March 22, 2010
Heaven on Earth. That’s the first impression of the vista outside the New Haven Clinic, one of 17 health centers overseen by Doctors Without Borders/Médecins Sans Frontières (MSF) in the Shiselweni region of Swaziland. At the top of a verdant hill, the clinic is not far from a village, a few dozen houses, a church, and a school surrounded by fields and prairies. In the shadow of a large tree, three women sell colorful fruits and vegetables.
At one time, TB was considered on its way to being eradicated. However, the disease, which in the past afflicted hundreds of thousands of “consumptives” in Europe and drove the most privileged of them into Alpine sanatoriums for treatment, started a frightening comeback beginning in the 1980s. The main hotbeds of this resurgence are southern Africa, southeast Asia, and central Asia—three regions where MSF teams are treating TB patients.
The return of TB to the dire honor roll of global epidemics is accompanied by an even more worrisome phenomenon: the emergence of forms of the disease that are resistant to standard drug regimens. In these cases, the treatments—antibiotics discovered in the middle of the twentieth century—are no longer effective. When confronted with the resistances developed by some patients, health workers must prescribe a much longer, more difficult treatment regimen. And recovery is not always guaranteed. “These patients receive injections every day for an average of six months, and their treatment, which is based on multiple tablets, can last up to three years with numerous side effects,” explains Dr. Hermann Reuter, an MSF volunteer in Swaziland. These side effects range from unpleasant to unbearable, or even dangerous. Several TB medicines have horrible gastric effects and may lead to sudden nausea or kidney or liver dysfunction. The only way to fight these side effects is to take even more medicines in addition to the already extremely high number of daily pills.
© 2013 Doctors Without Borders/Médecins Sans Frontières (MSF)