Nuestra Casa: Achievements and lessons learned in conducting an ACMS strategy

Dr. Eva Moya, Dr. Blanca Lomeli and Bruno PonconProject Concern International SOLUCION TB

Innovative ACMS to address TB and TB-HIV challenges41st Union World Conference on Lung Health

November 14, 2010 Berlin, Germany

Project Objectives• Increase TB detection and cure rates.

• Improve collaboration between TB, HIV and Diabetes Mellitus programs to reduce risk of infection and increase information and co-morbidity detection.

• Promote a person-centered approach in health services and in the community.

• Mitigate stigma and discrimination in TB, HIV and DM care.

Scope and Locations• Initiated in Tijuana and Mexicali in Baja California in 2004

• Expanded to 12 states in 2008

• The focus in 2010-2012 is on TB co-morbidity management (TB/HIV & TB/DM).

STB Participating Jurisdictions

Recruitment and training of dedicated health workers for TB care

Advocacy, Communication and Social Mobilization

Skills and competencies of health personnel, PATB and

project stakeholders

SSAStrengthen

DOTS Team

ACMS

PATB

Strategies

Text best practices

• In 2007: Damien Schumann developed the TB/HIV Shack representing a typical South African, low-income dwelling, to raise awareness about one of the settings where TB and HIV/AIDS coexist.

• In 2009: Project Concern International, USMBHA, Mexico’s National TB Program with financing from USAID Mexico, took on the adaptation of the TB/HIV Shack to Mexico and develop “Nuestra Casa”

• Nuestra Casa resulted from the need to reinforce the ACSM efforts for the prevention and control of TB in Mexico.

BackgroundPhotos courtesy of Oaxaca

The TB/HIV Shack

• Stories of the struggle to phase the social reality and surrounding conditions of TB

• Stories of hope, resilience and stigma dealing with TB; personal stories as well as stories of entire communities taking action

Representation Photos courtesy of Reynosa TB SOLUCION Project

Nuestra Casa

Nuestra Casa is:• A Touring Project for TB

ACSM

• A three-dimensional house which reflects the life and stories of people affected by tuberculosis, their surroundings and their messages of reality and hope.

• An ACSM tool to promote action among decision makers, health care providers, and the public in general to get involved to prevent the spread of TB, reducing the number of cases and deaths caused by it.

Photo: Courtey of Medicina Social Comunitaria

Nuestra Casa, a place where persons affected by TB interact with local, state, national and

international decision makers

Between October 2009 and June 2010, there were four exhibitions in Mexico and two in the U.S.

More than 23,900 persons from all backgrounds visited the Nuestra Casa.

2. 40th UNION Conference in Mexico: more than 1500 visitors

3. Oaxaca: 700 visitors

4. Reynosa: 800 visitors

5. Tijuana 900 visitors1. El Paso, Texas: 3000 visitors

6. Centers for Disease Control and Prevention Global Odyssey Museum: 17,000 visitors

Exhibition Comments "I am now rethinking my career path so that I can do research to contribute to the efforts to combat TB. Also, I want to go abroad so that I can actively help out.“Atlanta, Georgia

“Spirit of change starts with your presence here at Nuestra Casa”Union International Conference on Tuberculosis and Lung Health, Cancún México

“[Nuestra Casa] It touched my heart. You guys opened my eyes to the illness. So glad I came by to see it.”Oaxaca, México

“It's a very emotional presentation, though somewhat shocking. Sometimes it is necessary to take these steps to let people know the reality of such a common, yet deadly, problem.”Reynosa, Tamaulipas México

“It was a great experience with contradictory feeling[s]; it shows the pain of the people who suffer from TB and gives the strength to remove the disease from our community.”Oaxaca, México

“Very interesting, it urges all of us to be informed and put a stop to TB.”Tijuana, México

“Nuestra Casa profoundly moved our audiences at the Global Health Odyssey Museum at the Centers for Disease Control and Prevention. From public health professionals from around the world to young people, individuals left the exhibition with an emotional understanding of the challenges of TB prevention, and the connection between the disease and issues of poverty. Damian Schumann, the South African artist who worked with TB Photovoice participants and the border communities affected by TB along the U.S.-Mexico border, highlighted how persons affected by TB can b tell public health stories in innovative, meaningful and emotionally resonating ways.”Louise E. Shaw, Curator, Global Health Odyssey Museum

Media andPress

Lessons Learned• ACMS strategies need to effectively raise awareness, mobilize

community members and leaders, and empower and engage PATB, to successfully prevent and control the diseases and its repercussions.

• In addition, a person-centered approach to service delivery is required to improve detection, treatment, adherence, cure, and to mitigate all forms of stigma related to TB.

• Nuestra Casa is a powerful communication, advocacy and social mobilization intervention to increase social and political will to improve TB prevention and control and to mitigate stigma.

• Community participation, as well as involvement of TB affected persons has increased and is now fundamental for successful social mobilization.

• The TB Photovoice testimonies and photographs are now part of the mobile exhibit.

• Partnerships and collaborative actions are essential. Through partnerships, six exhibitions were launched, multiple advocacy events were organized, in-kind contributions were secured (i.e., media, health and academic sectors) and commitments from policy and decision makers for TB/HIV care were established.

• Financial resources are necessary to mobilize, disseminate and amplify the touring exhibition beyond local communities.

Lessons Learned

Thank you – Gracias For more information:www.soluciontb.org

www.projectconcern.org