Photovoice raises TB awareness in Thailand
By, Masimba Biriwasha, HDN Key Correspondent, March 1, 2007
A community project in northern Thailand named ‘TB Photovoice Thailand’ is using photos and stories to tackle often hidden issues surrounding TB and HIV infection, diagnosis, treatment and coping strategies. The project is proving that a picture can indeed speak a thousand words, but even more than that, it can help influence social change.
Thailand is ranked 18th among countries with high tuberculosis (TB) incidence according to the World Health Organization's (WHO) TB 2006 report, and also has approximately 570,000 people living with HIV. It is estimated an average of 30 percent of people living with HIV are co-infected with TB. HIV infection increases the demands on TB programmes through the need for better diagnostic tools, monitoring and treatment. A combination of HIV-related tuberculosis (TB), and an inadequate provision of treatment and community awareness among a myriad of migrant groups, is currently reversing previous gains in TB control.
Clinical diagnosis of TB is more difficult in co-infected patients, and similar symptoms can be caused by various types of infections. In addition, there is increasing evidence of multi-drug resistant TB (MDR-TB) in the country.
In the TB Photovoice project, people with experiences of TB take photos of their daily lives, and write personal essays based on the pictures, with an ultimate goal of influencing the way society perceives the disease.
According to Caroline Wang, creator of the photo-voice methodology, it is a process through which people can identify, represent and enhance their community through a specific photographic technique.
"This project aims to raise awareness on TB and HIV in Thailand. Through pictures people can tell their stories, share some of their problems, and give recommendations as individuals affected by TB and HIV," said Kaetwa Sangsuk, TB Photovoice Thailand's coordinator.
Poverty and a vast diversity in languages and cultures pose a significant challenge to reaching immigrant groups with much-needed TB/HIV education and treatment. It is clear that to be effective, TB/HIV services in Thailand require active engagement with local communities, especially already marginalized migrant groups.
Equipped with essential local knowledge and experience, TB/HIV control programmes can exponentially increase their effectiveness. Local communities need to be involved in the planning, implementation and evaluation of TB control programmes.
"Informed local participation is the most direct way to address obstructive misconception and to facilitate educational outreach," states the U.N. Millennium Project report titled "Investing in strategies to reverse the global incidence in TB."
Using pictures to communicate about TB and HIV, particularly in low literacy contexts, can significantly improve community awareness as well as influence the government’s response to providing medication and services.
Participants in the TB Photovoice Thailand project came from a TB/HIV support group in Chiang Dao and Muang district in Chiang Mai province, in the north of Thailand.
Chiang Dao – a border district with Myanmar – has a population of 74,000, and nearly half of those are immigrants. The majority of the migrants are poor and work in the agricultural sector. The district has one of the highest TB prevalence rates in Chiang Mai province, which already has one of the highest provincial case-loads in the country.
Participants receive training on how to take photographs, and are then given cameras to enable them to take pictures that document their experiences of TB.
Through taking and writing about the pictures, participants undergo a process that helps them to reflect about difficult issues associated with TB and its implications to their health and community.
"All my pictures are about my experience with TB. They show the various stages of TB, including treatment and recovery," said Narai Daenchai, 29, a participant in the TB Photovoice project.
In 2005, Daenchai was diagnosed as TB-infected. Like many of the project's participants, Daenchai was already living with HIV but he knew little about the connection between HIV and TB.
He fell sick and lost a lot of weight. He even locked himself away in his room to keep away from attention until he finally sought treatment. Throughout that period, his mother was his pillar of support. She fed him and prayed for him. Today, Denchai thanks his mother for staying by his side during his illness.
"I was in treatment for almost nine months; now everything is almost back to normal except that I cannot do too much work because my lungs are still weak," said Daenchai.
Last year, he joined TB Photovoice through the Chiang Dao Hospital's People Living with HIV and AIDS support group.
"Taking pictures has enabled me to express myself and also to become a messenger within my community," said Daenchai. "I get all the information that I can about TB, and the pass it on to people. I tell people that it is possible to treat TB."
In an attempt to reach out to the community, the photographs taken by participants are also displayed at the Chiang Dao Hospital to help attendants gain knowledge about the disease.
Coming together at monthly sessions, participants get to share experiences and feelings through the pictures and offer each other emotional support.
Having someone in the community who has had personal experience with TB, and can prove that it is treatable is a critical component in helping communities to respond to the problem of TB.
"The TB Photovoice project has enabled me to communicate to members in my village about TB/HIV and how to prevent problems. Also, knowing that there are other people with the problem has helped me to cope," said Saengmuang Muangchongsang, 40, also a participant in the project. "I use the photographs and stories to talk to people that may be affected by TB."
Participants also use pictures and their personal stories to advocate for TB/HIV treatment in their communities.
At Chiang Dao Hospital, the participants maintain a bulletin board which shows their pictures, stories and information about TB infection and treatment.
"The project is very good because by providing health communication within our communities, it fills a gap left by government," said Nuttawardee Areenu, a nurse in the TB/HIV unit of Chiang Dao Hospital.
"There are many migrant groups in Chiang Dao, who speak different languages, which make health communication very difficult."
TB Photovoice was founded in November 2004 by Romel Lacson shortly after his wife Claudia and their unborn child succumbed to TB meningitis.
The goal of the project is to provide local people around the world with a voice to articulate best practices and obstacles toward TB eradication, and to assist local communities disseminate this knowledge, and promote media awareness of the toll that TB exacts upon millions of lives.
