The Republic of Moldova is among the WHO European Region’s 18 high-priority countries for tuberculosis (TB) control and one of the world’s 27 countries with the highest burden of multi-drug resistant tuberculosis (MDR-TB). 

Almost one-third of newly diagnosed TB cases and two-thirds of previously treated TB cases in the Republic of Moldova have MDR-TB. Significant ongoing transmission is due to many factors, including unjustified and lengthy hospital stays, poor infection control in TB hospitals, poverty and poor living conditions, late diagnosis and migration.  

Since it was founded in 2006, the NGO Speranța Terrei has developed a large number of activities and projects to help TB patients and raise awareness about TB. The NGO collaborates with the health department and the TB dispensary to implement the TB control program in Bălți. Under earlier projects, Speranța Terrei collaborated with TB programs in 8 districts in Moldova and Transnistria, a breakaway region of the Republic of Moldova with a special status. The main objective of Speranța Terrei is to help patients vulnerable to treatment interruption complete treatment through community-based Directly Observed Therapy (DOT). 

TB doctors and nurses request our moderators to give DOT to patients who are not able to come daily to the TB dispensary to take pills. These patients suffer from alcohol and tobacco addiction, homelessness, insufficient nutrition, unsanitary living conditions, isolation, and stigma as former prisoners. Moderators take anti-TB drugs from the TB dispensary to patients for DOT, reinforce doctors’ instructions on drug regimens and side effects, and take patients to follow-up tests. A very important detail to mention is that moderators are from the community, they are medical assistants, former patients, relatives of former patients, people that know better than anybody else how much TB can affect somebody’s life and how much sick people need help and support. This is why they always find necessary arguments and suitable words to reassure and persuade patients to continue treatment. The moderators are trained and guided by TB doctors and taught on TB transmission and disease, risk factors, treatment regimens, screening, and confidentiality. 

Thanks to Bălți municipality that  authorized Speranța Terrei to use part of a municipal building rent-free for 15 years in exchange for extensive renovation and services to TB patients, we opened in this building in 2015 a Centre for Tuberculosis Patients. Here, we train moderators, counsel patients and help them apply for residency permits and social assistance, serve meals to the homeless, and bring together patients and the larger community. Since 2006, 151 moderators have given treatment support to 1335 patients who had new and previously treated drug-susceptible TB and MDR-TB or who were contacts of TB patients and needed prophylaxis treatment. For patients we serve, the overall treatment success rate is 87%. You can find more about our work from our reports on the Global Giving platform https://www.globalgiving.org/projects/community-support-150-tuberculosis-patients-in-moldova/reports/#menu 

Our organization conducts outreach in schools and among patients’ families, the homeless, former prisoners, and the Roma minority to screen for TB symptoms and to assist them to be diagnosed and treated. We organize public awareness events on World Tuberculosis Day, World No Tobacco Day, and Bălți City Day. Our latest campaign took place in the autumn of 2019, from September to November. In this campaign, 12 volunteer students from Ion Creanga High School from Balti organized about 50 meetings with young people aged 14-20, informing more than 1300 people about TB, the symptoms of the disease, risk groups, treatment, and stigma. There was a great need as according to the statistics in 2019 just in Balti 9 new cases of TB were recorded among children and this is alarming. One of our volunteer’s schoolmates was diagnosed with TB in spring 2019, so they found their duty to inform and raise awareness about TB as much as possible. The fact that the information was presented by their peers had a great impact on the audience, more than that, our volunteers used interesting interactive activities and online platforms like www.kahoot it is to check the students’ knowledge at the end of the information meetings. 

Some of the messages of the campaign were: “The disease doesn’t choose, each of us can be affected!”, “Take care of your peers, friends, parents, relatives and when you notice some alarming symptoms, advise them to consult a doctor and take some tests!”, “Learn to cough in a correct way to protect you and the others!”, “Lead a healthy way of life and you’ll be more protected!”, and “Don’t judge sick people, they are not guilty of being ill, they need your support and help more than ever!”; Teachers and parents seemed to be impressed by our volunteers’ initiative and their responsible attitude towards the problem. “It’s a pity that so many children and adults get sick, we didn’t know the statistics are so alarming. You are doing a great work informing people and encouraging them to follow your advice. Let’s hope that with common effort we’ll manage to diminish the number of infected people” said Miss Inna, a teacher in one of the visited schools.  

In 2014, the Moldovan government granted Speranța Terrei a Certificate of Public Utility, which attests that our organization promotes the public good and protects health and disadvantaged persons. In 2019, the certificate was extended for a longer period of time, proof that we are doing right and this encourages us to continue.  

 

Irina Mutruc, project coordinator and translator, Speranta Terrei, Balti, Republic of Moldova 

Moldova