Better pay for South Africa’s TB medics

TB nurses and doctors are six times more
likely to be infected with the disease in
South Africa. The country’s department of
health has announced plans to give
the health workers incentives, for risking
their health to care for patients
and fight the disease.
(Image: Picasa)

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Department of Health
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Nosimilo Ramela

The South African Department of Health has announced plans to make it safer and more financially rewarding for doctors and nurses who work with high-risk multidrug-resistant tuberculosis (MDR-TB) and extensively drug-resistant tuberculosis (XDR-TB) patients.

Over the years nurses have been appealing to government for pay that takes the danger of the job into account. They have also appealed for access to specialised protective masks, and better ventilation in the hospital wards, waiting rooms and consultation areas.

The national Department of Health recently announced that it is working towards ensuring that all hospitals are equipped with adequate supplies of masks and sufficient ventilation systems.

It would also put plans in place to give incentives to TB doctors and nurses for putting their health at risk and being at the frontline of the fight against the highly infectious disease that affects many South Africans.

“We are always worried as nurses, we are scared that we might get infected. We do take the precautionary measures of wearing masks and so on, but we still worry about our health,” said Notuthuko Bhengu, a nurse from Pietermaritzburg in KwaZulu-Natal.

“It’s not easy being at the frontline. As TB nurses, we are in the firing line. If patients refuse to cooperate and start rioting because of the frustration of being quarantined for a long time while they are being treated, we are the first ones they take their frustrations out on. They may try to infect us by coughing in our faces, or refusing to adhere to other safety measures.”

Bhengu said she is happy that the government has heeded their call for better safety measures. She added that a number of hospitals are getting fans, air-conditioning and ultraviolet germicidal radiation systems installed.

Fans and air-con help reduce the risk of infection by ensuring adequate circulation of air, while the UV system sterilises the environment.

“Many people currently working as nurses or training to become nurses are refusing to train as TB nurses because they think it’s too risky and not worth it,” Bhengu said.

The health department said it is battling to attract and keep TB nurses and doctors because they are scared of contracting the disease.

“We are often stigmatised as nurses working at TB hospitals or TB units at hospitals, said Thabang Mokoena from Vosloorus, east of Johannesburg.

“People automatically assume we have the disease too and are afraid to interact with us at times. I dont think anyone would want to come and work as a TB nurse or doctor. Introducing incentives might be a good way to attract people to the field again.”

Mokoena said she believes in the work that she does, but she has some concerns. “To work with TB patients you have to be a strong and patient person. There are times when it can get tough and I do fear being infected, however I take all available measures to ensure that I protect myself and encourage patients to also protect themselves and to avoid exposing others to the disease.”

She said seeing patients recover and leave the hospital TB-free is very rewarding and motivating. “It makes it all seem worth it. As nurses, we are grateful that the government recognises our work and is offering us incentives as motivation to keep doing what we do – which is helping people and ensuring the disease is contained.”

Better protection still needed

Lillian Madikane, a TB nurse from Ermelo in Mpumalanga, said she hopes the government will also work towards introducing programmes that will help nurses and doctors understand the disease better to dispel myth and fear.

She said some nurses still don’t understand the disease well enough and view being sent to work in the TB wards as punishment. “There need to be programmes that teach practitioners about the disease. If you do follow the protective measures, you are not going to get the disease – you should be fine. Hospitals also do tests on us regularly to ensure we are not infected and provide us with healthcare immediately if we are.”

Madikane said she welcomes the incentives, but says better protection is needed. “The incentives are good, they are well deserved by the TB nurses and doctors because they are providing specialised care, and also putting their own health at risk.

“I do, however, think the government should also do more to protect us. We still need proper ventilation systems at hospitals. We do keep windows and doors open, but on winter days or rainy days, we can’t do that so we need ventilation systems that will ensure there is still proper aeration in the wards.”

Gwen Kraai, TB nurse from Bloemfontein in the Free State, said although she knows she is not yet infected, she worries she might start showing symptoms at a later stage.

“I might still be strong now as I’m young and active, but I worry I might get infected as the disease might stay dormant, and over time I might show symptoms as I grow older and less active.”

She said she hopes the government will introduce medical insurance for TB nurses and doctors so they will be able to access quality healthcare for a certain period after they stop working.

“What happens after we stop working and only then start showing symptoms of the disease? I would like the government to allow us some kind of insurance that would cover us for about three years after we stop working.”

But Kraai said she does welcome the government’s announcement. “It’s really great news to hear of the plans to give us incentives. It will really motivate us to continue our work and hopefully attract more people to join us in the fight against this stubborn disease.”