A community project in northern Thailand named ‘TB Photovoice Thailand’ is using photos and stories to tackle often hidden issues surrounding TB and HIV infection, diagnosis, treatment and coping strategies. The project is proving that a picture can indeed speak a thousand words, but even more than that, it can help influence social change.
Thailand is ranked 18th among countries with high tuberculosis (TB) incidence according to the World Health Organization's (WHO) TB 2006 report, and also has approximately 570,000 people living with HIV. It is estimated an average of 30 percent of people living with HIV are co-infected with TB. HIV infection increases the demands on TB programmes through the need for better diagnostic tools, monitoring and treatment. A combination of HIV-related tuberculosis (TB), and an inadequate provision of treatment and community awareness among a myriad of migrant groups, is currently reversing previous gains in TB control.
Clinical diagnosis of TB is more difficult in co-infected patients, and similar symptoms can be caused by various types of infections. In addition, there is increasing evidence of multi-drug resistant TB (MDR-TB) in the country.
In the TB Photovoice project, people with experiences of TB take photos of their daily lives, and write personal essays based on the pictures, with an ultimate goal of influencing the way society perceives the disease.
According to Caroline Wang, creator of the photo-voice methodology, it is a process through which people can identify, represent and enhance their community through a specific photographic technique.
"This project aims to raise awareness on TB and HIV in Thailand. Through pictures people can tell their stories, share some of their problems, and give recommendations as individuals affected by TB and HIV," said Kaetwa Sangsuk, TB Photovoice Thailand's coordinator.
Poverty and a vast diversity in languages and cultures pose a significant challenge to reaching immigrant groups with much-needed TB/HIV education and treatment. It is clear that to be effective, TB/HIV services in Thailand require active engagement with local communities, especially already marginalized migrant groups.
Equipped with essential local knowledge and experience, TB/HIV control programmes can exponentially increase their effectiveness. Local communities need to be involved in the planning, implementation and evaluation of TB control programmes.
"Informed local participation is the most direct way to address obstructive misconception and to facilitate educational outreach," states the U.N. Millennium Project report titled "Investing in strategies to reverse the global incidence in TB."
Using pictures to communicate about TB and HIV, particularly in low literacy contexts, can significantly improve community awareness as well as influence the government’s response to providing medication and services.
Participants in the TB Photovoice Thailand project came from a TB/HIV support group in Chiang Dao and Muang district in Chiang Mai province, in the north of Thailand.
Chiang Dao – a border district with Myanmar – has a population of 74,000, and nearly half of those are immigrants. The majority of the migrants are poor and work in the agricultural sector. The district has one of the highest TB prevalence rates in Chiang Mai province, which already has one of the highest provincial case-loads in the country.
Participants receive training on how to take photographs, and are then given cameras to enable them to take pictures that document their experiences of TB.
Through taking and writing about the pictures, participants undergo a process that helps them to reflect about difficult issues associated with TB and its implications to their health and community.
"All my pictures are about my experience with TB. They show the various stages of TB, including treatment and recovery," said Narai Daenchai, 29, a participant in the TB Photovoice project.
In 2005, Daenchai was diagnosed as TB-infected. Like many of the project's participants, Daenchai was already living with HIV but he knew little about the connection between HIV and TB.
He fell sick and lost a lot of weight. He even locked himself away in his room to keep away from attention until he finally sought treatment. Throughout that period, his mother was his pillar of support. She fed him and prayed for him. Today, Denchai thanks his mother for staying by his side during his illness.
"I was in treatment for almost nine months; now everything is almost back to normal except that I cannot do too much work because my lungs are still weak," said Daenchai.
Last year, he joined TB Photovoice through the Chiang Dao Hospital's People Living with HIV and AIDS support group.
"Taking pictures has enabled me to express myself and also to become a messenger within my community," said Daenchai. "I get all the information that I can about TB, and the pass it on to people. I tell people that it is possible to treat TB."
In an attempt to reach out to the community, the photographs taken by participants are also displayed at the Chiang Dao Hospital to help attendants gain knowledge about the disease.
Coming together at monthly sessions, participants get to share experiences and feelings through the pictures and offer each other emotional support.
Having someone in the community who has had personal experience with TB, and can prove that it is treatable is a critical component in helping communities to respond to the problem of TB.
"The TB Photovoice project has enabled me to communicate to members in my village about TB/HIV and how to prevent problems. Also, knowing that there are other people with the problem has helped me to cope," said Saengmuang Muangchongsang, 40, also a participant in the project. "I use the photographs and stories to talk to people that may be affected by TB."
Participants also use pictures and their personal stories to advocate for TB/HIV treatment in their communities.
At Chiang Dao Hospital, the participants maintain a bulletin board which shows their pictures, stories and information about TB infection and treatment.
"The project is very good because by providing health communication within our communities, it fills a gap left by government," said Nuttawardee Areenu, a nurse in the TB/HIV unit of Chiang Dao Hospital.
"There are many migrant groups in Chiang Dao, who speak different languages, which make health communication very difficult."
TB Photovoice was founded in November 2004 by Romel Lacson shortly after his wife Claudia and their unborn child succumbed to TB meningitis.
The goal of the project is to provide local people around the world with a voice to articulate best practices and obstacles toward TB eradication, and to assist local communities disseminate this knowledge, and promote media awareness of the toll that TB exacts upon millions of lives.
posted by AIDS-Care-Watch at 12:55 pm
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