Selumi lives in the Promise Land informal settlement near Kuruman. Although the municipality has provided water tanks to the community, residents say that the water is not enough. The settlement also lacks electricity.

The paraffin stoves used by residents put the community at risk of burns, fires and respiratory illnesses due to indoor population.

When Selumi began coughing, he might have nothing of it and blamed the household stove like many of his neighbours often due. Selumi’s illness progressed and he was eventually admitted into Kimberley Hospital where he was diagnosed with MDR-TB. He has since been discharged and sent back home where health workers visit him daily to ensure he takes his medication.

Selumi was previously diagnosed with TB but says the chronic lack of food in the house made it difficult for him to adhere to his treatment.

MDR-TB is resistant to both the most commonly used ant-TB drugs. While MDR-TB can develop in patients who have been unable to adhere to previous TB treatment, it can also be spread from one person to another.

In August 2011, the South African government formally introduced a policy to decentralise drug-resistant TB care and treatment, moving it out of hospitals and closer to patients. This was in part to deal with a shortage of beds for drug-resistant TB patients. Implementation of the policy has been slow, admitted Department of Health’s Dr Norbert Ndjeka in an interview with Health-e News last year. Ndjeka heads the department’s division on HIV, TB and drug resistant TB.

No ID, no grant

Selumi tells OurHealth that he worries about transmitting MDR-TB to one of his family members, including his mother, Kresie. The Selumis’ shack has no windows. Opening windows and allowing a flow of air in and out of homes can help reduce the spread of TB.[quote float= right]Selumi tells OurHealth that he worries about transmitting MDR-TB… his shack has no windows

The family was recently visited by members of the provincial AIDS council and the Department of Health, who took the Selumis’ case to Kuruman Mayor Sophia Mosikatsi. During the meeting it was agreed that Mosikatsi would fundraise among local business people in order to install windows in the Selumi home.

All children in the household are also set to be screened for TB. At higher risk of contracting TB than most adults, children under the age of 5 years old who have been in close contact with a TB patient should be started on medication to prevent developing the illness.

Selumi was also advised to apply for a temporary disability grant through the South African Social Security Agency (SASSA). MDR-TB patients may apply for temporary disability grants through SASSA following evaluation by a medical doctor.

However, Kresie said she never registered her son’s birth and that neither herself nor her son have ID books.

According to Selumi, the pair have begun the process of applying for an ID book and acquiring birth certificates, but said that systems have been offline. Department of Home Affair representatives contacted by OurHealth have promised to look into the matter.

• Read more: Doctor turns patient after contracting XDR-TB
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