Fighting TB, One Picture Book at a Time

Speeches Shim

TB Nurse Florita Dalida presents picture books to children.
TB Nurse Florita Dalida presents picture books to children.

Eight-year-old Abby and five-year-old Bella carefully rock their baby dolls to sleep, letting their imaginations run wild with make-believe. Giggling happily, they are the picture of health and childhood delight. But two years ago, their situation was vastly different.

In December 2018, the sisters were diagnosed with tuberculosis, Bella with drug-resistant tuberculosis (DR-TB) and Abby with drug-susceptible tuberculosis (DS-TB). At that time, Bella was just three, and Abby was six. Abby shared, “We thought we were going to die.”

Their mother, Marissa, was shocked that her children could get tuberculosis, or TB, at such a young age. “We did not want to believe it at first,” she said. “We didn’t want to lose our daughters, so we followed the doctor’s advice: to enroll the girls for treatment right away.”

Every day, the girls had to take medicines that made them nauseous to the point of vomiting. The hospital was two hours away from their house, which made obtaining the treatment drugs even more difficult. “No matter how hard I tried to be strong, I had this fear. What if we don’t make it? What if the kids cannot bear the pain? So many nightmares,” Marissa remembered.

Even though the treatment was difficult, Bella said the love and care she received made the treatment more bearable. “People said they loved us. People in the hospital said they would take care of us,” she recalled.

After nearly a year of uninterrupted TB treatment and support from their whole community, the sisters were finally declared TB-free in December 2019. “I was so happy and grateful to God and to all the people who helped us. Until now, we can’t believe we survived TB,” Marissa said.

Now, the girls are enrolled in school, Bella in kindergarten and Abby in grade 3. However, even though they are TB-free, their TB journey is not over. Encouragingly they have emerged as leaders in the Philippines’ fight against TB.

Cover of the Tibay ng Dibdib picture book
Cover of the Tibay ng Dibdib picture book

Through USAID’s TB Platforms project, Abby and Bella are now able to share their story with thousands of children across the Philippines through the “Tibay ng Dibdib” (Filipino for “chest strong” or “resilient”) children’s storybook, coloring book, and video. The children also join in various TB education campaigns.

“I am very proud of these sisters and their parents because despite all the challenges, they battled and recovered from TB and are now TB advocates,” said TB Nurse Florita Dalida, who provided care to the girls during their treatment. “They share their TB journey and inspire other Filipinos to show extra compassion to TB patients.”

USAID partnered with Rogaciano Mercado Memorial Hospital (RMMH), where the sisters received their treatment, and with the Central Luzon Center for Health Development (CLCHD) to officially launch “Tibay ng Dibdib” in August 2020. The book, which USAID and its partners distribute during community outreach events, has inspired thousands of communities across the country to find and fight TB, as well as support TB patients in their communities.

Abby said she is excited and proud to have a book based on her and her sister’s TB journey. “We love how they wrote our story,” Abby said with excitement. “It will teach children about TB and how to fight TB. We hope they can be braver than us.”

In partnership with the Philippine Department of Education (DepEd) and Department of Health (DOH), “Tibay ng Dibdib” was integrated in all public elementary schools in the National Capital Region in the 2020-2021 school year to raise public awareness about TB and promote positive, health-seeking behavior and community support. In February 2021, USAID’s TB Platforms project received the “Partner Award” from DepEd for its collaboration in integrating this book into classes.

“Elementary pupils love storytelling sessions,” said Marianne Lobrin, a teacher in Quezon City. “Because it is a dialogue-type, conversational, and true-to-life story, students and parents find the story interesting, informative, and soulful.”

Principal Ann Regoso-Abacan, principal of Sophia School in Bulacan, said the book is especially relevant now because both TB and COVID-19 are killer airborne infectious diseases. “I think academic institutions play an important role in raising awareness about TB in children,” she said.

Sophia School is currently partnering with USAID to create a “Tibay ng Dibdib” animated video, which will be shown in cinema advertisements and LED billboards in transport terminals, public markets, and malls.

Children holding the Tibay ng Dibdib picture book
Children holding the Tibay ng Dibdib picture book

As a result of USAID’s partnership with DepEd, several local government units launched child-friendly TB screening in public elementary schools. In addition, the Department of Social Welfare and Development has rolled out this storybook in 49 daycare centers serving impoverished communities.

“Nobody will be left behind. We will popularize ‘Tibay ng Dibdib’ to the most remote areas and will ensure that TB services are available during the pandemic,” said Dinalupihan Mayor Angela Garcia during the November 2020 handover of the storybook and village-wide free chest X-ray.

Private sector partners such as news outlets and health organizations have also joined in this campaign. The Philippine Daily Inquirer, one of the largest publications in the Philippines, featured Abby and Bella’s story in its first-ever “Inquirer Read Along” via Facebook Live in November 2020.

According to the World Health Organization, the Philippines is one of eight countries that account for two-thirds of the world’s TB burden. Even though TB rates have decreased since 2000, TB is still one of the nation’s leading causes of death and illness. In addition, disruptions to TB services due to COVID-19 threaten to erase years of progress in the Philippines’ fight against TB. USAID is working with countries on recovery efforts to address the pandemic’s impact on TB.

“I hope this book will build courage. Families of TB patients need that courage to survive TB,” said Marissa. “We hope that our TB journey will give hope to TB patients and their families – especially those who must undergo treatment during this pandemic.”

Last updated: March 23, 2021

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