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A PHARMACIST TURNED TO BE A CHAMPION OF TB CONTROL

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pharmacist - a championPharmacist - a champion1

“You look out there and there’s people that, their day is changed because of your contribution to it.”      – Brad Praisely

These words are remembered with the role of the pharmacist in augmenting our efforts in TB Control as follows:

I am Thirulogachandar, a pharmacist running AVI Medicals in Kolathur, Chennai. It has been 20 years since I am in the pharmacy field. One fine day, just 4 years back, I got introduced to REACH and their initiative of engaging pharmacies in TB Control. Being motivated by the objective of the organization, I decided to work towards the Noble Cause – Ending TB.

I usually do not get as many customers who come with the symptoms of TB as I am dealing more with the psychiatric medicines. How can I contribute towards TB Control?

I joined with the Pharmacy Initiative Team of REACH.  Being a Treasurer of Chemist & Druggist Association (C&DA), Chennai, I have an easy access to influence the key personnel of different Zonal Druggist Associations. Slowly there started a schedule allotted for REACH in the zonal meetings to talk about the role of pharmacists in TB Control. Gradually the pharmacists started enrolling into TB control – referring the symptomatic patients for TB diagnosis, spreading awareness, issuing IEC materials about TB to the patients, being a DOT Provider etc.,

Now it becomes a regular practice to include the discussion on TB Control in every Annual General Meeting of C& DA. It leaves me with the satisfaction of being a kind of ‘lead’ in reaching more pharmacists to engage themselves in TB Control.

— Shared by Mr. Thirulogachandar, Treasurer, Chemist & Druggist Association (C&DA), Chennai.

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COUNSELLING: A NECESSARY AID FOR CURE

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It is well defined – “The Counselling is to work with people over a short or long term to help them bring about effective change or enhance their well-being.”

It is not only the medication, but also Counselling plays a major role in curing the disease.  The patients may undergo the psychological trauma replete with the ebb and flow of their emotions. This burden of disease sometimes makes them to discontinue the medicines, results in severe illness.

The journey of 18 year old TB patient Savitha* tells volumes of such psychological stress when she shuffled from one corner to another with wrong diagnosis.   She was initially diagnosed with MDR TB but finally with none other than Pulmonary TB & also Extra Pulmonary TB. Referred by a Pharmacist – Narayana Pharmacy to REACH, she was assisted not only with a correct diagnosis, but mainly with counselling and continuous follow up to complete the treatment. The effort of counselling also influenced her family members to undergo the TB diagnosis Test and were declared negative.

“I could not balance my emotions and could not take it up when I was diagnosed with TB” – a pharmacist who supports REACH in TB Control.  He knows about TB, he advocates people and helps in TB control. Still, when he faced the malady directly by himself, he was completely broken and could not execute what he advocated.  His emotional hurdles along the pathway of TB treatment was completely removed at each and every step by effective counselling of the REACH Staff.

“I completely understood the dynamics of TB and my crucial role in TB control when I myself experienced the mindset of a patient. I am proud to be part of this initiative” he said – his words reveal the competent role of Counselling towards ‘Ending TB’.

*name changed to protect the identity

– shared by the Pharmacy Initiative team

GENDER AND TB: A LONG WAY TO GO

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According to World Health Organization (WHO), “TB is nevertheless a leading infectious cause of death among women and about 700 000 women die of TB annually around the world.”

Why does it happen? What are the factors that make women die of TB?

Cultural and financial barriers can act as major obstacles for women seeking care resulting in delayed presentation and more severe illness. People with chronic, infectious diseases such as TB and HIV are generally stigmatized and avoided. Women suffer more stigma and discrimination than men. Stigma and discrimination make women reluctant to seek care for TB until the disease is advanced.

Saroja* is suffering from MDR TB today, backed up with her long story of malady unfavorably on her. Her initial treatment for TB was irregular due to constant family problems with her husband. TB was one of the main issues that made her husband to desert her and leave her utterly alone. She found it difficult to think about her illness and had to make several adjustments for herself and her children. She lost both the moral and financial support from her life partner. As per our cultural norms, a married woman’s life in society is marked by her marital status and if the husband deserts her, she becomes the ridicule of her family as well as the society.  The social and financial stress forced her often to discontinue her treatment and she gradually ended up by developing drug resistant TB.

Savithiri*is an XDR TB patient, Being a spinster, she was taken care by her brother when she had undergone treatment for MDR TB. Her treatment got interrupted due to the sudden demise of her brother. She was totally isolated by her sisters who refused to provide her a nutritious diet. They just believed that their brother expired because he attended to her specially. The loss of economic security was of larger concern for having sick sister in the family. Family bonds can suffer when someone has TB and sometimes family members can be heartless in their actions. At present the patient is admitted in a tertiary hospital for her XDR treatment.

How can these women cope up to the rigors of TB treatment? With Absolutely no care from their loved ones, they are dependent on the care from the health system that is already heavily burdened.

Treatment for TB is not only lies in the qualitative, timely medical care, but also with the societal care of patients beyond any discrimination. Society must inculcate in people that they do not abandon their family member when they have TB, but try to adhere to the doctor’s advice and provide care. Psychological support cannot be provided with medicines alone, but with tender loving care, from the family members. Quality treatment and loving care are both necessary for patients with TB.

