TB interventions must include the provision of social support for the most vulnerable groups to ensure a comprehensive and holistic response.
It was a cold January morning when somebody knocked on the door of the Russian Red Cross office in Khabarovsk. A very thin and shy girl handed over a referral letter from the local TB service asking to include her in the target group of the Red Cross TB programme. She needed social help.
This young woman’s name was Valentina. She and her family had moved to Khabarovsk from Okhotsk because neither she nor her husband could find a job there. The couple had hoped that by moving to the capital of the Russian Far East that their financial situation would improve, that both would find prestigious, well-paid jobs and that their two small daughters would go to a good school.
But reality was tough on the family. Once in Khabarovsk, Valentina’s husband could hardly find work and Valentina, even though she was a certified nurse, couldn’t find any at all. They could only afford to rent a shabby apartment in the outskirts of the city that lacked even the most basic utilities. Valentina’s husband’s salary barely covered their rent and food for the children.
One evening, several months after moving to Khabarovsk, Valentina started to feel unwell. Valentina thought she simply had a cold and decided not to go to the doctor. She was afraid the doctor would prescribe medication her family would not be able to afford. Valentina stayed in bed for several days and hoped for the best. During the following days her condition deteriorated, and she could no longer avoid going to the doctor. Her diagnosis was a shock for her – she had tuberculosis.
Valentina was immediately hospitalised. Valentina spent many months in hospital before being referred for outpatient treatment at the Red Cross programme.
Once Valentina began treatment, she was asked by the Red Cross coordinator what she normally ate. Valentina said she was seldom hungry, and that her priority was feeding the kids and her husband so that he had the energy to go to work. Valentina was given daily food aid as a reward for taking her medicines and received clothing for herself and her girls. She also worked with a psychologist who helped her to build self-respect, to gain self-confidence and to hope that her treatment would be successful. Red Cross workers helped to send Valentina’ daughters to kindergarten and assisted her husband in coming back to his job after he was fired on the grounds of his wife’s disease. Valentina fully recovered after her treatment ended, and she stopped being a member of the programme’s target group. When she discovered that one of the DOTS nurses wanted to quit her job due to her own health complications, Valentina offered herself as her replacement. She was properly trained by the programme’s health coordinator and was given the job as a visiting nurse.
Valentina now oversees DOTS for 45 patients, hands out the Red Cross social aid and assists those who interrupt their treatment. Red Cross beneficiaries note that Valentina is a very considerate, understanding and responsible nurse.
They say she is always there for the patients, always ready to help, always glad to solve problems related to treatment and to answer questions about it. Valentina knows how to approach ‘difficult’ patients who repeatedly interrupt their treatment, and she now uses her own story to encourage patients to continue treatment and to believe in their full recovery.