medecins sans frontieres

medecins sans frontieres

  • MSF Fact Sheet: Malaria

    What is Malaria?

    Malaria is a parasitic infection transmitted from person to person by the bite of infected female Anopheles mosquitoes. These mosquitoes usually bite from around dusk to dawn. Once transferred to the human body, the infection travels to the liver where it multiplies and then enters the red blood cells. Inside the red blood cells the parasites multiply rapidly until they burst releasing even more parasites into the blood stream.
     
    Malaria begins as a flu-like illness, with symptoms first occurring 9-14 days after infection. Symptoms include fever (typical cycles of fever, shaking chills, and drenching sweats may develop), joint pain, headaches, frequent vomiting, convulsions and coma. Malarial death may be due to brain damage (cerebral malaria), or damage to vital organs.  The reduction of red blood cells can cause anaemia.
     
    There are four main species of the malaria parasite: P. falciparum, P. malariae, P. vivax and P. ovale. P. falciparum is the main cause of severe clinical malaria and death.
     
    It is possible to be re-infected with the same strain of malaria a number of times, as minimal resistance (and protection) is provided by previous infection.
     
    Severe Malaria

    If simple malaria is left untreated it can become severe;around 8 million malaria cases progress to severe malaria annually. Severe malaria, usually caused by the Plasmodium falciparum, causes organ damage and leads to death if untreated.
     
    People suffering from severe malaria are more likely to experience convulsions and coma. This can cause damage to organs including the brain, lungs, kidneys and blood vessels. If early diagnosis is not performed and effective drugs are not available for the treatment of severe malaria, the infection can rapidly become life-threatening.
     
    The majority of deaths due to malaria are due to severe complicated malaria. Children and pregnant women are the most at risk.
     
    Treatment and Prevention

    Currently, artemisinin-based combination therapy (ACT) is the most effective treatment for malaria caused by Plasmodium falciparum. ACTs are a combination of an artemisinin derivative (artesunate, artemether or dihydroartemisinin) and a partner drug. The choice of the combination is based on the efficacy in the area, as well as other aspects such as the national protocol and the (expected) effectiveness. ACTs work quickly and have few side effects.
     
    For uncomplicated malaria, the treatment is a three-day course of ACT. For severe malaria it is injectable artesunate.  Artesunate reduces the risk of death by 39 percent in adults and 24 percent in children. In 2010, World Health Organisation (WHO) guidelines were altered to recommend the use of artesunate, a derivative of artemisinin, for the treatment of severe malaria in children.
     
    In 2011, MSF treated 364,848 patients in outpatient departments and 10,503 in inpatient departments for malaria. The majority of these cases were severe, and half of them were treated at Baraka hospital – one of our projects in Democratic Republic of Congo.
     
    In many countries, MSF piloted the introduction of ACT and malaria Rapid Diagnostic Tests (RDTs). Since 2002, MSF has been advocating for systematic parasitological confirmation of diagnosis of malaria before treatment to ensure proper diagnosis and treatment of all patients. Since 2010, this has been integrated into WHO guidelines, but it is still yet to be integrated into many national protocols.
     
    Long lasting insecticide-treated bed nets are an important means of controlling malaria. In endemic areas, MSF systematically distributes nets to pregnant women and children under the age of five, who are most vulnerable to severe malaria with staff giving patients advice on the most effective way to use the net.. In 2011, 171 650 bed nets were sent to the field to be distributed to those most at risk
     
    Indoor residual spraying is implemented in all our health facilities and in the houses of some of the local communities.
     
    Educating communities about malaria and its symptoms and teaching them how to use their bed nets and what they should do after their houses have been sprayed with insecticide is an important part of prevention.
     
    Despite ongoing research, there is no vaccine against malaria.
     
    Children with malaria

    In areas where the malaria infection rate is high year after year, morbidity and mortality fall mainly on children and pregnant women. Children are particularly at risk for severe malaria as their immune system is less developed. If not treated quickly it can cause a coma with the chance of long-term neurological damage. Furthermore, children often suffer from anaemia due to malaria, leaving them vulnerable to other diseases.
     
