Chest camps in Pakistan bring TB services to the people

In 2014, Mercy Corps, an international humanitarian organization and Global Fund partner, launched chest camps: mobile health facilities that bring TB and health care services to people living in some of the most remote parts of Pakistan.

 Vincent Becker deserves credit. Vincent Becker deserves credit. facebook sharing buttontwitter sharing buttonlinkedin sharing buttonmessenger sharing buttonwhatsapp sharing buttonbluesky sharing button

 On a cold winter day, Adnan Saeed and his brother Rizwan travel from their home to the nearby village of Chak 168 GB Sirāj, about an hour’s drive from Faisalabad, Pakistan.

 Despite the fact that the temperature approaches zero degrees Celsius, dozens of people, including men, women, and children, congregate around the tent to exchange information and wait to register for a tuberculosis (TB) screening and test. His name is added to the registry by Adnan. Saeed Adnan Credit: Credit: Vincent Becker

 Adnan Saeed.  Credit: Credit: Vincent Becker

 “I’m suffering from shortness of breath after doing little work,” Adnan says.  He recognizes the symptoms: months earlier, another brother, Imran, died while receiving treatment for TB.

 

Adnan and Rizwan are here, along with 50 or 60 others, for a checkup.

 Fauzia Ghafoor has attended several “chest camps” in her 17 years as a health worker and supervisor with the government’s district health unit.

 She asserts, "Earlier, people even avoided talking to a TB patient." “Now, it’s a different story.”

 Pakistan's fight against tuberculosis has made significant progress. In 2022 alone, approximately 425,000 people were treated for TB – about 85,000 more than in 2021.

 Still, Pakistan ranks fifth among countries with a high burden of the disease, with millions of people living in areas without easy access to TB testing and care.  Clinics with the tools to accurately diagnose TB are too far to reach on foot; farmers, laborers and parents with young children can’t afford to spend a day away from their work and families.

 At the same time, people with TB symptoms can face stigma and discrimination, which may prevent them from accessing care and risk further spreading the disease.

 In 2014, Mercy Corps, an international humanitarian organization and Global Fund partner, launched chest camps: mobile health facilities that bring TB and health care services to people living in some of the most remote parts of Pakistan.

 The camps provide a community-focused place where people can safely access health services they would otherwise go without.

Adeel states, "Many of our clients are women with children and elderly people." "People who don't have anyone to help them take care of their health and face more practical challenges, so we can have twice the impact." Vincent Becker deserves credit. People at the chest camp.  Credit: Vincent Becker

 Preparations for the chest camps begin weeks in advance.

 Villages like Chak 168 GB Sirj are visited house to house by community health workers like Fauzia. After Imran's death, a health worker came back and told Adnan and Rizwan about this chest camp. “It is routine when we visit any home, people start telling us their health issues if they are facing any,” Fauzia says.  “We counsel anyone who has had a cough to get themselves examined, and don’t delay.”

 Mercy Corps also reaches out to local health clinics and district leaders to identify trusted figures in the community – such as teachers and imams – who announce the camps in schoolrooms and mosques.

 Their message: The doctor is coming to you – and the care they provide is free.

 These coordinated health awareness campaigns are changing the way that TB is perceived.

 Chest camps are part of an integrated approach among Pakistan’s public health system, including federal and district health leaders, and private partners, such as Mercy Corps and doctors with private practices.

 The public-private mix can help bridge the gap among various health entities working to end TB in Pakistan.

 Additionally, it may present opportunities for adaptability and creativity. In 2022, catastrophic floods blocked roads that connected people in remote communities to hospitals and clinics.

 Chest camps became health camps: Mercy Corps' 40 vans – equipped with X-ray machines, diagnostic equipment, medicines and teams of health care providers – navigated little-used roads to reach those isolated by floods.

 And the technology to screen, test and treat TB is improving.

 Digital X-rays and GeneXpert machines can screen and diagnose TB among patients like Adnan on the spot.  Tools based on artificial intelligence (AI) assist in identifying "hotspots" and giving priority to areas where chest camps will reach a greater number of people who might have tuberculosis. AI is also used to read X-rays effectively and efficiently and identify people who should receive additional testing – which often means that TB is caught and treated much earlier.

 A patient steps out of a truck at the chest camp.  Credit: Vincent Becker

 At the chest camp, a patient exits a truck. Vincent Becker deserves credit. Adeel has been going to chest camps for close to a decade. With the Global Fund’s support, Mercy Corps now holds 600 camps per month across 100 districts and procured 25 portable X-ray machines that can fit on the back of a motorbike.  Providers can bring them down narrower roads to reach rural communities.

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 The Global Fund’s support in Pakistan is also strengthening diagnostic networks, lab facilities, sample transportation and helping to procure and distribute TB medications across the country.  Chest camps are one crucial part of a comprehensive approach by multiple partners to fortify Pakistan’s health systems.

 Still, Adeel hopes for a future without TB – in which chest camps are no longer needed.

 “We are trying to put as many resources toward ending TB as possible,” he says.