Addressing respiratory health in Latin America

17 Jun 2022

While health systems globally are experiencing significant challenges following the burden of the COVID-19 pandemic, for some parts of the world, accessible public health has never been a privilege they’ve known.

None more so that in parts of Latin America, where St Vincent’s Hospital’s Senior Staff Specialist Thoracic Physician, Associate Professor Anthony Byrne, has dedicated much of his time to improving access and education to the people of Peru and Haiti.

According to peer reviewed medical journal The Lancet, Tuberculosis (TB) in Peru is still endemic, being one of the countries with the most cases in the Americas. But for socio economic and political reasons, half of the primary care centres do not have a doctor, nine out of ten have inadequate infrastructure, and eight out of ten do not have internet.

“Health care is a human right”, says Dr Byrne who is leading an interventional Post TB lung disease study in Lima, Peru.

Through a collaboration with Partners in Health, Harvard University, St Vincent’s and UNSW, the study measures lung function of patients who have recovered from TB, evaluating the feasibility for wider roll-out, cost and patient experience.

“We are systematically assessing patients that have successfully completed TB treatment in the last three months, for respiratory symptoms and obstructive lung function”, he explained.

Using artificial intelligence, an online ‘chat bot’ is used to screen people that are then assessed in person. Eligible patients are enrolled in to a pulmonary rehabilitation program and if obstructive lung disease is detected, prescribed inhaled bronchodilators over three months prior to reassessment.

“Peru has practically no interaction with specialist health care, and there is little help for many with (un-diagnosed) respiratory diseases”, said Dr Byrne. “But now we are providing medication and pulmonary rehabilitation. This has never been done before in this way”.
Similarly, Professor Byrne along with Respiratory Physician, Professor Christine Jenkins, are leading a lung function study in Haiti with assistance from Harvard University and GHESKIO.

Haiti is subject to one of the most challenging and under resourced health care systems in the world. To make matters worse, the political instability, violence and economic underdevelopment is hindering access to the minimal services they do have.

However for the past 6 months Dr Byrne has been teaching lung function online to the medical community in Haiti, enabling them to provide more specialised care for their patients on the ground. Prior to this, there has been no respiratory or lung health service in Haiti at all, despite respiratory disease being one of their leading causes of adult death.

“Sometimes I can’t call them because the local gangs have circumvented the hospital’s power or their internet is out of action. One of the biggest issues for the people of Haiti is just staying alive, there is a real threat of violent crime. Despite these challenges, the local doctors are so enthusiastic to learn about respiratory disease diagnosis. In fact, we are learning just as much from them”, he said.

The study not only looks at cardiovascular health and lung function, its introducing new and novel treatments for TB for some of Haiti’s most vulnerable patients.

“It’s so inspiring to work with these people. Their ethos is the same as St Vincent’s, they bend over backwards to care for those who need it.”

To find out more about these and other international studies please see the following links;

The “LIBRE Post TB” in Peru:
https://drive.google.com/drive/folders/1Yr6CIWCaGCCBhsAjkEjXc58bglePNwGa?usp=sharing

Partners In Health (Socios En Salud) website
https://sociosensalud.org.pe/

GHESKIO in Haiti website:
https://www.gheskio.org/

Treatment of a patient with tuberculosis at the Sergio E. Bernales National Hospital.

Photo courtesy of The Global Voice