Facilitating Access to Tuberculosis Care in Mali

Dear friends,

As our stay in Mali is drawing to a close, we wanted to take this occasion to thank you once again for your support of TB Bolo. Without you, our project would not have been possible.

Also, we would like to update you on the progress we have seen with our own eyes. Over the past month, we gathered information about the tuberculosis epidemic in Mali and evaluated the impact of GAIA’s peer-education and referral program. Aside from falling in love with this beautiful country, we have had the privilege to witness successes in the fight against tuberculosis. Please know that the continuation of this valuable program would not have been possible without you!

During our internship, we examined all levels of tuberculosis care in Mali. Though there is a high prevalence of tuberculosis in Mali, only a small fraction of cases are detected. For these cases there remains not only a high risk of infecting others but also a high risk of dying from tuberculosis.

A main goal of ours was to find out why so few cases are detected. One reason for the low detection rate is a gap in the general population’s knowledge about tuberculosis and their awareness of the services available to them. In the Sikoro slum, where our work is based, only 46% of the 84 individuals we surveyed were aware that tuberculosis treatment is free. We met people who had been coughing for years without seeking healthcare because they were wary of the costs that they might face.

These observations invigorated our faith in the importance of GAIA’s TB-Bolo education and referral program. TB-Bolo not only educates people about Tuberculosis, but also allows suspect cases to see a doctor at a reduced cost. In this way TB-Bolo helps to break down two barriers between someone who is sick and someone who is on treatment.

Thanks to your support, the TB-Bolo peer-educators went out four times in July for door-to-door education and referral for tuberculosis. Close to 1000 individuals were educated and over 50 suspect cases were sent to the health center with an 80% discount to see a doctor. As part of our evaluation, we tested people’s knowledge about tuberculosis before and after the education sessions, and found that knowledge went up dramatically. All of the individuals we surveyed said that they appreciated the program and learned something new, and some even added that they had already passed the message along to their friends and neighbors. Meanwhile, the national tuberculosis program has expressed interest in replicating the TB Bolo model in other communities in Mali.

On the ground in Sikoro, we know that we have only been exposed to the tip of the iceberg. However, we feel invigorated by the progress we see, and by the tenacity of the peer-educators, health personnel, and community members alike. We have also witnessed the fruits of international collaboration, which we thank you for being a part of. Little by little, we advance – or as Malians say, “Doni doni!”

Best wishes to all,

Julie Caplow and Lauren Pischel

• THANK YOU! (DOC)