Civil society participation is integral to providing patient-centred care, and national TB programmes must work in partnership with civil society to support these community interventions.
Dr Feodora Rodiucova, known to her students as ‘Doamna Profesoara’ and to everyone in
Balti as ‘Dora’, is the driving force behind a community movement to give treatment support to TB patients. Seven years ago, when TB was raging in Moldova and in her beloved city, Balti, Dora realised that TB patients were abandoning treatment because they lacked a bus fare for the trip to the dispensary or were confused about drug regimens.
Dora joined forces with medics who wanted the community’s help to increase treatment completion. Her community organisation, Speranta Terrei, manages a group of 21 treatment supporters called moderators. They carry TB drugs from the dispensary to patients’ homes and explain and observe the treatment. Directly observing a patient swallowing their TB medications contributes to higher completion rates and a reduced risk of drug resistance.
“Of course, it is super crazy to not spend 800 Moldovan Lei (US $70) a month for a moderator’s allowance when we see what their steady encouragement does for a destitute patient.”
Dora has attracted a swathe of Balti to the TB cause. Some moderators have had TB themselves or watched their children regain health after a moderator’s intervention. Others wanted to lend a hand to a neighbour. Medical college students wanted to act against a treatable disease in their midst. Former prisoners and the homeless offered to join when they saw that Dora did not stop at TB treatment but also tried to find them temporary housing or a residency permit. Dora does not hesitate to knock on the doors of the Balti municipality because she understands TB is one of many impediments marginalising patients.
Nothing deters Dora from her pursuit of giving form to the term ‘patient-centred care’. She thinks it should not only be words in a document. Dora associates 625 individual faces with patient centred care. That is the number of TB patients who have received treatment support from Speranta Terrei in the last six years.
Dora’s forceful yet polite voice brings hope to patients. She is determined to make it heard so that caring treatment support becomes the norm and not the exception in Moldova.