Kyrgyzstan: Tackling tuberculosis

تم النشر: 23 مارس 2009 0:00 CET

Amanda George, British Red Cross, in Kyrgyzstan

Kyrgyz Red Crescent nurse Sooronova addresses a class of enthusiastic eight-year-olds at City School #20 in Bishkek, Kyrgyzstan: "We have to tackle tuberculosis together," she says. “Not everything can be done by the doctors, so we have to start learning about it at school."

Sooronova is one of a group of Red Cross Red Crescent nurses who are working as part of a programme to reduce TB-related stigma. In her one-hour session, she teaches the children to recognize the symptoms of TB, and tests their knowledge through a series of interactive games that get the children dynamically involved with the issues.

Aiday, eight, is asked if she is scared of catching TB. The messages are getting through, because she replies: "I follow a healthy lifestyle and I know TB can be cured, so I am not afraid."

Raising awareness
Poverty levels in Kyrgyzstan significantly exceed those in many developed and developing countries, and this can exacerbate health issues. In 2007, according to the National Centre of Statistics, TB incidence was 109.7 per 100,000 population, with a mortality rate from the disease at 9.7 per 100,000. This is lower than the 2005 statistics, but still a great cause of concern.

The Red Cross Red Crescent TB programme, funded by AstraZeneca through the British Red Cross, raises awareness of the disease through classes in schools, leaflet distribution and radio announcements in markets and workplaces.

The educational component is supported by direct observation of treatment of people with TB by Red Cross Red Crescent visiting nurses, who help clients adhere to treatment and provide information for their relatives. The results are impressive: treatment completion rates have reached 91 per cent, compared to the 85 per cent figure from the Kyrgrz health ministry.

Social problem

Roza Shayakhmetova, secretary general of the Kyrgyz Red Crescent, says: "TB is not just a medical problem but is also a social problem. The current social situation in the country contributes towards the spread of the disease."

The Kyrgyz Red Crescent is working to address this through advocacy, community-based social mobilization and communication initiatives to combat fear and misinformation around TB. The social approach to TB works to complement the state’s medical approach, and the National Society has an excellent relationship with the country’s health ministry.

"We are filling the gaps where the health ministry has a harder time reaching, by helping to target the most vulnerable populations," says Shayakhmetova. “What makes us different is that we want to be on the same level as our clients. We want to be their friends."

Tackling stigma

Although TB is curable, the stigma faced by those with the disease is astounding. Jelena, a qualified doctor, has been working as a Red Crescent nurse in the town of Kara Balta for seven years.

"People are afraid that they might lose their jobs or that their relatives might alienate them if they find out they have TB," she says, adding that the stigma is so comonplace that even her own son does not like that she works with TB clients.

"Some people are so scared of the stigma that when they are able to go back to work they lie about why they were off sick. Some people are more comfortable saying they had syphilis than TB!"

The most moving case that Jelena remembers is a 76-year-old woman who was diagnosed with TB and hospitalised for one month. “She was so distraught that she had contracted TB that she was planning to kill herself by throwing herself over the hospital balcony. Helping her overcome TB and understand that she had not done anything wrong to catch it is one of the most satisfying experiences I can remember."

Psychological support

TB sufferer Rassoha, 31, and her 13-year-old son Rachid live on the fifth floor of an apartment block in Kara Balta. "When I found out that I had TB I was so shocked and depressed because I used to think that it was not curable," she says. “I was scared that my son would also catch it and that we would both die."

"The day that Jelena, a Red Crescent nurse who lives in my area, starting visiting us, things started to look up. She brought us food packs that were a real help, but the psychological support she gives me is even more important. After I see her I am always feeling more positive, stronger and think that things are not so bad.

“I don’t know how I would have survived if the Red Crescent had not been there," she adds.

When asked if she is hopeful for the future, Rassoha smiles widely for the first time. "It is so good to know that people care," she says. "I am almost finished with my treatment. Now I have hope for the future."