    Pregnant Women with malaria

    Pregnant women are also particularly at risk of developing severe malaria.  WHO estimates that 1 in 10 maternal deaths can be attributed to malaria, and that each year 200,000 babies will die because their mother is infected with the disease.
     
    There is increasing evidence of the danger of malaria in pregnancy for the woman and her unborn child, both for whom, it can cause life-threatening complications. For the woman these complications could be anaemia or miscarriage; for the unborn child, low birth weight or premature birth. 
     
    Due to this we regularly test all women in our antenatal clinics for malaria, and provide them with two bed nets at their first visit.
     
    Price List

    The Cost of Malaria Prevention and Treatment Material  (*prices as of November 2011)
     

    Bed Net €4 Long-lasting insecticide-treated bed net
    Spray €0.40 to €1.60 Insecticide spray that provides six months effective protection against the infected mosquitoes
    Tests €0.40 Rapid diagnostic test for malaria

    Medicines
         
    Simple Malaria

    €10 ACT pills to cure 13 adults with uncomplicated malaria in three days
    €0.31 Three-day course of ASAQ or €0.36 for Coartem for babies (2-11 months)
    €0.35  For three-day course of ASAQ or €0.72 for Coartemfor children (1-5 years)
    €0.54  For three-day course of ASAQ or €0.95for Coartem for an older child (6-13 years)
    €0.77 For a three-day course of ASAQ or €1.05 for Coartem for an adult
    Severe Malaria

    €2.30  Treatment for severe malaria is artesunate via injection for a child

    Depending on the local situation regarding procurement of medicines we use ASAQ, Coartem, or other ACT combination

    For more information contact:

    Kate Ribet
    Communications Officer
    Médecins Sans Frontières / Doctors Without Borders (MSF)
    Tel: +27 (0) 11 403 4440
    Fax: +27 (0) 11 403 4443
    E-mail: kate.ribet@joburg.msf.org
    Twitter: twitter.com/MSF_southafrica
    Facebook: facebook.com/MSFsouthafrica

    For more about MSF South Africa, refer to www.msf.org.za.

  • Know About Medecins Sans Frontieres/Doctors Without Borders (MSF)

    Médecins Sans Frontières/Doctors Without Borders (MSF) is an international, independent, medical humanitarian organisation committed to two objectives: providing medical assistance to people affected by armed conflict, epidemics, healthcare exclusion, natural and man-made disasters, and speaking out about the plight of the populations assisted. MSF offers assistance to people based only on need and irrespective of race, religion, gender or political affiliation.

    Founded in 1971 as a not-for-profit organisation, today MSF is present in more than 60 countries, where thousands of MSF doctors, nurses, logisticians, water-and-sanitation experts, and other medical and non-medical professionals work together to bring essential health services to people caught in humanitarian crises. Services and activities include provision of emergency medicine, response to epidemics, war surgery, nutrition and vaccination campaigns, operating feeding centers for malnourished children, mental health care and support to hospitals and clinics.


    In emergencies and their aftermath, MSF provides essential health care, rehabilitates and runs hospitals and clinics, performs surgery, battles epidemics, carries out vaccination campaigns, operates feeding centers for malnourished children, and offers mental health care. When needed, MSF also constructs wells and dispenses clean drinking water, and provides shelter materials like blankets and plastic sheeting. Through longer-term programmes, MSF treats patients with infectious diseases such as tuberculosis, sleeping sickness, and HIV/AIDS, and provides medical and psychological care to marginalised groups such as street children. MSF is often one of the first humanitarian organisations to arrive at the scene of an emergency. Its large-scale logistical capacity ensures that MSF emergency teams hit the ground with the specialised medical kits and equipment they need to start saving lives immediately.

