By Terhi Heinasmaki, health coordinator, Asia Pacific
Both my grandmother and uncle died of tuberculosis in rural Finland during the 1930s. At that time, the only medication for TB was sunlight and good food, neither of which were readily available in Nordic countries.
Tuberculosis is still a disease of poverty. Overcrowding creates the ideal conditions for the tuberculosis bacteria to thrive. Hunger, stress and other diseases reduce the natural barriers of the body, allowing bacteria that cause the disease to invade and spread.
When I worked in Namibia, many of the patients in the hospital were living with HIV. You did not have to be Dr House to diagnose their acute illness: it was almost always tuberculosis. HIV kills the very cells that protect us from tuberculosis and, because of this, TB has a deep connection with HIV- and AIDS-related deaths.
David was a 36-year-old teacher who came to the hospital with all the symptoms that pointed to TB: a cough, night sweats, weight loss and poor appetite. But even with treatment, he didn’t get better. It turned out that was not taking his tablets. He thought that he deserved to die because he was infected with what he thought of as a shameful disease. It took weeks to convince him of the value of his life.
I have met many Davids, of African, American, Asian and European origin. Some of them have died and, for this reason, I want to add another cause of death: neglect. To survive TB, medication is not enough. To survive, the Davids of this world need the support of their friends and communities.
I have been infected with TB bacteria myself, just like one-third of the world’s population. If my immunity weakens, I can easily catch the disease. If I do though, I have a far better chance than my grandmother and uncle. My TB can be treated through a long course of several antibiotics, over a minimum of six months. They might make my stomach churn and my liver act up, but if I take them regularly, I will be completely cured. Six months is a short time. Still, many fail to take their medication regularly. Even more fail to get treatment at all, because they are used to being poor and ill, and do not seek help in time.
TB is one of the neglected diseases because it lacks the headline potential. It is slow and stagnant, like the dull air it is carried through. Tuberculosis was called consumption because it seemed to consume those infected from within. One third of the world have been infected by TB; one more every second. How many people have caught TB since you started reading my words? How many with the disease have access to treatment? The numbers don’t yet match.
The original David, mentioned above, finally completed his treatment with the help of a man he met at the hospital; he brought John to the clinic every day to take his medication. The friend was not a Red Cross volunteer, but he could have been.