MSF doctor Ioanna Haziri listens to Orion’s lungs and breathing during her check-up of the little boy. Tajikistan 2013 © Wendy Marijnissen

As Orion, a 4-year old boy, runs happily around his family’s home near Vose in southern Tajikistan, his grandfather holds up a picture that shows what the boy looked like just 12 months ago. Though he’s now smiling and full of life, back then he was in a coma and severely malnourished due to tuberculosis (TB) meningitis, a disease that leaves even many of the patients who manage to survive it with severe neurological damage.

Orion’s right leg and one of his hands are partially paralysed , but he’s improved since he woke up from his coma and his entire right side was paralysed. Both his father and grandfather have assiduously preformed exercises with him that were designed to help him regain control of his damaged limbs.

And in the words of Ionna Haziri, a doctor who is part of the Doctors Without Borders/Médecins Sans Frontières (MSF) team that treated him, “Orion is a real win. For us, but also for the people here. No one thought he would survive. He was in bad shape. But he’s getting better, a little bit every day.”

Orion was hospitalised when the tuberculosis bacteria spread to his spine. As he lay comatose, severely dehydrated, and malnourished, hospital staff struggled to find suitable treatment for him. MSF’s team recommended intensive treatment with antibiotics to fight his infections, and three months later, Orion had recovered enough to go home.

Orion is still being treated with first-line TB drugs. He is still getting all the help he needs from his devoted family as well.

“It can be difficult to have him take his medication,” says Orion’s grandfather. “If the doctors are here, then he takes them without complaints. But without them, it’s very difficult. He mainly thinks the drugs don’t smell nice. But in the end he always takes his pills.”

Orion’s grandfather doesn’t mind his grandson’s reluctance to take the medicine, he says, because he knows how much progress he has made. “A year ago, Orion was so sick and thin, he was basically just a sack of bones. There was no hope. Even when he left the hospital, he could not move or talk.”

Now, however, he continues, “I am very pleased that he has improved so much. And as long as I have my strength, I will continue to take care of Orion. Until he is completely well. I thank God that Orion is back on his feet. And I thank MSF. Because without them, this was not possible.”