    Independent Humanitarian Action

    MSF's decision to intervene in any country or crisis is based solely on an independent assessment of people's needs and not on political, economic, or religious interests. MSF does not take sides or intervene according to the demands of governments or warring parties.

    MSF volunteers frequently work in the most remote or dangerous parts of the world. When crises unfold, they make themselves and their skills available on short notice, usually dedicating six to 12 months to each assignment. Their expenses are covered and they receive a modest stipend. MSF teams are composed of international volunteers and other skilled local staff. Together, they work closely with national medical professionals and cooperate with other aid organisations.

    Speaking Out to End Suffering

    MSF unites direct medical care with a commitment to speaking out against the causes of suffering and the obstacles to providing effective assistance. Its volunteers raise the concerns of their patients with governments, the United Nations, other international bodies, the general public and the media. In a wide range of circumstances, MSF volunteers have spoken out against violations of international humanitarian law they have witnessed from Chechnya to Sudan.

    Based on its field experience, MSF is addressing obstacles preventing people in the developing world from obtaining affordable, effective treatments for diseases such as HIV/AIDS, malaria, and tuberculosis. Through its Campaign for Access to Essential Medicines, MSF advocates for lower drug prices, stimulate research and development of new treatments, and overcome trade and other barriers to accessing treatments.

    Worldwide, MSF raises public awareness of the plight of people at risk. The organisation sends field volunteers and staff to speak at international and national conferences, and arranges informational events and traveling exhibitions. Special public education projects have addressed the stark realities of living without access to medicines, the devastation caused by malnutrition, and the hardships of life in a refugee camp.

    Financial Independence and Accountability

    To maintain its operational independence and flexibility, MSF relies on the general public for nearly 89 percent of its operating funds. The remaining 11 percent of funds come from international agencies and governments. The organisation counted more than 3.8 million individuals, foundations, corporations, and nonprofit organisations among its donors worldwide in 2009. In 2009, MSF's worldwide income was €665.5 million.

    For more about the Médecins Sans Frontières/Doctors Without Borders, refer to www.msf.org.

  • Five Lives: Getting on to Effective TB Treatment Earlier

    ‘Five Lives’ are the stories of people that Médecins Sans Frontières/Doctors Without Borders (MSF) works with every day, whose health and lives often hang on a simple medical intervention.

    These personal experiences are a snapshot of the unnecessary suffering MSF medical staff see first-hand daily in places where people can’t get adequate medical care and that could be avoided with proper, sustainable funding and investment.

    Download a copy of the briefing 'Five Lives: How a Financial Transaction Tax Could Support Global Health'

    We’re doctors and nurses, not bankers, but we can see how investing in real futures - like the futures of the people profiled here - will transform the lives of those made vulnerable through illness, and create a strong foundation for their families and their communities to build on.

    That’s why MSF supports calls to direct a small but permanent portion of a new financial transaction tax (FTT), proposed by some governments, to meet global health needs. 

    A regular stream of funding would help provide some funding to address unchecked health crises around the world.

    The accounts told here of individuals that have benefitted from a medical intervention, might be just a drop in the ocean, but what we see in their story is the possibility of an amazing impact if the interventions that saved their lives could be made available on a wider scale. An allocation of proceeds from the FTT for global health could help make that possible.

    ife 3: Phumeza



    South Africa 2011 © Samantha Reinder


    " I had so many different tests but they still couldn't see what was wrong. I just got more sick."

    At 21 years old Phumeza should have her whole life to look forward to. Right now she’s confined to a bed in a tuberculosis (TB) care centre in Khayelitsha near Cape Town, on treatment for the most virulent form of TB currently known –  extensively drug-resistant TB, or XDR-TB. 

    Last year for the first time in 10 years the number of people dying from TB worldwide dropped but still every year we miss diagnosing and treating around three million cases of TB, and half of those people die as a result of not being treated. So many people with this curable disease fall through the net because, until recently, the tests to confirm that someone has active TB or not have been so completely inadequate

    Now, a new test using molecular technology is clearing the path for getting many more people on the treatment they need earlier.  It’s still only a start -  too many patients will still be kept waiting for a diagnosis so they can get the treatment they need but some first steps have at least been taken to improve TB diagnostics.
     
