Armenia 2013 © MSF
A ‘flying’ MSF tuberculosis (TB) surgery team has successfully completed surgery on six drug-resistant (DR) TB patients in Yeravan, Armenia – the first mobile TB surgery ever carried out by the international humanitarian medical organisation. Surgery used to be a key intervention for TB in the pre-chemotherapy era to remove part or all of a lung affected by the disease. In the 1960s, the development of new anti-TB drugs improved medical treatment outcomes and consequently reduced the use of surgery. However, the emergence of multi-drug resistant (MDR) and extensive drug-resistant (XDR) TB in recent years has seen some patients end up with minimal chances of recovery through medication alone. The relevance of TB surgery has therefore risen again but presents new challenges in high-burden TB countries. <br/>The MSF TB surgery team comprised experienced multi-disciplinary team of a thoracic surgeon, anesthesiologist, operating theatre nurse and a chest physiotherapist, who worked closely to share their skills with Armenian Ministry of Health counterparts.In addition to treating patients who acutely needed operations, the objective of the MSF surgery mission was to improve the procedures and skills of the local surgical team at Armenia’s national TB hospital. The key constraints preventing Armenian health authorities and those in many countries around the world from conducting this kind of surgery include a lack of qualified and experienced surgical staff, as well as a lack of modern operating theatre equipment. <br/>Preparation was key to the success of the visit. Well ahead of the arrival of the team, a multi-disciplinary team comprising MSF and Ministry of Health staff meticulously planned the entire process, including the careful selection of patients for operations and what would be needed in the weeks following the surgery. <br/>Following the success of the initiative, the MSF mobile surgery team aims to conduct regular visits to Armenia to continue to improve the skills and capacity of the local staff and offer patients a chance to reclaim their lives from this devastating disease.