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MSF in Armenia, 2011
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In Armenia, Doctors Without Borders/Médecins Sans Frontières (MSF) is supporting the treatment of patients suffering from drug-resistant tuberculosis (DR-TB).
DR-TB can be caught from someone already suffering from the disease, or it can develop when a patient with drug-sensitive TB becomes resistant to medication, which can happen if their treatment regime is disrupted.
MSF began working with Armenian authorities to improve the detection, diagnosis and treatment of DR-TB in 2005. Supporting people who have fallen through gaps in the national program – often those with social or psychological difficulties that may put them at risk of stopping treatment – is a key part of MSF’s activities.
In 2011, MSF expanded its program for children with DR-TB, and helped improve facilities at several medical laboratories. At the end of the year, 290 patients were undergoing treatment for DR-TB in Armenia.
A patient with drug-sensitive TB has to take medication daily for between six and nine months, while a complete course of treatment for drug-resistant TB can take up to two years, is much more costly, and is not always readily available.
Patients are usually admitted to hospital at first, where they are closely monitored, and even when they return home they must continue a grueling treatment regime. Many of the drugs are toxic and side effects can include headaches, vomiting and dizziness. For some patients, the treatment is unbearable.
MSF uses a range of methods to help patients cope with side effects and to encourage adherence to treatment. In addition to regular check-ups with medical staff, counselors offer support in individual or group sessions. Staff also make home visits to patients and provide food if necessary.
Shortages affecting care
Regular staff shortages in the national TB program, in particular a lack of nurses, prompted MSF to allocate more staff to patient care and counseling in 2011.
Then, in July, a global shortage of one of the key DR-TB drugs, capreomycin, resulted in an increase in the number of people put on waiting lists for treatment. MSF introduced specific counseling sessions for patients who had been on waiting lists for more than one month to explain why they couldn’t get treatment, offer advice on infection control measures and provide basic TB education.
In 2010, MSF began collaborating with the national tuberculosis program in the northern provinces of Armenia, and this initiative was expanded in 2011. The aim is to enable geographically isolated patients in the rural areas of Kotayk, Ararat and Lori to complete their treatment at home, with the support of local clinics. MSF increased cooperation with national partners during 2011, including the further handover of home-based care activities to the Armenian Red Cross.
At the end of 2011, MSF had 85 staff in Armenia. MSF has been working in the country since 1988.