Much to be done in preventing tuberculosis and HIV co-infection in Peru

Also available in: Español

Source: Corresponsales Clave

15 years ago, Segundo Chamorro Valderrama came out of anonymity and faced prejudice and discrimination, to address the problem of tuberculosis which nobody dared to expose, amid reflectors and flashes. From the North of Peru he tells us about his work.

By: Marlon Castillo Castro

Key words: COREMUSAGlobal Fund, La LibertadMCPPerupoverty, Tuberculosis

Despite extraordinary economic growth figures, Peru still has alarming rates of tuberculosis (TB): it ranks second in Latin America in the sensitive form and first in multidrug-resistant form.

Segundo Chamorro, leader of La Libertad Region, at the North of the country, talked to Corresponsales Clave and shared part of his history in working to decrease tuberculosis and HIV co-infection, and he gives us the key for people with co-infection to overcome poverty.

Corresponsales Clave: What encouraged you to make the issue of tuberculosis visible in La Libertad, Trujillo?

Segundo Chamorro: Those were very difficult times. A press conference was going to be held in 2005 and I had to come to the front to say what many did not dare saying because of the fear to be rejected. I remember that I thought it was going to be small news, but the next day there were big headlines in the press.

CC: Did that visibility imply a cost in the relationship with your friends or family?

SC: Before speaking in front of the cameras I told my family what I was going to do (publicly state that I had tuberculosis) and they supported me, but the people around me, at work, stayed away from me once they knew. This situation changed gradually because there was more information on the topic.

CC: You are one of the most representative activists in the health area in the whole region.

SC: Well, I am co-founder of COREMUSA (Multisectoral Regional Coordinator on Health), like a regional CCM, in La Libertad and founder of the Association Pro-Health and Life that focuses on TB and HIV co-infection. We also work hard with the media and make campaigns and complaints on cases of violation of rights.

CC: How do you see the picture in preventing co-infection in your region?

SC: I think there is still a lot to do to empower civil society on transmission modes; usually, people who are diagnosed with TB come to the hospital with 3 or 4 crosses (minor, moderate, severe and resistant) and we need to work more on this aspect. From Coremusa we have held information and awareness workshops at schools, universities, soup kitchens and glass of milk programs for preventing co-infection. Those of us affected with TB and HIV have worked on prevention and we have trained 20 thousand students in educational institutions.

CC: Regarding awareness, in your organizations you work hard with social networks and the media.

SC: Social networks are tools that allow us to be informed, to receive complaints and to contact other organizations in Peru and abroad. We make frequent campaigns and the media are our allies, because we have already sensitized them on health issues and they are always aware of our complaints.

CC: You also participated in one of the Global Fund projects.

SC: Yes, it was in the Eighth Round. This project was very useful to achieve our formalization as an organization, as we were able to register in the Public Registry and, in addition, we could carry out prevention activities. It was then when we started the Peer Counseling project for people with tuberculosis, adapting what we had on HIV.

CC: So the Global Fund was useful for your organizational development.

SC: Yes, then we also worked with the municipality and were able to implement the delivery of food baskets; however, unfortunately, with the new mayor of Trujillo, this was interrupted for 16 months, as many authorities do not put themselves in the shoes of others and although there is a budget, they are not aware of the prevention work.

CC: And, why do you think this happens with the mayor of Trujillo?

S C: There is a lack of greater involvement of political authorities. Before, with the mayor Cesar Acuna, we had food baskets, peer counseling, but when Colonel Emilio Espinoza Quispe joined the municipality, many doors were shut down for us. When we told him that TB and HIV prevention was important, he said that was not his business. Now, with a removal decision in progress, meaning that people want to remove the mayor from his position, he has started to deliver the baskets, showing there is no willingness to work on prevention and everything is done to get political benefits.

CC: You told me that you suffered discrimination, how do you see this situation in La Libertad?

SC: Civil society is already aware of the issue to some extent, but there is still discrimination and stigma. This is also related to social determinants regarding tuberculosis and poverty, but there are also people leaving in 800 meter houses and others in 2 square meter houses that are also vulnerable. We should know that tuberculosis and HIV is everyone’s problem.

CC: And in the labor field…

SC:The situation is severe there. We have noticed that agro-exporters and private companies do not hire people with tuberculosis, because they show TB traces on their medical tests. Only an injury in the lungs X-rays will be enough to prevent you for accessing a job, and we are working on that because people with co-infection need to work for survival.

CC: What else could be done to eradicate tuberculosis and co-infection with HIV?

SC: From our organizations we have promoted the Regional Multisectoral Plan on TB and HIV, we are aware that a crucial issue to eliminate poverty and contribute through prevention, is the title deed registry for houses and land owners. This would be an excellent solution. First, it improves the person level, because she/he is the owner of a house, where they only lived before, then the person can access to loans or credit for the program Techo Propio (Your Own House). In this way overcrowding would be eliminated and basic utilities could be installed, such as water, electricity and sewerage.

(…) Actually, we have made good progress in this regard. For instance, at the human settlement Alto Trujillo, there are around 20 thousand houses without title deed and 100 thousand people live there. We were able to make that 50 of them with TB or TB-HIV co-infection get their title deeds and could start building. Even more, if a house was valued at 3 thousand soles (1,000 US dollars)before, now with the title deed it can be sold at 44 thousand soles (15 thousand US dollars approximately).

CC: Which is your final request to society and the authorities?

SC: There is still a lot to do in the prevention of tuberculosis and co-infection with HIV. We want committed authorities and a better informed and sensitized society. Better health conditions.