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23 March 2001 by Ilmira Gafiatullina and Skip Von Kaemel in Almaty,Joe Lowry in Moscow. Orolhon Khodjaisova sits on her bed in a crowded tuberculosis ward of Muynak hospital. She used to be a Red Crescent volunteer assisting people in need in this remote part of western Uzbekistan, but now, like those around her, she has become vulnerable and in need of support herself. The area around the Aral Sea where Orolhon lives, like many regions in Central Asia and the former Soviet Union, have been hit hard in recent years with falling living standards, poor nutritional status, low immune defense of the population and these have all contributed to the rising trend of the deadly disease. Orholon's weary face brightens into a smile as she receives a visit from Abadan Bazarbaeva, the regional chairperson of the Red Crescent Society of Uzbekistan in the autonomous republic of Karakalpakstan. There is a poignancy to this visit as she has now become one of 36,000 TB sufferers which the Red Crescent supports and who need nutritional assistance with supplementary feeding. The programme has been made possible by the support of the American Red Cross and the International Federation. The plight of Orolhon and thousands of TB sufferers like her, is being highlighted by World TB Day this Saturday March 24, followed by a week of activities organised by leading humanitarian agencies including the World Health Organisation and the Red Cross Red Crescent. According to the WHO, TB is the world's leading curable infectious killer. Tuberculosis most often hits those living in poverty and who can least resist it - the most vulnerable. Every day around the world 20,000 people develop active TB and 5,000 die from the disease. Without treatment, about 70% of people with TB will die, and if untreated, a single person with infectious TB can infect between 10-15 people a year. At a press conference in Moscow today, the International Federation and Russian Red Cross warned that unless living conditions are improved, TB cases could double by 2010, resulting in 60,000 deaths per year in Russia where already 30,000 people per year die prematurely from TB among a population which has fallen by 3.5 million in the past eight years. Speaking alongside other agency experts, International Federation Medical Advisor Dr. Michael Pelly said that a community-based organisation like the Red Cross is uniquely placed to help stop the spread of TB. "In the past two years great strides have been made by Russian Red Cross and the Federation to raise awareness of TB, how it can be detected, how it can be treated, and how it can be cured", said Dr Pelly. "However, the campaign against TB must be long-term and everyone must be involved - government, NGOs, press, medical professionals and the general public. There are no quick fixes", he warned. Internationally-funded Red Cross programmes in Belarus, Moldova, Ukraine and Russia have already helped to reduce the numbers who interrupt their treatment courses and so helped to reduce the threat of outbreaks of multi-drug resistant TB which is deadlier and hundreds of times more expensive to treat. The programmes concentrate on information, monitoring of treatment and social support, including hot meals and warm clothes for TB patients and their families. The International Federation now beginning to implement similar programmes in Central Asia where tuberculosis is rising at an alarming rate. The International Federation along with the Red Crescent/Red Cross Societies are committed to prevent further increases in tuberculosis cases and support tuberculosis control programmmes. "The National Societies see their role in the social aspect of tuberculosis control and advocacy for DOTS," said Dr. Manan Ganguli, Health Delegate for Central Asia. DOTS (Directly Observed Treatment, Short-course) is key in the strategy to combat TB. Ganguli explains the crucial role of Red Cross/Red Crescent nurses across the region: "Trained community health nurses make sure that the tuberculosis patients, when they are sent back home after intensive treatment in hospital, complete the full course of treatment. They are the bridge between the patients and their families at home and the doctors in the hospitals and polyclinics". The region has seen one of the harshest winters in years, but even on the coldest days, Red Cross/Red Crescent community-based health care workers and volunteers in Kazakhstan, Kyrgyzstan, Turkmenistan, Uzbekistan and Tajikstan continue this vital work. They visit patients in their homes to make sure that they continue their treatment and to provide information for family members. They travel to schools to raise awareness of tuberculosis amongst the school children. They distribute posters, leaflets, story books for children all designed with information about tuberculosis. On 31 March, during the World TB Day 2001 week, the Federation's delegation for Central Asia will host a regional conference. "The conference will highlight the theme of World TB Day 2001 and to enhance collaboration between the Ministries of Health and the international agencies," said Dr. Ganguli. "Also, we are planning to launch the Russian translation of Clinical Tuberculosis book and distribute it to different Ministries of Health in Central Asia. It is written in simple language, this book is known worldwide as a practical book for non-specialist doctors and health workers." Prior to his departure from the Federtion's Geneva-based Secretariat for Almaty in Kazakhstan this weekend, Dr. Bradley Hersh, a Federation TB expert, said. "The DOTS strategy is very effective. 95% of patients can be cured in six to eight months on DOTS and the best way to prevent the spread of TB is through full treatment of TB cases." He pointed out that in recent years there have major increases in the incidence of multi-drug resistant (MDR) TB for which treatment is very difficult and lasts as long as two years and can cost up to $50,000 whereas for non-MDR TB treatement with DOTS can cost as little as $20. "However, incomplete TB treatment increases the risk for developing MDR-TB," warned Dr. Hersh. |
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During
a home care visit in East Kazakhstan, a TB patient receives a package
of hygiene items 
