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MSF in Georgia, 2008
Field Staff: 164
Reason for Intervention:
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Doctors Without Borders/Médecins Sans Frontières (MSF) treats drug-resistant tuberculosis (DR-TB ) in Abkhazia, one of the separatist regions of the republic of Georgia, and in Zugdidi, western Georgia. In August 2008, a war erupted over another separatist region of South Ossetia, which caused thousands of people to flee the violence.
Tuberculosis (TB) is the scourge of the Caucasus region. It is estimated that 10 percent of new cases are drug resistant, but that as many as half the people who have already been treated have developed DR-TB. In 2008 an average of six to seven new patients with DR-TB were admitted every month to the Zugdidi project. Since the opening of the program in November 2006, more than 150 patients have been treated. They have adhered well to the treatment, but it is still lengthy and difficult and the drugs cause many side effects. The war in August 2008 briefly interrupted treatment for 30 percent of patients.
In July 2008 the first Zugdidi program patient completed his treatment, having taken handfuls of medicine daily for 20 months. Although it is still too early to declare him fully cured, given the risks of relapse, the fact that he finished the course is encouraging. Since then, nine more patients in Zugdidi have finished the treatment program.
In Abkhazia, MSF treats patients in Gulripsh, near the capital Sukhumi. MSF has supported the national TB program in Abkhazia since 1999 and, since 2001, has focused on DR-TB. Since then, 204 patients with DR-TB have begun treatment, 38 of those in 2008. MSF refurbished the hospital near Sukhumi and supplied it with drugs, materials, and laboratory equipment. A third of the MSF patients have few material resources and, without the psychological and social support, as well as firewood, clothes, proper nutrition, and other necessities that MSF provides, many of them would be unable to follow their treatment correctly.
MSF introduced life-prolonging antiretroviral (ARV) therapy in Abkhazia for HIV/TB co-infected patients. Currently nine patients are on ARV therapy. MSF also supports the newly opened national DR-TB programs in the Georgian cities of Tbilisi and Abastumani, providing training for local nurses and adherence counselors.
The health access program for vulnerable people in Abkhazia has been downsized. In 2008, 143 vulnerable people, mainly elderly, were registered in the program.
Assisting those displaced
Tens of thousands of people were displaced as a result of the fighting in August 2008. MSF provided health care services and psychological support in Tbilisi and Gori to people who had been forced to flee their homes. Over 30 percent of the 8,500 medical consultations dealt with chronic conditions. Many people suffered from depression, anxiety, post-traumatic disorder, and psychological problems. MSF also strove to keep patients on their DR-TB treatment programs. Though international MSF staff were evacuated due to the violence, national staff continued the program. Most of the patients maintained their treatment schedule, which is vital because any interruptions can lead to a relapse or complications.
MSF has worked in Georgia since 1993.