Tuberculosis (TB) is not something you hear of every day. When was the first time you heard of it? For me, it was when I first watched Baz Luhrmann's film Moulin Rouge! a few years ago, although it was called consumption in the film. At the time, I didn't understand why Satine was coughing up blood and why that was such a worry until I read the plot summary afterwards and did some reading on TB. However Moulin Rouge! was set in 1900 - so much has changed, and today in the Western world we rarely ever have to worry about contracting TB it has just about disappeared.

But many people in other parts of the world are not so lucky.

Soba holds her son Sawai Naruwa, who has lost the use of his legs as a result of tuberculosis in Daru in 2011. Photo: Jason South

In countries, like our closest neighbour Papua New Guinea (PNG), TB is on the rise again. TB is still a major cause of death in kids along with pneumonia especially in Africa. And it's one of the most common deaths for people with HIV, but it's not part of the statistics because they count as deaths because of HIV and so those people become invisible.
But what exactly is it?

However TB incidence, prevalence and mortality are falling, which is good news.
If you want to find out more, here are some links:
WHO Tuberculosis Factsheet
Tuberculosis Factsheet NSW Government
Tuberculosis Better Health Channel Victoria Government
Tuberculosis South Australia Government Health

TL;DR: Tuberculosis is a curable disease. The most well known symptom is coughing up blood and it can cause damage to lungs and death. 

Okay you're probably still asking 'Who cares?', but what if I told you that TB is the number one cause of death and hospitalisation in PNG in 2014, and the average South African family spends 20% of their income on funerals? (Source: MSAP Global Health Short Course 4).

I was lucky enough to attend a talk on Global Health a few weeks ago and the speaker was telling us about TB as a lesser known global health problem, especially since it's often a silent killer. I think it's important to know about the world around us as global citizens, especially since PNG has the highest rate of TB in the Pacific Region (Source: World Vision).

Here's a video from MSF Australia (watch the first 20 seconds):

There's estimated 30,000 new cases of TB diagnosed each year in PNG, with drug resistant strains on the rise and one in four infections in children. But according to World Vision's PNG country director Curt von Boguslawski, it's a good sign because it shows that the collection of health data has improved since only 5000 cases were detected five years ago (Source: SMH).

But how is this relevant to us here in Australia?

Until 2010, Australia provided 2 TB clinics for Torres Straight Islanders but they were closed because they were so efficient that many PNG citizens flocked across the border to use these clinics. In PNG it's very difficult to get to clinics from remote areas, as most of their clinics are in the Western Province including the largest treatment centre in the Western Province on Daru Island.

Instead our Department of Foreign Affairs and Trade (DFAT) are now supporting Daru Island hospital, with a focus on shifting away from direct service delivery since a country is more likely to increase domestic funding rather than being reliant on foreign aid. But supporting the hospital directly comes with its problems - it's very difficult as many health workers cycle in and out of there every two years and there's a lot of political sensitivity around the topic. DFAT are also working the NGOs like World Vision.

There's been a drop in international funding as PNG increases domestic funding to TB control. Source: WHO

Of course this post can only be a snapshot of the effects and impact of TB on a particular country, region and the global community, but it also serves as a starting point to help us become better and more knowledgeable global citizens.

Something else was brought up during the talk - the fact that Cuba has a better health care system than the US. But that's another topic for next time because this post is so long already!

Be aware of the world around you friends - we are global citizens whether we like it or not and we should know what's happening in our world.

With love, Sarah x

To see part 2, click here: Tuberculosis, Cuba and Healthcare (Part 2).