Image: Ethel Pamumum TB counselling in Daru, Western Province, Papua New Guinea

On World TB Day 2020, we celebrate the dedication and leadership of Health Promoters Ethel Pamumum and Kyrol Kaison at the TB front line in Daru, Papua New Guinea.

Ethel Pamumum and Kyrol Kaison are Health Promoters with the Burnet Institute, working on the Western Province Tuberculosis Program in Papua New Guinea to address the unprecedented epidemic of drug-resistant TB (DR-TB) centred on Daru Island.

Passionate about health education, they both play an important role in the MDR-TB household contact screening and management operational research project.

Equipped with a nursing qualification, Ethel Pamumum has been treating and supporting patients on treatment for TB since the 1980s.

Born in Daru, her father was the orderly at Daru General Hospital and she grew up in the hospital compound. She attributes being raised in the compound as influential to her and her sister’s career trajectories; they are both nurses.

Ethel has been working with Burnet since 2016, first as a counsellor in the patient education and counselling program, and now as a health promoter, supporting a pilot initiative for household contact screening for TB and MDR-TB and providing preventive treatment for young children who are at higher risk of developing disease.

‘What I enjoy is that I feel for the people, I enjoy working with them and helping them in their needs. Not only in medicine, though also supporting them with their troubles in food, life,“ Ethel said.

“I feel for them, how they live a hard life sometimes, how they talk. I always think about their situation and how I would feel if I was living their life.”

Kyrol Kaison’s connection to the TB epidemic in Daru is also a personal story. Kyrol was born and raised in Daru with a few years spent in neighbouring Gulf Province.

Image: Kyrol Kaison, Health Promoter, Western Province Tuberculosis Program, PNG

In his spare time Kyrol would enjoy fishing, gardening, hunting and spending time with his family, however life changed for Kyrol four years ago when he was diagnosed with DR-TB.

With support from the TB Program, Kyrol commenced the long and arduous treatment course, which he successfully completed in 2017.

After completing treatment, Kyrol was offered a role in the Western Province TB Program as a community mobiliser and began working on the Systematic Screening Initiative, which commenced in 2018 and was completed in 2019.

Now working as a health promoter with Burnet, Kyrol is enjoying every moment of his work. He draws on his own experiences as a former patient and is motivated to inform people as well as he can, giving them the knowledge and encouragement to stand up and say ‘yes’ to treatment.

Ethel and Kyrol have been working with their team of peer counsellors and health promotors to establish a community advisory group and conduct community consultations to co-design approaches for reaching key at-risk groups (including adolescents) to deliver comprehensive TB care and community education.

Ethel echoes the importance of community consultation, awareness and education to ensure that people aren’t afraid of being diagnosed with TB and are interested in being tested.

“We need to make sure we say the right message from the beginning, one message, the same message… so we don’t confuse people and send the wrong messages. That’s where stories and the wrong messages start.”

With PNG recently confirming its first case of COVID-19, governments, frontline health workers and partners like Burnet Institute have been called on to prepare and respond to another unprecedented global health security threat.

Both Ethel and Kyrol are aware of the challenges that lie ahead, but remain optimistic. They are motivated by working with people who share their passion for improving health outcomes in their community and with the community’s needs and voice at the centre.

The Reducing the Impact of Drug-resistant TB (RID-TB) project and Stronger Systems for Drug-resistant Tuberculosis and Malaria research grant are supported by the Australian Government and implemented in PNG by the Burnet Institute.