Alternative methods of treatment help patients to defeat tuberculosis
Within the framework of the UNDP/Global Fund project, the National Red Crescent Society promotes the use of alternative treatment methods in patients with multidrug-resistant tuberculosis in difficult life situations in Bishkek.
Nurbek's struggle with tuberculosis was long and difficult, but he finally overcomes the disease. His treatment ends in less than a month, and he already feels well, ready to take his life back into his own hands. It took him a long time to see this light at the end of the tunnel: he had been ill with tuberculosis since 2016, but had refused treatment twice before. "I had severe side effects from the medications, and there was nothing I could do while I was being treated. But I had to work to feed my family, so I had to make a choice."
This time Nurbek achieved victory thanks to video surveillance treatment, an innovative, more convenient approach to treatment, with the support of UNDP. Treatment of drug-resistant forms of tuberculosis lasts up to two years, during which patients must take pills every day under the supervision of a nurse. It is important to make sure that they take the treatment regularly, because it is effective only if all medications are taken systematically and until the end of treatment, and to detect side effects in time. But now that he is on video treatment, Nurbek no longer needs to go to the hospital every day to take his treatment: he just needs to record a video on his smartphone as he takes pills and send it to the nurse on WhatsApp.
"Now I take pills before going to bed," says Nurbek, 29. Thanks to this innovative approach to treatment, he can sleep after taking the medication and suffer less from side effects, and he is free to work during the day. This is extremely important for him, since he has to accept any job. Nurbek lives with his two children, who are 7 and 4 years old, and his pregnant wife in a small empty house that he built himself not far from Bishkek. Having no documents for this property, Nurbek and his family live in terrible conditions, without water and any heating system. They sleep on the bare ground, there is almost no furniture in the house, and sometimes there is no money left for tomorrow's bread. "We survive as best we can," says Nurbek, the sole breadwinner in the family. They live on his small disability pension of group 2, on 1000 soms, which he receives every month from the UNDP/Global Fund Project for adherence to treatment, and on the pennies that he receives for day work.
Patients undergoing treatment under video surveillance can take pills when it is convenient for them, and they do not need to spend time or money on daily visits to the hospital. "It saves valuable time. They don't have to go to the hospital every day; they can go to work instead. And they don't need to spend money on transportation. Some patients are in a very difficult financial situation, and they need to work during treatment," says Begayim, a nurse in Bishkek.
Treatment under video supervision
Within the framework of the UNDP/Global Fund project, the National Red Crescent Society promotes the use of alternative treatment methods in patients with multidrug-resistant tuberculosis in difficult life situations in Bishkek. Such methods include treatment under video surveillance, as well as case management and social, psychological and legal support. This comprehensive assistance is designed to help each patient complete treatment for tuberculosis, despite all the difficulties they may face.
Inessa, who is now 37 years old, is also a client of the Red Crescent. She lives with her mother and 8-year-old daughter in a shabby tiny rented apartment in the basement; they share a narrow bed, and due to lack of space they have to store all their belongings on it, including clothes. Their only source of income is her mother's small pension; due to tuberculosis, Inessa cannot work now.
In January, she was also transferred to treatment under video surveillance. Her case manager Seynegul supports her with all his might and monitors her treatment daily. "She sends her videos perfectly. She never misses a single day," Seynegul says.
"My brother died of tuberculosis, so I know how serious it is," explains Inessa, who wants to overcome tuberculosis despite a difficult life. "It's not easy, but my daughter is small and I need to take care of her," she says. She is grateful for the financial assistance she sometimes receives from the Red Crescent, but "can't make ends meet."
"We were evicted from our housing, which was in an emergency condition, but we were not given anything in return, we do not receive any help. We were left with nothing. I would like us to get land on credit in order to have decent housing..."
Psychological, social and legal assistance
In addition to video-supervised treatment and case management, the Red Crescent offers psychological, social and legal assistance to tuberculosis patients in need as part of a UNDP/Global Fund project. Ruslan, for example, was helped by a psychologist. He was diagnosed with tuberculosis in Krasnodar, where his family lives, but he had to return to Kyrgyzstan for treatment. However, after a few weeks, he felt depressed and wanted to give up.
"I wanted to finish the treatment, but I couldn't take the pills. I felt that something was wrong." Ruslan turned to Ainurayim, a professional psychologist who met with him several times and referred him to a psychiatrist for further treatment. "I realized that all this was a side effect of his treatment. He wanted to finish the treatment, he is responsible, but some drugs had a negative psychological effect on him," she explains. With this help, Ruslan feels much better, the treatment is almost over; he is looking forward to reuniting with his family in Russia.
"Patients like Ruslan have a high risk of interruption of treatment," explains Ainurayim. "I talk to them and try to understand why they feel this way; it's because of treatment or other difficulties in their lives. And we are trying to help accordingly so that they can complete the treatment."
Gulnaz has also had a hard time in recent months, but Kumarkul eje, a Red Crescent social worker, helps her overcome many difficulties. Her husband died of tuberculosis last year, and she had to leave her mother-in-law's house in the Toktogul district with four children, who are now 9, 6, 4 and 1 years old. She herself was diagnosed with TB in September, shortly after the birth of the child.
Gulnaz had to rebuild her life from scratch, and Kumarkul helped her a lot. She helped her get into a free professional training program for vulnerable women in the Red Crescent, where she learned to sew. Kumarkul also sent her three older children to the tuberculosis pediatric hospital in Cholpon-Ata, where they will be able to undergo treatment and recover in the best conditions, while their mother takes care of herself and the youngest child in a modest rented apartment in Bishkek.
"I certainly miss them. I want to take them home. They don't have a phone, but they borrow it from other children from time to time to call me," Gulnaz says. "The treatment is difficult, but I have to finish it for the sake of the children. Doctors say that to fight tuberculosis, you need to live in good conditions, but we have a poor standard of living. I am grateful to Kumarkul eje for everything she does to help us." Despite the tears in his eyes, Gulnaz smiles broadly. Thanks to the help she receives, Gulnaz can stay strong for the future and hopes that one day life will smile back at her.
* Names changed at the request of patients.