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Psychological Help to Bring MDR-TB Patients back to Treatment

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Consultation of the Red Crescent psychologist with the TB doctor at the Centralized Lab for Infectious Diseases / UNDP Turkmenistan

TB treatment is a very long and complicated process. Often, patients are left alone to face the disease because their community does not often understand how the disease is transmitted and what the patient is going through.

A person living with TB has suppressed immune system and must very carefully follow all instructions of the assigned treatment, adhere to the dietary prescription and regularly visit his doctor. The treatment usually takes around 6-8 months. However, there is a multi-drug resistant form of TB (MDR-TB) with the treatment period of 2 years. During those 2 years, MDR-TB patient shall take medications under the supervision of the TB doctor and regularly undergo medical checkup.

“Every year around 6 to 10 million people are diagnosed with TB. However, modern medical care allows full cure of TB under the condition that the diagnosis is made and the treatment has started on time. Nevertheless, there is another very important condition - a moral and psychological state of the patient, his will, persistence and optimism,” explains Bahar Bayramova, psychologist of the National Red Crescent Society of Turkmenistan (NRCS) – a Sub-recipient of the TB grant from the Global Fund to fight AIDS, tuberculosis and malaria (Global Fund).

Starting from 2013, the United Nations Development Programme (UNDP) in Turkmenistan and the NRCS provide support to MDR-TB patients to complete the full course of medical treatment. The support includes home visits and phone consultations with patients to confirm that they follow the prescribed treatment. Nurses also inquire whether patients experience any problems that prevent them from adhering to the treatment in which case the NRCS helps in finding the solution. The Red Crescent holds educational trainings for patients and their relatives at the “School of patients”. Starting from April 2016, the project also provides qualified psychological counseling.

“In my everyday work, I visit the TB hospital twice a week to consult with the TB doctors on the treatment and progress of the patients. Those who fail to adhere to the treatment, do not pick up their medications, miss regular checkups and demonstrate low spirits are offered psychological counseling to find solution to the issue that prevents them from taking the medications. We have capacity to support patients residing in Ashgabat and throughout all five regions of Turkmenistan,” says Bahar Bayramova.

Psychological counseling is an integral part of the treatment process for all patients. Usually, patients have family, friends and colleagues who provide moral support to them. Even then, sometimes patients go through depression because of the long process of treatment. Patients get tired and lose their motivation to become healthy. Some patients might be lonely, or because of their personality features might be in conflict with their kins, leading to a low motivation to get cured. Those patients require correction of their emotional condition to help improve their discipline and create positive thinking regarding the treatment.

“I had a patient who regularly complained about depression and fatigue. She was always irritated and had complicated relations with her husband. The patient was suggested to focus on the following: find space for her own self – concentrate on her mood, her relations with the relatives; find free time for her own self – send children to kindergarten. The patient was also advised to take long walks outside, observe the beauty of the nature around and pay attention to how unique her life is. The patient was also advised to start physical exercise. As a result of psychological counselling the patient’s emotional status recovered and she has been continuing her treatment for over a year already. Of course this is a simpler case, but we encounter more complicated cases and help patients in various situations,” shares Bahar Bayramova.

Through the individual counseling sessions and thanks to commitment of the TB doctors and nurses along with the NRCS staff, more than 200 MDR-TB patients have been returned and completed medical treatment.

Highlights

·        In 2016, UNDP project “Ensuring universal access to high-quality diagnosis and treatment of drug resistant tuberculosis (DR-TB) in Turkmenistan” was granted extended grant from the Global Fund until 2018.

·        More than 1,200 MDR-TB patients received treatment with the project grant.

·        MDR-TB diagnosis and treatment is available in all regions of the country. Patients receive medications per the standard scheme recommended by WHO.

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