Chechnya: MSF Hands Over TB Dispensaries

Doctors Without Borders/Médecins Sans Frontières (MSF) is starting the process of gradually handing over its tuberculosis (TB) program in Chechnya. Gudermes district TB dispensary is the first of five TB facilities covered by the program to be handed over to the Ministry of Health.

MSF’s TB activities in Chechnya have been in place for more than five years and have supported over 3,000 patients. The program covers the entire republic, providing support to five district TB dispensaries in Chechnya: Gudermes, Nadterechny, Shali, Shelkovskoy, and Grozny.

Although MSF teams did not treat TB patients directly, they supported the Ministry of Health staff in the dispensaries by training health care workers on standard protocols for TB diagnosis and treatment monitoring, as well as on registration and reporting in TB facilities.

Since 2004, 603 patients have been admitted to the program in Gudermes district. By the end of 2008, 480 patients had completed their treatment. MSF teams provided counseling and health education to patients and their relatives. To raise awareness about the disease, staff organized annual activities, including events for World TB Day in March.

Four facilities to support outpatients’ adherence to treatment, and where patients receive their medicines, were also opened in the district. These Directly Observed Therapy (DOT) corners are controlled by MSF specialists and referred to as “DOTS-monitors”. Their work combined with the efforts of educators and Ministry of Health staff have ensured a successful treatment rate at about 90 percent while reducing the percentage of the district’s default cases to a minimum.

MSF has also provided quality drugs for treatment, laboratory consumables, and food for patients and staff, ensured minimum water and sanitation standards in the health facilities, and implemented infection control measures and health care waste management.

Due to the success of the program and the existing capacity of the Ministry of Health, MSF is planning to gradually hand over program activities in Gudermes, starting in October 2009, to the Ministry of Health. The handover of four district dispensaries in Chechnya will continue throughout 2010, and the pace will depend on progress achieved and regular monitoring and review of the program. MSF program activities in the Republican TB dispensary in Grozny will continue.

MSF has worked in Chechnya since 1994. MSF current activities include TB program, psychosocial assistance focused on chronic trauma and primary health care.