These patients were identified by pharmacists and have been directed to proper care services of the government. They are under regular follow up of the field officers. We hope the best treatment outcomes in spite of their life situations and hope that their families provide them the love and care they need.

*name changed to protect the identity

— shared by our Pharmacy Initiative Team.

PHARMACISTS OBSERVED WORLD TB DAY 2016 IN THEIR JOURNEY OF TB CONTROL

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Mr. Balasubramanian, proprietor of Bala Pharmacy, Royapuram addressing the community meeting

Mr. Balasubramanian, proprietor of Bala Pharmacy, Royapuram addressing the community meeting

“At the beginning, I thought REACH is getting benefitted reaching more people through me. But when the days roll out, I recognized the improvement in myself and also in my business. I have undergone several trainings by REACH which helped me to approach my customers not in a business mode but with care. When I became the spoke person of TB, I got the satisfaction of saving life of my customers and their families. Obviously, it develops the personal bondage with my customers who TRUST me completely. It is not REACH or its programs but I and my customers are benefitted.”

Mr. Balasubramanian, proprietor of Bala Pharmacy, Royapuram.

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Mr. Indrasithu, proprietor of Divya Pharmacy, Pulianthope issuing pamphlet to the customer

“Though being in the Pharmacy industry for a longer time, I considered TB as also the one of the health problems as same as fever till I was approached by REACH. When I became a TB patient, I fully understood the dynamics of TB and its social complexities the patient faces. Since then I stopped selling TB medicines at my pharmacy and advocates the symptomatic customers to approach DOTS through REACH, also supports them throughout the treatment.”

Mr. Indrasithu, proprietor of Divya Pharmacy, Pulianthope.

These are not mere words but the journey of the pharmacists in TB Control along with REACH. The pharmacists conducted the community meetings on 24th March 2016 in order to observe World TB Day. They shared their experience to the community people which in turn motivate them to approach for any TB related assistance.

About hundred people participated in the three such community meetings organized by Pharmacists on this World TB Day in Royapuram by Bala pharmacy, in Pulianthope by Divya Pharmacy and in Ayanavaram by Ramesh Pharmacy. The community meeting ended up with the distribution of pamphlets with the information about TB.

The Community Engagement in TB control was also initiated at 14 pharmacies in different localities throughout Chennai. The customers of the pharmacies are encouraged to engage themselves in one of the ways of TB control mentioned in the Poster such as creating awareness in neighbourhood and workplace; referring the symptomatic person for the treatment; be a DOTS provider etc. The motivated customer can sign under any of the categories they wanted to be the part of TB control.

The pharmacies at Tandiarpet and Pulianthope of Chennai, Tharanallur of Trichy distributed pamphlets with the information about TB to the general public. REACH, at the significance of World TB Day, gifted all its active pharmacy stakeholders with the key chains having information about the initiative.

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The customer signing her engagement in TB control at pharmacy

SPEAKING UP ABOUT TB: ONE OF THE AGENDA OF CHEMISTS GENERAL BODY MEETING

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Can we speak about TB in any formal meeting of professionals?! Why not!! The Drug and Chemist Association of Purasawalkam zone included ‘Speaking about TB’ by REACH in the Agenda of their Annual General Body Meeting held on 7th February 2016.

Ways of innovative engagement of pharmacists, patients’ outcome through the referrals done by the pharmacists, strategies to strengthen the existing collaborative efforts and also the importance of enrolling new pharmacists in the collaboration towards achieving TB free Society were explained by Ms. Sujatha, Program Officer from REACH. Further, druggists belong to KK Nagar, Padi, Kilpauk showed interest voluntarily in joining hands to be the part of the greater initiative of controlling TB in their area.

Above all, the secretary of Druggist Association, Purasawalkam zone proclaimed that he himself was a TB Patient and get cured through taking up medications through REACH…!! He encouraged the pharmacists to speak about TB in order to break the myths connected with the disease. The President of the association also made a plea to refer symptomatic patients to REACH when they approach pharmacies.

Key personnel of 20 zones were also met individually during the meeting and built a rapport to control TB collectively towards TB Free Society.

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Ms. Sujatha, Program Officer, REACH, addressing the Pharmacists

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NEW PHARMACIES ON BOARD TOWARDS TB CONTROL

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Involving Pharmacists in TB control is one of the major initiatives undertaken by REACH towards achieving TB free society…! On part of this, sensitization program for pharmacies was conducted on 25th January 2016 by REACH in Hotel Thiruvizha, Ambattur with the support of Drug and Chemists Association of Ambattur Zone. The good number of 43 new pharmacists in Ambattur zone participated and they were sensitized on the unique role of Pharmacists in TB Control, sharing of the experiences of pharmacies who are playing dynamic role in this greater cause etc. The movie on TB control was also played to make the participants more attentive and inspired to get involved in the greater cause.

Our Sincere Thanks to Chennai Drug & Chemists Association for motivating the Chemists of Ambattur to be part of this MOVE along with REACH…!

It is worth to mention the impact of the programme here: Six Symptomatic Patients were referred to REACH for further diagnosis and also three Chest Physicians have been extended their supportive hands through the greater efforts of the pharmacists of Ambattur Zone.

The more visibility also occurred as the event was reported in the local newspaper ‘Ambattur Town News’.

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Dr. Radha addressing the pharmacists

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Reporting in the local news paper