Why are we there?
- Armed conflict
- Health care exclusion
This is an excerpt from MSF-USA's 2013 Annual Report:
MSF is working with Russian health authorities to address tuberculosis (TB) and drug-resistant TB (DR-TB) in Chechnya.
Years of conflict in the North Caucasus have left gaps in many areas of the health system, resulting in a resurgence of TB, especially DR-TB. Poor diagnosis, interrupted treatment, and the questionable quality of the TB drugs available on the open market are some of the factors contributing to high drug-resistance levels.
In 2013, MSF, together with the Chechen Ministry of Health, continued to implement a comprehensive TB diagnosis and treatment program for patients with both TB and DR-TB. The program promotes a patient-centered approach, and as the treatment is arduous and the management of side effects an important component, MSF health educators and adherence counselors provide psychosocial support to all TB patients and their families.
Expanding Cardiac Care
There is a high rate of heart disease in Chechnya, but the scale and quality of medical services do not meet the needs of those with acute coronary syndromes and other cardiovascular emergencies. In Grozny, Chechnya’s capital, MSF is improving the cardiac unit in the Republican Emergency Hospital through staff training and the purchase of medical equipment and medicines for specialized treatment. During 2013, the team conducted further training on fibrinolysis (the breakdown of fibrin, or clots) and improved laboratory procedures, as well as the quality of consultations pre- and post-admission.
Providing Mental Health Support
An MSF team continued to offer counseling to patients in Grozny and communities in the mountainous districts of Chechnya, who are still experiencing the psychological effects of exposure to violence and death.
MSF has been working in the Russian Federation since 1988, and in the north Caucasus since 1995. At the end of 2013, MSF had 153 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.”