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From Mama with Love: Cooking Fresh Meals for Hundreds of TB Patients a Day in Papua New Guinea

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PNG
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World Bank
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Story Highlights

  • The Island of Daru in Papua New Guinea is a global flashpoint for multi-drug resistant tuberculosis.

  • The World Bank and our development partners are working with the government of PNG to address this – Daru now has five dedicated TB treatment sites that bring medication and support to communities.

  • One woman is in charge of providing warm meals and essential nutrition to those undergoing treatment – she is known by patients and health workers as ‘Mama’.

DARU, March 20, 2019 - Her day always starts just before dawn, but ‘Mama’ Pina Paru usually wakes a few times before then, anticipating the work ahead.

“I don’t have an alarm, so every night I get up and check the time,” she laughs. “When I see it’s 3am, I go back to sleep again. Then, I check again, and it’s 4am, so I go back again. Finally, I wake up and it’s 5.30am already and that’s when I get up.”

Pina is the nutritionist, cook and kitchen supervisor for the Daru Island operation of World Vision Papua New Guinea, one of the key partners, together with the World Bank, responding to the tuberculosis (TB) crisis in Papua New Guinea.

"I cook every day from Sunday to Sunday, Sometimes our numbers go up when we have new patients coming in, and sometimes our number goes down when patients complete treatment, but normally it’s 100 plus patients that we’re feeding every day." Pina Paru Nutritionist, cook and kitchen supervisor

Papua New Guinea’s global hotspot for TB

Following the World Health Organization (WHO) categorization of Daru as a global hotspot for multi-drug resistant TB in 2016, five dedicated TB treatment sites were established across Daru Island. These sites give TB patients a place to come for their daily medication and health support, and are much easier to reach than hospitals, which is essential considering the extended and intensive regime of treatment required for multi-drug resistant TB. They are also the distribution points for Pina’s cooked lunches.

Pina and her team prepare a meal of rice and chicken in a commercial kitchen, and pack these into stacks of containers. These lunch boxes are collected and transported to sites across Daru in time for lunch, returning empty a few hours later for Pina’s team to wash and dry them before the cycle begins again the next morning.

“The meals are important because [the patients] need to eat with their treatment and most of the time they don’t have anything at home,” explains Pina. “Sometimes the drugs are too strong for their body, they have to at least eat something before they take them.”

To make a full recovery, TB patients must take heavy doses of medication every day; many for two years. The drugs can cause serious side-effects including nausea, lethargy and joint pain, making successful completion of TB treatment both a physically and mentally challenging time for patients. A freshly-cooked meal not only helps combat these side-effects but provides a good incentive for patients to attend the clinics each day.

“The food also helps their immune system,” adds Pina. “We normally cook nutritious food which is good for their bodies and we like to get veggies, especially greens or maybe fruits. But in Daru it’s hard to find things like oranges and apples that can cater for the patients.”

Pina’s commitment, alongside that of her many colleagues, is clearly having a big, positive impact on reducing TB in Daru, with the percentage of TB patients on the island who are not completing their treatment having dropped from 30% in 2012 to zero in 2018.

Cooking from the heart

To her co-workers and the TB patients, Pina is known affectionately as ‘Mama P’ or ‘Mama’ Pina; a reflection of warmth and generosity she shows for all those who visit or work in the treatment centers.

“I’m more than happy to be called that name because I take care of who whoever comes my way. I treat them like my children,” she laughs.

“I think it comes from down – way down – in my heart. It comes from there all the way to my thoughts,” Pina explains, when asked where her motivation comes from. “I enjoy my job cooking in the kitchen and I love taking care of the patients.”

The Emergency TB Project is funded by the World Bank, through the International Development Association (IDA), the World Bank’s fund for the world’s most in-need countries, alongside the Australian Government and PNG’s Department of Health, together with partners including the Burnet Institute, WHO and World Vision PNG.