    Phumeza doesn’t know how she contracted TB, she thinks it could have been on a crowded bus or at school. She knows she felt ill and that no-one could tell her what was wrong. So began a long and painful journey of misdiagnosis and waiting while she just got sicker and sicker. “At first, they gave me aspirins and paracetamol” says Phumeza. “. They didn’t see any TB on the smear they took. I had so many different tests but they still couldn’t see what was wrong!  I just got more sick.”

    Finally, nearly two months later Phumeza was diagnosed in hospital with MDR-TB (multidrug-resistant TB) by which time she was so ill she was forced to drop out of school. “Sometimes I didn’t know whether I was coming or going,” she says of the experience.

    This agonising wait could have been much shorter had Phumeza’s nurses had access to a new desktop diagnostic machine, that has since arrived in Khayelitsha's clinics. The device can diagnose drug-resistant TB within just two hours - older diagnostic methods take up to four months to confirm drug-resistant TB and many patients have died, while waiting for a diagnosis that arrived too late.

    “This new test is so empowering”, says MSF’s medical officer Dr. Ian Proudfoot, who works at the Ubuntu clinic in Khayelitsha where the new test is being trialled. “It’s completely the opposite of the immense sense of powerlessness you feel when…you’re seeing a patient dying in front of you and are absolutely powerless to do something about it because you don’t have a diagnosis."

    Phumeza herself is now on the treatment she needs finally. But she’s reassured the test will spare others in her position the agonising wait in future by delivering quicker and more accurate results.

    "I don't blame the doctors for not diagnosing me earlier - the smear test couldn't give them the right results. But this new test will save lives."

    What it costs to diagnose and cut the time to life-saving TB treatment:
    • One test cartridge of the new test costs at best US$17 and the each machine is priced at $17 000 in developing countries. Those costs are still very high for developing countries and efforts must be made to reduce them and come up with a test that is equally well performing but cheaper;
    • Treatment for drug-resistant TB can be up to almost US$9 000 - nearly 475 times more than a US$19 treatment course for drug-sensitive TB;
    • The funding shortfall: WHO estimates that for 2012 there is US$1.5 billion shortfall to prevent, test, and treat TB properly;
    • US$1 billion is needed for research and development for better tools including the development of a rapid and more affordable point-of -care TB test and new and better drugs.

    In 2010, MSF treated close to 30 000 people for tuberculosis. This includes 1 000 people with drug-resistant TB across 15 countries.

    For more about 'Five Lives: How a Financial Transaction Tax Could Support Global Health', refer to www.msf.org.za/publication/five-lives-how-financial-transaction-tax-could-support-global-health.

     

  • MSF Names Two Spanish Abductees, Crucial Medical Activities Stopped

    On 13 October 2011, an Médecins Sans Frontières/Doctors Without Borders (MSF) team suffered an attack in Dadaab, Kenya. One of the MSF drivers, Mohamed Hassan Borle, 31, was injured during this attack. His medical condition is stable, he is out of danger and remains hospitalised. Two international staff, both Spanish, were taken. As yet, MSF has not been able to establish contact with the two staff taken. A crisis team has been set up to deal with this incident.

    The two Spanish colleagues abducted are Montserrat Serra, aged 40, from Girona (Palafrugell) and Blanca Thiebaut, aged 30, from Madrid, both working as logisticians for MSF in the Dadaab Refugee Camp. Their families have been informed. MSF is calling on all media to respect the privacy of the families in this difficult time.
     
    "We are in regular contact with the families of our colleagues involved and relevant authorities since the first moments. We are doing all we can to ensure their safe and swift return. Our thoughts are with them and their families", says José Antonio Bastos, president of MSF in Spain.
     
