By Yuliya Chorna

WTBD2017_Logo_EN_H100pxEvery year, more than 30,000 people are diagnosed with Tuberculosis (TB) in Ukraine alone. Every hour, there are four new cases; every ninth patient dies. In fact, even more people are getting sick every year, but one fourth of the cases are not registered by the medical system. These are so called “missed cases” which means that 10,000 people with TB are getting sick, but do not get treatment. TB problem is global, but our situation has become a real catastrophe.

This may come as a shock because TB is thought of in many circles as a disease of the past. It is an ancient disease indeed, but it remains with us. The TB we are facing now is even more dangerous because there are new strains of the disease, called multi drug-resistant TB, which are not receptive to many anti-TB drugs. Ukraine is among top five countries in the world hit by multi drug-resistant TB. Only 40 percent of patients with multidrug resistant strains are cured.

World TB Day, observed annually, March 24, is a timely opportunity on the need to remind our policymakers of the prevalence of the disease among us. We should remember that because TB is mostly transmitted through air when a sick person coughs, anyone can get it. Symptoms typically include a cough that lasts more than three weeks, weight loss, fatigue, night sweats, and periodical fever. If the person has symptoms like that, it is very important to timely visit a family doctor in the local policlinic. General practitioner will advise if the further check-ups are necessary.

Treatment for TB, including provision of medicines, is free of charge. However, it is a long term treatment. It may take from six months, when TB is susceptible to the impact of the main anti-TB drugs to 20 months of treatment, in case when TB is resistant to the drugs. It is hard for the person to be on treatment for so long, but it is important to complete the course to destroy all the bacteria in the body. Within couple weeks of starting treatment sick person ceases to contagious. As a result, there is often no need for hospitalization. Upon consultation with a doctor, a sick person can be treated in the ambulatory settings, or at home. Where the patient is treated is not an issue; how treatment is approached is what makes the difference.

The patients facing the burden of taking handfuls of pills daily for many months should be supported from different angles. Clinical interventions alone will not suffice to ensure successful treatment outcomes. The critical point is to integrate medical, social and psychological support according to the individual needs of the patient. The role of civil society organizations here is very important as a backup for medical care. For example, Alliance for Public Health has administered the programs for patients with multidrug resistant TB who were treated at home with the daily visiting of Red Cross Nurses. Upon getting drugs delivered to patients at home combined with food parcels and counselling, twice more patients who started on treatment in 2013 were treated successfully in comparison with those who received only drugs at polyclinics. This is one of the examples of the difference, helping people to be successfully cured, as a result of putting the person in the center of comprehensive care. Such an approach, which account for medical, social and emotional needs of the individual patient is called a people-centered care.

As World TB Day approaches, workers and community activists involved in TB care are urging government to make the reforms necessary to widely introduce people-centered approaches for TB care. Alongside the demand from civil society for governmental actions there is room for everyone to contribute to the fight with TB – to seek timely diagnosis, when symptoms arise, complete the treatment course without interruption, and do not turn away from those suffering from the disease.

Yuliya Chorna Chorna is a TB Advocacy Project Manager at Alliance for Public Health, Ukraine. She recently participated in an advocacy workshop in Paris, France, sponsored by www.ACTION.org.


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