussed the difficulties and potential solutions to the problem of TB in rural South Africa during #RHC2024. His thoughts highlight how TB is multifaceted, involving not just medical but also socioeconomic factors, such as poverty and inadequate healthcare access.
Healthcare providers in rural areas, Dr Mphothulo stressed, must engage in ongoing professional development. “Clinicians in rural settings often miss out on training opportunities available in urban centres,” according to him. Healthcare providers often experience burnout due to factors such as a lack of training, shortages of the necessary pharmaceuticals and not enough staff, which in turn impacts the quality of treatment offered to TB patients. Improving TB management in rural areas requires guaranteeing that practitioners there have access to diagnostic equipment, medications used in treatment of TB, and continuing professional education.
The close relationship between TB and densely populated areas gives the impression that the disease is more prevalent in cities. Dr Mphothulo, on the other hand, detailed the main means by which the disease spreads to rural areas: migration. As he put it, “TB spreads through movement, people working in urban centres or mines often bring the disease back to their rural homes, infecting others along the way.” Because of this, it is clear that tailored TB interventions are necessary in rural areas, since the people in these places are also very susceptible to this disease.
Communities already struggling to make ends meet, such as those in overcrowded housing or without adequate sanitation and access to healthy food, are disproportionately hit by TB, according to Dr Mphothulo. He says, “TB is often termed a disease of poverty because it thrives in environments where people are already struggling with basic needs.” Rural areas often have high levels of deprivation and this increases the risk of these communities to TB. When a person’s immune system is weakened due to malnutrition, latent TB infections can easily manifest.
The early detection and treatment of TB face multiple obstacles in rural settings. Many people ignore TB symptoms, which manifest over time, and Dr Mphothulo noted that this is a major problem. He went on to say that “Access to healthcare is a significant barrier, clinics are often far, understaffed, and patients may face long waiting times.” Other causes of delayed diagnosis and treatment initiation in rural areas include people’s preference for traditional medicine and the stigma associated with TB.
A community-centered strategy is necessary to combat TB in rural regions. Community education on TB and its significance in early detection is something that Dr Mphothulo strongly supports. “TB is not just a medical problem; it’s a social problem,” he said. He suggests that healthcare providers expand their screening efforts outside of traditional clinics and into public spaces like soccer fields and taxi ranks if they want to identify the undiagnosed and untreated.
When Dr Mphothulo was first assigned to a TB ward early in his career, he did not realise it would be the beginning of his journey into TB management. He became emotionally invested in the plight of TB sufferers and resolved to do all in his power to alleviate the disease’s societal causes. He now fights for a more comprehensive strategy to treat TB, one that takes into account socioeconomic determinants of health and aims to enhance circumstances outside of medical facilities.
In light of Dr Mphothulo’s observations, it is clear that medical treatment alone is not enough to end TB, a problem that persists in rural areas of South Africa. All South Africans, no matter where they reside, must have access to the TB care and assistance they require, and this can only be achieved if we work together to tackle the social determinants that contribute to the spread of this disease.