    Following the attack, MSF has evacuated part of its team working in Dagahaley and Ifo, two of the three refugee camps in Dadaab. As a consequence, crucial medical activities had to be stopped. However, MSF is still maintaining its life-saving activities.
     
    This attack is jeopardising the assistance to thousands of people in urgent need of humanitarian aid and a quick and satisfactory solution is necessary.
     
    These incidents call for prudence and discretion. In order to facilitate the best and swiftest resolution of the incident, MSF will not provide further information for the moment nor will it comment on statements, rumours or public information related to it. MSF is also calling on all actors involved to refrain from commenting publicly about this incident. “The current publicity around the incident is particularly unhelpful, for it can only hurt the families and jeopardise efforts to get our colleagues back”, says Bastos.
     
    MSF started providing medical assistance in Dadaab in 2009.

  • MSF Makes its Submission to South African National AIDS Council for the New National Strategic Plan

    The most important document guiding government’s response to HIV in South Africa is the National Strategic Plan for HIV, AIDS and STIs (the ‘NSP’). This document is South Africa's ‘HIV Constitution’, defining national objectives and commitments on HIV treatment and prevention. 
     
    The current NSP (2007 – 2011) will expire at the end of this year. Médecins Sans Frontières / Doctors Without Borders (MSF) has been coordinating an advocacy project to ensure that crucial objectives, including the expansion of antiretroviral therapy to all people who need treatment, and the decentralisation and integration of TB/HIV services to community level, are included in the next NSP. 
     
    Here is MSF's formal submission to the South African National AIDS Council on Draft Zero of the NSP. The objectives included here are being presented by MSF advocacy staff to civil society partners at a public consultation from 5-7 September 2011 in Pretoria.

    For more about Médecins Sans Frontières / Doctors Without Borders, refer to www.msf.org.za.

  • Almost All of the Hospitals Around the City are Receiving Wounded

    A three-person Médecins Sans Frontières/Doctors Without Borders (MSF) team is currently in Tripoli with supplies and is starting to support facilities that are already overwhelmed with patients wounded in the fighting currently taking place in the Libyan capital. MSF has also dispatched teams to Zlitan, east of Tripoli, and Al Zawiyah, to the west, to support hospitals faced with an influx of wounded. Speaking from Tripoli, Jonathan Whittall, MSF Emergency Coordinator, describes the situation on the ground.
     

    Jonathan Whittall
    Jonathan Whittall. Photo: Zethu Mlobeli/MSF

    What is the situation like right now?
     
    What we’re dealing with at the moment are health facilities in Tripoli that were already stretched even before the clashes erupted this week. Hospitals had shortages of personnel, due to the fact that many foreign medical staff who worked in the health system had already fled Libya. And hospitals had shortages of medical supplies because of the sanctions imposed on the country. The health system was already struggling to deal with the wounded coming from the frontline outside of Tripoli.
     
    For the last three weeks, medical staff have been focusing almost exclusively on emergency cases and just haven’t been able to deal with any other medical problem the population has faced such as chronic diseases, emergency C-sections, and other medical conditions. The care really just hasn’t been available. When you add this to the clashes and fighting that’s broken out this week in Tripoli — and it has been extremely intense in some parts of the city — then you have a situation where already overstretched hospitals are trying to cope with the influx of wounded, and they just don’t have the support they need in terms of personnel or supplies.
     
    What is the situation like in the hospitals you have been able to assess?

    Almost all of the hospitals around the city are receiving wounded, but some of the hospitals have not been accessible due to the fighting, which means that other hospitals have an added burden. Now that the city is beginning to calm down a little bit, the hospitals are beginning to deal with the patients who weren’t able to reach them before. That’s not only the recently wounded, but it’s also the injured who have been too afraid to travel by road, along with other emergency cases.
     
