EXERCISE THE UNDERUTILISED DRUG IN POST TUBERCULOSIS SEQUELA HEALING PALI 2022

The goal of the awareness program which was held in Otjomuise Constituency in Windhoek, Namibia on World Lung Day was to raise awareness on post Tuberculosis lung disease among the patients, community health workers and physiotherapy students.

The event was mostly organized by a team of six final year physiotherapy students and a lecturer. The processes which were done for this event to be successful included the following:

1. Formal writing of an application letter to the Executive Director of the Ministry of Health and Social Services. This letter was signed by the head of department of the Department of Occupational Therapy and Physiotherapy and also endorsed by the Executive Dean, Faculty of Health Sciences. From the MOHSS there was then liaison with the respective offices which included Primary Health Care coordinator, TB program coordinator and Disability and Rehabilitation Coordinator. The team was then linked to the community health workers in the constituency to assist with patient identification and mobilization of the patients to attend the function.

2. A formal invitation letter was also written to the Regional Councilor of the Khomasdale Constituency. The letter also sought permission to make use of a community hall in this constituency for this event. Approval was obtained from the councilor and the facilities were availed to us to make use of them for this day. We got support from the staff who helped us with setting up and also cleaning and arranging of the hall for this event. There was also a security guard on the premises during the event who was watching over the area including the car park.

3. UNAM Faculty of Health Sciences really provided us with much support as well for this event to be successful. We were provided with two quantum vehicles for our 22 students to be ferried to the venue from medical school and back to campus after the event. The drivers were really accommodative as they had to work on a Sunday. This was only successful as we got the support of the Faculty Executive Dean and also our Associate Dean for the School of Allied Health Sciences.

4. The UNAM Marketing department was contacted for assistance and support to make this day a memorable and successful one. The support received from the UNAM Marketing department included two media interns to cover the day (taking photos and writing a report to be published in the UNAM newsletter), UNAM banners to display at the venue to make our presence noticed in the community

5. A private catering company was tasked to provide lunch for the participants on the day. The menu of the day was chosen based on providing a well-balanced diet which is more context specific. The lunch pack included portions of meat (beef, pork, lamb, chicken) which was served with roasted bread and mashed potatoes (mixed with vegetables). Water and fruit juices were also served to the participants

6. The event started at 1100hrs but students were picked up from the UNAM medical school by 1000hrs and transported to the venue. The event started with Mrs Farirai Kamba, A UNAM lecturer, welcoming participants and giving opening remarks. After that, the final year students held an educational talk. The most important message which was emphasized during this awareness campaign was the role of exercise in the management of TB and also in post TB lung disease. Pamphlets were designed which had all the information and given to the participants and the information was explained to them as well. The session was interactive as participants also raised questions which were answered by the students and the lecturers assisted too in some instances. The MOHSS and Community Health Workers were also given a chance to educate the participants on adherence to TB medication. Education talk focused on the symptoms the patients might still present with even after completing their treatment, the effect of these symptoms on long term outcomes like respiratory function, exercise endurance, mental health and quality of life in general.

7. After the educational talk, the final year students then guided the second and third years to do some assessments on the patients. The lecturers were also there to offer the support which was needed. The assessments which were done include the following: spirometry (for patients who had been on treatment for more than 6 months), dynamometry for grip strength measurement, BMI assessment (height and weight), use of standardized outcome measures like CAT, mMRC, Patient specific Functional Questionnaire, EQ 5D to assess symptoms, quality of life and functional status. The students appreciated this method of learning as it was different from the class based and also hospital setting. Through this event, students had an opportunity to accomplish the outcomes of a community-based rehabilitation. Besides education the participants on TB and role of exercise, they also had the chance to advocate for their profession as participants asked questions on what physiotherapy is.

8. The materials printed on the day include the pamphlets and posters. We also printed T-shirts which were printed World Lung Day on the chest. The t-shirts were distributed to all the participants and our students

9. The most exciting part of the day was the games which were played by our participants. The students had arranged for the participants to do four games. The games included the following a) Balloon blowing which was done as a form of positive expiratory pressure exercise (breathing exercise) to help with lung expansion and increase compliance. Participants were put in three groups. Each group was given a few balloons and they were given two minutes to blow the balloons. They were supposed to exercise team work and blow as many balloons as possible during the specified time b) Egg race-the groups then went on to complete in an egg race. Each participant was supposed to balance a boiled egg on a table spoon without using the other hand to support the egg from falling. The participants had to walk over a distance of 30 meters c) Sack race and musical chairs were the last games which were not played due to running out of time d) From the two games which were played, the winners were given prizes. The prizes included coffee mugs, water bottles, resistance exercise bands, notebooks and pens, umbrella and an adult coloring book for stress relief.

10. After the games. Participants were served lunch. After that, closing remarks and vote of thanks was given and the meeting ended at 1530hrs.

By Cathrine Tadyanemhandu (2022)