China: Red Cross project contributes to preventing MDR-TB

Publicado: 23 marzo 2011 14:16 CET

Feng Wenli, 38, is racked by a fit of coughing as her husband, Li Jianbing, helps her to sit up. Her bed has been her refuge for the past year. “Every time I try to get up or exert myself, I start coughing up blood again.”

The couple’s home is strewn with boxes of medicine, but they do less and less to alleviate the symptoms of Ms Feng’s tuberculosis and, despite four stays in hospital, it seems to have worsened. Also heaped on the floor are empty packets of instant noodles. They provide inadequate nutrition, but they are almost all the family can afford, given that Mr Li rarely works now that he has his wife and elderly father to care for.

Relief in sight

Some relief is in sight though, in the form of a Red Cross Society of China pilot project. Supported by the IFRC, the project helps TB patients in this corner of Shanxi Province.

Red Cross volunteers help supervise an increased dose of medication to fight TB, while offering psychosocial support. Patients also receive supplies of nutritious food and help with transport to hospital.

The project currently focuses on people who have been diagnosed with TB and have failed to complete their treatment. Although TB treatment in China is free, patients need to pay up front for medication and claim reimbursement from their health insurance, and this – combined with transport costs – is often an insurmountable obstacle.

“For various reasons, patients fail to complete their treatment. If the treatment is not completed and the patient is not cured, patients need to restart their treatment, which increases the risk of developing a multidrug-resistant strain of the disease,” says Dr Amgaa Oyungerel, the IFRC’s East Asia regional health coordinator. “This project contributes to the prevention of MDR-TB developing.”

Neighbourly volunteers

The Red Cross volunteers have been selected from communities near the patients. This is crucial as they need to check on their patients five or six times a week to make sure they are taking their medication consistently.

In conjunction with this project, the government health authorities are providing additional drugs for TB patients who need close monitoring for regular medication and potential side effects. “Not taking the medication consistently is a major cause of TB becoming multidrug resistant,” says Li Meirong of the local centre for disease control in Changzhi City.

The volunteers receive a two-day intensive training course including role-play in dealing with patients’ doubts and fears, and how to communicate behaviour-change messages.

Set against the total number of MDR-TB patients in China and India – two of the largest countries in the world – this project is small-scale, but it is hoped that it will expand. And the hope is that while helping clients like Feng Wenli, this project will test an approach that could serve as a future model for other diseases.