    The hospitals that I’ve visited since the clashes started are often quite chaotic scenes with many doctors and nurses unable to reach the hospital because either they live in areas that are still not secure or they can’t travel through the city from one side to another. There’s a shortage of health workers inside the facilities, but there is a huge number of people who are responding as volunteers and who are going to the hospitals to try and support and assist where they can. But this is creating quite a chaotic environment.
     
    The hospitals that I’ve been to have been full of wounded – gunshot wounded – in the emergency departments as well as the other wards. In one health facility that I visited, they had converted some houses next to the clinic into an inpatient department. For example, in the one house I went into, patients were lying on the floor, lying on the desks that were left inside the house and had been converted into a makeshift ward for patients to stay. But because of the shortage of staff, there was no nursing staff and the patients were essentially caring for themselves. In another facility, I saw wounded people waiting outside the hospital to get into the emergency room.

    Are there other obstacles to providing aid beyond the fighting?

    The problem that’s facing ambulances is that there’s a massive fuel shortage in Tripoli. The fuel is not able to come in yet across from Tunisia. This is a big concern because electricity is very sporadic, so generators are being used to run hospitals, but hospitals have quite limited reserves of fuel.

    How is MSF responding to the situation?
     
    The medical situation requires a very quick response, which is why we’re bringing in additional teams and supplies. More staff arrived with supplies and more will come tomorrow. We will start supporting health facilities immediately. There are still clashes happening in parts of the city today and this will definitely have an impact on the medical needs.
    The health facilities are stretched, but by no means are they completely collapsed or not functioning at all. Health workers are treating the injured, they are responding to the needs of their community, but they are, of course, facing massive challenges. It’s not a matter of competence or willingness. It’s a matter of needing the support to be able to better address the very urgent and overwhelming needs they’re faced with.
     
    Has there been any let-up in the intensity of the fighting?
     
    Now it’s quieter. Three days ago I wouldn’t have been able to talk to you on the phone because of the constant gunfire and shelling outside. Today the fact that I can speak to you without hiding behind a wall is a progress.
     
    But it’s such a fluid situation, such a rapidly evolving situation. It’s been four days now and I can’t begin to explain the changes I’ve seen in Tripoli. It’s been extremely quick, the way in which the violence erupted within Tripoli and the way in which the city is now changing. We have to remain extremely vigilant in how things develop in the coming days.

    In one of the hospitals that we haven’t been able to access because of ongoing fighting, we’ve heard of a critical situation with patients who are unable to be seen by medical staff because they can’t reach the hospital and because of fighting happening in the areas around it. It is absolutely essential in the coming days that all hospitals need to be accessible to patients. Health workers must be allowed to reach medical facilities and the sanctity of these structures must be respected by combatants on all sides of the fighting.

    About MSF:

    MSF is an international medical humanitarian organisation that has been working in Libya since February 25, 2011. To ensure the independence of its medical work, MSF relies solely on private financial donations to fund its activities in Libya and does not accept funding from any government, donor agency, nor from any military or politically affiliated group. Today, the MSF team in Libya is made up of 44 Libyan staff and 30 international staff and is currently providing medical care, mental health care, surgical services, and pharmacy support in the cities of Tripoli, Misrata, Zlintan, Yefren, and Benghazi.

    Listen to an audio interview with Janathan Whittall, MSF Emergency Coordinator in Tripoli. He describes the huge pressures on medical staff and hospitals in the Libyan capital as they struggle to cope with high numbers of wounded patients. There is also a critical shortage of fuel needed for ambulances and generators.

    For more updates on MSF's emergency response in Libya, refer to www.msf.org.za.

  • When My Little Brother Asks About Our Mother, I Tell Him She Went to the Market

    Some 3 000 sub-Saharan Africans are stranded in camps at the Tunisian border with Libya. Most had fled violence or repression in their own countries in search of work in Libya. Due to the war, they had to flee. But due to the situations in their native countries, they cannot be repatriated, and are therefore stuck where they are, their futures uncertain.

