Kazakhstan: Leading by example in the fight against TB

Published: 23 March 2009 0:00 CET

Amanda George, British Red Cross, in Kazakhstan

Rosa, a former client of the Kazakhstan Red Crescent, contracted HIV through drug use and later caught tuberculosis (TB) in prison following a drug-related conviction. Today, the 48-year-old woman is the team coordinator for the Kazakh Red Crescent TB/HIV co-infection project in the country’s biggest city, Almaty.

Because of her personal history, Rosa understands perfectly what the Red Crescent clients have to go through - after her release from prison, she was successfully treated for TB. Then she decided to help those going through the same ordeal.

Rosa’s confidence has been boosted enormously since she began her job as team coordinator and gets great satisfaction out of being able to help others. ”Before I was just a drug user. Now I am more confident and have developed my own personality. Now I want to stay alive."

Facing stigma

Rosa still faces stigma because she is HIV positive. She has not told her daughter about it, even though three other family members are living with the virus.

"What I find hardest," she says with tears in her eyes, "is that although I am Kazakh and born in Almaty, I can not get Kazakh citizenship and only hold a Russian passport. This is because they ask for a certificate of health and I will fail the test. However I am lucky to have this job, because many others will find it impossible to find employment without a health certificate."

In a typical day, Rosa helps up to 20 people living with TB and HIV - including ex-prisoners, sex workers and injecting drug users. The Kazakh Red Crescent’s novel approach to support treatment is based on multidisciplinary teams of professionals that include a social worker, a lawyer and a psychologist. Rosa’s work includes psychosocial support, employment assistance, medical escort and assignment to rehabilitation centres. The job is anything but easy.

Treatment regime

”We face different obstacles in our daily work," she says. "For instance, many injecting drug users with TB break the treatment regime, and adhering to the treatment is essential. We work hard to persuade them to stick to it, but results are not guaranteed."

Rosa is a firm supporter of the work of the Red Cross Red Crescent. She has noticed a great improvement in the attitude and social integration of people living with co-infection.

"We used to have to actively look for people and invite them to visit our office to begin treatment and see the doctor. Now people with these specific needs come to us by themselves," she says.

Programme manager Sholpan Ramazanova says: "The Red Cross Red Crescent targets the most vulnerable people with the aim of preventing the further spread of HIV and TB.

Seeing the results

"TB is the biggest killer of people living with HIV. Our programme saves lives by helping people get through long treatments and supporting them in the face of social stigma. The programme is fairly new, but we are already seeing results."

Rosa believes that the most important aspect of the TB programme is its educational and information dissemination component.

"It is essential that people are aware of the risks of TB and HIV; how to prevent them, how to get treatment and how to support those who live with TB and HIV," Rosa says.

"When my daughter was at school they had special classes on TB and HIV prevention and how to lead a healthy lifestyle. Looking at her completing her homework, I thought that if I had been aware of risks and preventative measures earlier, I would probably not have contracted it myself."