International Activity Report 2005
Uzbekistan

International Staff: 13
National Staff: 130

In Uzbekistan's Karakalpakstan region, near the shrunken Aral Sea, the harsh environment and lack of health care services have caused severe health problems. While tuberculosis (TB) has long been a scourge, irrational medicine use and long treatment regimes have increased the number of people now resistant to the drugs used for first-line treatment. Today, Karakalpakstan's 1.5 million residents have one of the highest incidences of multidrug-resistant TB (MDR-TB) in the world. Currently, 13 percent of all new TB patients and 40 percent of those needing treatment again suffer from multidrug-resistant TB strains.

MSF works in the city of Nukus to treat people living with MDR-TB. The treatment is demanding. To kill the bacilli that cause the disease, patients must take medicines that can have serious side effects, for 18 to 24 months. The long regimen is difficult to follow fully for many patients, especially those who move often, are homeless or are the main providers for their families.

Through this project, MSF is seeking to demonstrate that non-wealthy countries such as Uzbekistan can conduct complex treatment programs. In cooperation with the ministry of health, MSF runs the 60-bed TB Hospital #2, which was established to treat patients in the first phase of MDR-TB. During the early phase, patients are at their most infectious and require intensive inpatient treatment. MSF and the ministry also work together in a number of specialized medical clinics that treat patients in the second treatment phase. In this later phase, patients can be treated on an outpatient basis, with careful monitoring.

To prepare the hospital to facilitate their care, MSF rebuilt its outpatient polyclinics and a specialized laboratory. The team has also trained hospital personnel. In 2004, approximately 100 patients were under treatment through this program. In May 2005, after 18 months of treatment, the first two patients were declared cured.

MSF has worked in Uzbekistan since 1997.