Why are we there?
- Armed conflict
- Health care exclusion
This is an excerpt from MSF-USA's 2012 Annual Report:
Years of war, the collapse of the health system, and social stigma collude to limit TB and DR-TB care in the north Caucasus.
MSF therefore works with the Chechen MOH to implement a comprehensive TB program that includes diagnosis and treatment for people with DR-TB, counseling, and special services for children and people co-infected with HIV and TB.
In Grozny, MSF works in the cardiac unit of Republican Emergency Hospital—one in six Chechens has heart disease—training staff and donating medical equipment and essential medicines. Almost 750 patients received emergency care in 2012.
MSF closed programs for women and children in three Grozny outpatient clinics after patient numbers decreased. Staff had provided some 15,700 pediatric consultations and 8,800 gynecological consultations since 2007.
Since 2002, MSF counselors have provided psychological support in remote regions of Chechnya and Ingushetia to individuals suffering from anxiety, mood disorders, and grief caused by psychological and physical violence. The program in Chechnya continues. Services in Ingushetia, however, ended in September after officials indicated that the assistance was no longer required.
MSF has been working in the Russian Federation since 1988, and in the north Caucasus since 1995. At the end of 2012, MSF had 189 staff in the region.
Khadija, 32 years old, from Grozny, is being treated for DR-TB.
“Around July, I started coughing. It happened to be Ramadan and I was fasting. My mother was very worried. My brother had been ill and so we already had an understanding of what TB was.
She told me that I should stop fasting as it lowers your immunity and I would end up getting ill like my brother. When the month ended my cough had got worse and I went to see a doctor about it.
I teach English at a school and I lost my voice completely. I live 10 minutes walk away from my work and one day I had to phone up my husband to ask him to come and drive me home. I didn’t have the strength to walk those 10 minutes.
As soon as I started treatment I started suffering from unpleasant side effects – dizziness and nausea – but now it’s getting better. The sheer number of pills I have to take makes me very depressed. I don’t have severe side effects but when I see the amount of medication I have to take it makes me really depressed.
There is a good Russian proverb: ‘A kind word heals’. Amina’s personality and manner of speaking is very calming [Amina is a TB counselor].
When she comes to talk to me, we don’t just limit ourselves to the medical questions that are on her list. She does very well! Her counseling calms me down, it helps me.
I have to live for my children, because if I’m not there their lives will be very different. It’s not the same if your mother is not beside you. I can advise other patients to have faith and hope, and not to give up; this disease is curable.”