Episode: "A Long Way From Home"

CHINA | SUDAN | PERU

In this episode, Dr. Ed Chai is providing medical care and training in China. Is healthcare in China free? If so, is there a need for MSF?

Health care in China is not free. The socialist market economy that has taken root in China has had strong repercussions on health in rural communities. The cost of medical care has skyrocketed, insurance coverage has plummeted, and many skilled medical workers have fled rural areas for more lucrative work in the cities. Few rural families can afford even basic medical care. MSF focuses its attention on largely rural areas in western China, fighting infectious diseases such as AIDS and tuberculosis, offering medical attention to those families that cannot afford it, training local health workers, and providing cleaner drinking water in a number of areas.

In this episode, nurse Marg Ward is treating a patient named Mary for TB in Sudan. The treatment will last eight months. Is this typical?

Tuberculosis (TB) is a contagious infectious disease caused principally by the bacillus Mycobacterium tuberculosis. Transmission occurs when airborne droplets of TB germs, which are known as bacilli, are propelled into the air by a patient with pulmonary TB (TB of the lung).

Effective treatment for TB involves lengthy multiple-drug regimens. Proper treatment is expensive and difficult to obtain in developing countries, where it is needed most, and because TB primarily affects the poor, there is scarcely any research and development being done into new TB drugs.

The most effective strategy currently available for treating TB is DOTS (Directly Observed Treatment Short Course). The DOTS approach includes direct supervision by a health care worker of the patient's daily intake of multiple drugs for six to eight months. This is to ensure the patient's adherence to treatment and reduces the risk of developing multi-drug resistant TB (MDR-TB).

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