From despair to hope: Surviving drug-resistant TB in Pakistan

A recurring fever indicates something more serious

Mafeefa’s journey toward healing was anything but straightforward. When she first fell ill, she assumed it was a seasonal fever. “I had a fever that kept coming back every few hours,” she recalls. “Then it lasted for two straight weeks, along with coughing and night sweats. That’s when we knew it was something serious.”

At the local hospital, she was diagnosed with tuberculosis (TB), a contagious bacterial infection that primarily affects the lungs. It spreads through the air when an infected person coughs, sneezes, or spits. Sitting beside her father in the doctor’s office, she heard the words that changed everything.

“I didn’t say anything, but my eyes filled with tears,” she says. “All I could think about was my aunt, who had TB and passed away when I was very young.”

Mafeefa’s father, however, was quick to reassure her. “He put his hand on my shoulder and said, ‘This is just a disease like any other, and it has treatment. You don’t need to worry. We will get the treatment, and you will recover soon.’“

When treatment doesn’t work

Mafeefa began treatment for regular TB, but she didn’t get better: “I wasn’t gaining weight, and my symptoms persisted.” Later, she went to another hospital where a senior doctor tested a sample of saliva and informed her that she had drug-resistant TB. Drug-resistant TB occurs when TB bacteria become resistant to at least one of the most effective TB medicines, making treatment more difficult and prolonged. The doctor advised her to visit the MSF-supported clinic in Gujranwala, assuring her that she would receive specialized care. That decision changed the course of her recovery.

“When I arrived at the clinic, they immediately took my sputum sample, did X-rays, and conducted other tests,” Mafeefa says. “I started my treatment right away,” Initially skeptical about yet another set of medicines, her doubts faded when she met TB survivors who had completed their treatment. “Meeting them relieved me a little. The staff assured me that if I followed their instructions, I would recover soon.”

Over the next 18 months, Mafeefa strictly adhered to her treatment plan, despite the challenges. “Taking medicine was difficult at first, but I never missed a dose. I kept reminding myself that this was the only way to get better.”

The stigma surrounding TB proved to be another battle. “At school, I heard people say, ‘Mafeefa is not well.’ Even my teachers suggested I stay home,” she shares. “It was discouraging, but my family always stood by me. I could tell people were uncomfortable with me wearing a mask, but I had enough confidence to ignore that. In the end, I was the one fighting this disease—why should I care what others thought?”

Pakistan’s high TB prevalence

Mafeefa’s battle is part of a much larger fight against TB in Pakistan. The country ranks among the highest in TB burden globally, with more than half a million new infections reported each year. According to the World Health Organization, an estimated 15,000 to 20,000 Pakistanis develop drug-resistant TB annually, yet fewer than 25 percent receive proper diagnosis and treatment. This gap not only fuels the ongoing transmission of TB but also threatens national health gains.

In response to this crisis, MSF has been operating a clinic dedicated to the programmatic management of drug-resistant TB in Gujranwala since 2021. The center provides free, state-of-the-art diagnostics and treatment, including rapid molecular tests like GeneXpert, which can detect TB and its drug-resistant variants within hours. But MSF’s work extends beyond medicine—it also includes psychosocial support and community outreach, helping to reduce the stigma associated with TB and encouraging patients to complete their treatment.

“One great thing I noticed at the clinic was how every department worked wholeheartedly with patients,” she says. “Doctors treated us with care, counselors listened to us, pharmacists provided medicine and motivated us to take it. Completing 18 months of treatment is difficult, but their support made it easier.

Life after beating TB

Now fully recovered, Mafeefa has resumed her education and is pursuing her childhood dream of studying law. She credits her recovery to her own determination, the unwavering support of her family, and the care provided by MSF. “The strongest thing is motivation,” she says. “When you are motivated to get treated, it works wonders.”

Mafeefa reflects on how the words of others impacted her journey. "I wish people understood that their words can be really hurtful,” she says. "When you're already feeling vulnerable and sick, harsh comments can make it even harder to stay positive. A little encouragement and support can go a long way in helping TB patients stay motivated and focused on their recovery.”

From the final pill of her treatment back to the early days of uncertainty, Mafeefa’s journey serves as both a beacon of hope and a call to action. Her story reminds us that when modern medicine and compassionate care converge, even the most formidable diseases can be conquered.