Staying on course

Tuberculosis (TB) is hard to treat and its side effects can be tough on patients, many of whom give up treatment. MSF’s medical teams help patients get through the bad days. Dr Merina Pradhan talks about how MSF’s clinic staff in Chhattisgarh keeps patients motivated.

© Abhishek Shankhwar

My team is rejoicing that one of our patients has successfully completed eight months of tuberculosis treatment. Raju lives with 6 people in his household of which 3 children are younger than 15 years old.

The 51-year-old farmer had a persistent cough. He was very thin when he came for a check-up at MSF’s clinic in Bijapur town of Chhattisgarh.

This is a rural area and people in nearby villages get to know about MSF’s medical services through word-of-mouth. Raju’s neighbours had heard that MSF treats TB patients and suggested that he see us because his cough would not stop.

Most patients of tuberculosis have symptoms of prolonged cough and weight loss. We did the usual tests of TB for Raju, including a sputum test and X-ray. It turned out that he had a form of TB that can be cured with around six months of treatment.

Six months sounds long, but it is much shorter than treatment for other kinds of TB. For example, it takes around 24 months to treat multidrug-resistant TB, a hard-to-treat strain of the disease that is resistant to the usual drugs for treatment.

Treatment can be tough on patients with severe side effects. Raju showed strong willpower. He only missed his medication for around seven days. Several patients get discouraged and give up treatment, returning after a year or longer with worse conditions.

Our  clinic staff works hard to help patients stay on course. We offer counselling and our health workers visit patients’ homes to deliver medicines and for follow-up check-ups. When patients complete a stage of the treatment, we give them small incentives, such as groceries and dry fruit. This gives them a sense of achievement and keeps them motivated.

When a patient is cured, we are very happy. It is as exciting for us as it is for the patient. We did it together. Raju is going home with a bagful of goodies from us to celebrate with his family, a life free of TB.
 

Dr Merina was interviewed by Abhishek Shankhwar and Manisha Chauhan.

*The patient’s name has been changed and the photograph used is for representation purpose only.