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Marina Glasgow, a BC Centre for Disease Control (BCCDC) nurse practitioner, wants everyone to know that Tuberculosis (TB) is still a health threat to people in B.C. and beyond. Marina and her colleagues work with patients in-person in the Lower Mainland and support TB patients in virtually all parts of B.C. As a nurse practitioner, Marina provides direct medical care to patients accessing the BCCDC clinics.
"That includes making a diagnosis, ordering lab tests, writing prescriptions, educating patients and maybe consulting or referring to specialists, to ensure patients receive the care they need," says Glasgow.
"TB care requires a coordinated effort by a group of dedicated health-care professionals," she adds, explaining how the TB Services team works closely with clinicians, the BCCDC Public Health Laboratory and Clinical Prevention Services teams, pharmacists, nurse educators and administrative staff, among others.
Tuberculosis, commonly known as TB, is caused by a slow-growing germ called Mycobacterium tuberculosis. TB usually lives in the lungs, but can be in any part of the body, and is usually spread through the air from one person to another.
For this to happen, a person must have TB Disease in their lungs that gets into the air through coughing, sneezing, laughing or singing. Once TB is in the air, another person can breathe it into their lungs. TB is curable and only some people who get a TB infection become sick with TB Disease.
Who is most affected by TB?
Though TB is diagnosed throughout the province, including in remote and northern communities, most cases are diagnosed in the Vancouver Coastal and Fraser Health Regions. The BCCDC clinics see many TB patients who have recently arrived in B.C. from parts of the world where TB is still endemic – over 80 per cent of active TB cases in British Columbia occur in people born outside the country.
"A lot of times we’re working with newcomers to Canada,” says Jude McLellan, a TB social worker based out of the Vancouver clinic. “People may have varying impressions [of social work and the health-care system] …or may have had negative experiences in the past."
First Nations peoples have rich histories of wellness and colonialism has had damaging impacts on health, including harm caused by TB disease.
First Nations Health Authority (FNHA) Tuberculosis Services provides culturally informed wellness promotion, training and consultation to both health care providers who work with First Nations communities and the Indigenous population. FNHA coordinates with BCCDC TB Services to offer physician, lab, pharmacy and epidemiology services.
Social determinants of health
McLellan advocates for patients at both TB clinics throughout the treatment process, working alongside the nurses, physicians and staff at the clinics. As a social worker, a role added to BCCDC TB Services in 2021, she helps clients navigate government services, assists them in obtaining the appropriate documentation, assesses their finances and supports them in dealing with the emotional stress tied to diagnosis and treatment.
Pictured: Jude McLellan, TB social worker (left) and Anna Ryan (right), senior practice lead, TB Services, BCCDC.
McLellan says people are sometimes hesitant to accept help from a social worker, so she emphasizes that everything is voluntary and consent-based and encourages clients to reach out at any time.
"I always make sure that they have my phone number," she says, explaining that she'll often hear from patients a few months after they first come to the clinic. “It’s building trust. Always trying to have the person in the centre, allowing them to be the driver of this process."
TB tends to highlight structural inequities in our health care system and also affects people with unstable housing, mental health struggles and substance use disorders. Social workers like Jude can help address non-treatment elements of TB care that contribute to successful treatment and provide support for patients throughout the journey.
McLellan says her clients have experienced positive outcomes as she’s steered them through various systems over the past few years. She’s worked with interpreters to break down language barriers, and helped clients navigate bureaucracy to access valuable support and services.
She recently formed a group of TB social workers from different parts of Canada who plan to meet monthly to share experiences and ideas. Jude says the group is looking forward to finding ways to expand the role of social work in the treatment of TB, which she sees as being crucial to addressing the social determinants of health.
"There’s not a lot of TB social workers," says McLellan. "I think people are seeing why it is important, and we’ll be advocating to have more social work involvement."
World TB Day
On Sunday, March 24, organizations worldwide committed to ending tuberculosis will mark World TB Day. The cities of Vancouver and New Westminster have both issued mayoral proclamations officially recognizing the occasion.
"World TB Day is important because it raises awareness that TB still exists and highlights the need for collective efforts toward elimination," says Anna Ryan, Senior Practice Lead for TB Services at BCCDC.
If you're near the Vancouver General Hospital on Friday, March 22, you can visit a TB booth hosted by the
BC Lung Foundation in the Jim Pattison Pavillion, directly across from the gift shop. Staff can test their TB knowledge, try to win a prize and grab a coffee or a treat between 9 a.m. and 1 p.m.
On World TB Day, landmarks across Canada will be lit up in red as part of the international
Light up For TB campaign, including the Bloedel Conservatory, Science World, B.C. Place and Pacific Coliseum in Vancouver, City Hall in New Westminster, and the Legislative Assembly of B.C. in Victoria.
You can spread awareness about the fight to end TB by sharing some of the resources created by the
Stop TB Partnership and
StopTB Canada.
