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Dr Carmen Christian
With Tuberculosis Month approaching in March, a University of the Western Cape (UWC) professor examined the crucial role nurses play in caring for tuberculosis (TB) patients.
In an often underappreciated role, their dedication goes beyond medical treatment, extending into acts of kindness that significantly impact patient well-being and treatment adherence.
Dr Carmen Christian, an economics lecturer at the Economics and Management Sciences Department, emphasises how South African nurses working in TB clinics frequently provide food to their patients, often paying for it out of their pockets.
Locally, food insecurity is a reality and poses a significant barrier to TB treatment adherence. “Many patients struggle to maintain their medication regimen due to hunger, which can lead to treatment failure. “During the COVID-19 pandemic, funding cuts exacerbated the situation, reducing the availability of food parcels and other support programmes. Despite national policies emphasising the importance of addressing social determinants of health, budget allocations have not matched these commitments.”
Dr Christian said nurses' efforts to provide food to TB patients are vital in ensuring treatment adherence and improving health outcomes. Their kindness helps bridge the gap left by inadequate social support systems. However, these acts of generosity are rarely acknowledged or accounted for in healthcare planning and budgeting.
She said, “This practice emerged from interviews conducted as part of a TB study, revealing that many patients rely on the food provided by nurses as their only meal of the day. This selfless act is not unique to South Africa; similar stories have been reported in Kenya, Malawi, Nigeria and Uganda.
“The financial sacrifices made by nurses highlight a critical gap in the healthcare system. Despite the well-documented link between TB management and social determinants of health such as food security, there is a lack of research and policy focus on the financial burdens borne by healthcare workers.
“Nurses’ contributions are essential, especially given TB patients' challenges in accessing social assistance like disability grants. Studies show that only a small percentage of TB patients in South Africa receive these grants, often due to bureaucratic hurdles and high costs.
“Recognising and supporting nurses' financial sacrifices is crucial. Their contributions should be quantified and included in the design of TB interventions to ensure sustainable and effective patient care. I believe that addressing food insecurity and other social determinants of health can improve treatment adherence and outcomes for TB patients.
“Their efforts provide momentary, immediate relief to patients and contribute to the overall success of TB treatment programmes.
"The selfless and unacknowledged financial sacrifices that nurses make for their patients – often daily – is a phenomenon that needs to be further investigated, quantified and considered when designing TB interventions that support patient adherence to TB treatment.
“It is time to acknowledge and support the hidden costs of kindness that nurses bear every day,” said Dr Christian.
Dr Carmen ChristianIn an often underappreciated role, their dedication goes beyond medical treatment, extending into acts of kindness that significantly impact patient well-being and treatment adherence.
Dr Carmen Christian, an economics lecturer at the Economics and Management Sciences Department, emphasises how South African nurses working in TB clinics frequently provide food to their patients, often paying for it out of their pockets.
Locally, food insecurity is a reality and poses a significant barrier to TB treatment adherence. “Many patients struggle to maintain their medication regimen due to hunger, which can lead to treatment failure. “During the COVID-19 pandemic, funding cuts exacerbated the situation, reducing the availability of food parcels and other support programmes. Despite national policies emphasising the importance of addressing social determinants of health, budget allocations have not matched these commitments.”
Dr Christian said nurses' efforts to provide food to TB patients are vital in ensuring treatment adherence and improving health outcomes. Their kindness helps bridge the gap left by inadequate social support systems. However, these acts of generosity are rarely acknowledged or accounted for in healthcare planning and budgeting.
She said, “This practice emerged from interviews conducted as part of a TB study, revealing that many patients rely on the food provided by nurses as their only meal of the day. This selfless act is not unique to South Africa; similar stories have been reported in Kenya, Malawi, Nigeria and Uganda.
“The financial sacrifices made by nurses highlight a critical gap in the healthcare system. Despite the well-documented link between TB management and social determinants of health such as food security, there is a lack of research and policy focus on the financial burdens borne by healthcare workers.
“Nurses’ contributions are essential, especially given TB patients' challenges in accessing social assistance like disability grants. Studies show that only a small percentage of TB patients in South Africa receive these grants, often due to bureaucratic hurdles and high costs.
“Recognising and supporting nurses' financial sacrifices is crucial. Their contributions should be quantified and included in the design of TB interventions to ensure sustainable and effective patient care. I believe that addressing food insecurity and other social determinants of health can improve treatment adherence and outcomes for TB patients.
“Their efforts provide momentary, immediate relief to patients and contribute to the overall success of TB treatment programmes.
"The selfless and unacknowledged financial sacrifices that nurses make for their patients – often daily – is a phenomenon that needs to be further investigated, quantified and considered when designing TB interventions that support patient adherence to TB treatment.
“It is time to acknowledge and support the hidden costs of kindness that nurses bear every day,” said Dr Christian.
