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GeorgiaGeorgia, a former Soviet state, has high levels of poverty and in recent years has seen only marginal improvements in the standard of living.Economic stagnation and ongoing territorial disputes over South Ossetia and Abkhazia continue to threaten destabilisation of the country. Tuberculosis in AbkhaziaThe bitter secessionist war fought by the Abkhaz against Georgia in the early 1990s resulted in a political stalemate: Abkhazia has created its own government and institutions, but these are not internationally recognised and it is therefore not entitled to external donor support. MSF remains one of the few international humanitarian organizations operating in this isolated region. MSF’s Health Access program, which targets the vulnerable and elderly, operates through the City hospital in Sukhumi, Abkhazia’s capital, and supports a network of eleven dispensaries in the region. Doctors working in these facilities are given incentives by MSF to ensure they provide free drugs and consultations to the most vulnerable. An average of 2200 consultations were performed monthly in 2005. A mobile medical team in Sukhumi also visits people who are house-bound, and provides palliative care to cancer patients who have no other way of accessing pain relief. In a region adjacent to Sukhumi, MSF runs a tuberculosis (TB) and multi-drug-resistant tuberculosis (MDR-TB) program in Gulripsh hospital. Since 1999, over 1500 patients have been treated for standard TB, and innovations in 2005 included the introduction of ‘self-administered treatment’ where patients are allowed to leave the hospital after initial treatment and can continue taking medication with minimal supervision. The MSF team also attempts to help patients with MDR-TB deal with a complicated drug regimen and unpleasant side effects from treatment. When patients test negative for TB, they can go home, but must attend an ambulatory facility daily to receive medication and make monthly visits to the doctor. In 2005, a psychologist joined the program to help support individuals who have had treatment setbacks and have been hospitalised for extended periods. Working with a team of health educators, the psychologist also holds group sessions to support those in the ambulatory treatment phase. MSF has admitted 100 patients to the program since 2001. Surgical careIn Georgia, MSF provides surgical assistance to the population of the Pankisi valley, some of whom are Chechens displaced by the war. The surgical department of Akhmeta hospital and the Douisi surgical post receive drugs and materials and 30 operations per month are performed in Akhmeta. An average of 150 consultations and 50 minor surgeries are done per month in the Pankisi valley. At the end of 2005 MSF handed over a primary healthcare program in the Varketili-Vazisubani district of Tbilisi, the capital of Georgia. Six hundred patients with chronic illnesses were transferred to the care of Caritas. MSF continues to facilitate access to specialist care and surgery for patients from Abkhazia and Pankisi. MSF has worked in Georgia since 1993. |
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