    Many had been detained while they were in Libya. Others have lost relatives - parents, husbands, wives, or children. Some were physically injured. Some have endured severe psychological trauma. And now tensions are building in Shousha, the unsurprising result of the collective circumstances of the people in the camps. Despite past experiences, many would actually prefer to go back to Libya. Despite the dangers, many would rather risk the perilous and sometimes fatal journey across the Mediterranean to Europe.

    MSF has been working in the camps for several months, offering medical and psychological care, and collecting testimonies such as this one:
    Emmanuel, 15 and Jacob, 3, from Nigeria, lost their mother after a boat on its way to Italy capsized.

    “We were living with our mother in Libya for the past five years. She owned a hair salon in Tripoli.

    When the crisis began in Libya, everything was destroyed. We decided to flee the war and cross the Mediterranean Sea to start a new life in Italy, where one of our uncles lives.

    We took a ship at the end of May, but our trip went badly wrong. We spent six days lost in the sea without food, nor water. Some people drank sea water. People started dying.

    After six days, the ship hit a rock and capsized. Tunisian fishermen boats saw us and two bigger ships came to our rescue, but it was already too late for many of us.
    I was wearing a life-jacked and managed to swim, holding my little brother Jacob. But my mother did not wear one. We cannot find her.

    We were taken to the port of Sfax and brought at the Tunisian-Libyan border. There, we received food, water and clothes.

    But we want to find our mother. We don’t know where she is.

    Place for hope in Italy?

    Now the two of us live in a camp. We don’t know where our father is. Our parents divorced a few years ago. He may be in Egypt. We have an uncle in Italy, maybe they can help us to get there. At least our lives would be ok there.

    Jacob doesn’t understand what is going on. When he asks about our mother, I tell him she went to the market and has yet to return. That’s the only way I find to calm him down. He wants to see our mother. We cannot go back to Nigeria. There is nobody to take care of my little brother there. I want to go to Italy, because that is where we have someone.

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  • Fully Sick Rapper and the Blogging Crew Turn Up the Volume on MDR-TB

    Hi all,

    When I was first diagnosed in hospital, I didn’t know a whole lot about TB. In Australia it’s very rare, and although I had seen people in movies with TB, or heard of people dying from it many years ago, I had no idea of what it would mean for me that I had been diagnosed with it. I did a lot of Google’ing and reading online, which was a pretty scary experience. The Internet is full of figures, facts, and lots of bad stories. There are statistics that show people dying in the millions, as well as heaps of pictures of people and places that have been ravaged by the spread of the disease.

    Needless to say, the picture only got worse when I was reading about DR, MDR and XDR cases of TB. When the doctors told me that I had MDR-TB, the seriousness of my situation was amplified, and I realised that I was in for a long recovery.

    I wanted to steer away from the negative press, and the horror stories that seemed to fill the pages online, but at the same time needed to learn more about my situation and the things that I could do to ensure I would be in the best position to fight the disease. The best way to be able to learn about what I should do, and what I was in for, would be to talk to other TB patients and hear about their experiences, as well as share my own along the way. There is something about shared experiences that help you stay positive. I suppose it’s nice to know that you are not alone, that there are people out there having positive outcomes, and that you have the support of other people. Particularly when you are isolated for such a long period of time.

    Your friendships are placed under enough pressure as a result of the isolation and the fact that you feel like you’re becoming a fulltime patient, so you don’t want to always be venting about your health to your friends. You only get so much time to talk with them, and since you are trying to not let “being a patient” take over your personality, you don’t want to always be leaning on your friends and family. It doesn’t feel good for the dynamic of those relationships. If you are always talking about how hard it is living in a hospital, or eating a handful or drugs every day that make you feel like s***t, it doesn’t feel like you are moving your own real life relationships forward.

    In saying that, if you are in the active stage of TB, it’s also important to let your friends and family know when you have it. If you start keeping it a secret, or are too scared to tell even those closest to you, then it maintains the stigma that it is untreatable, or that people with TB are dirty. When someone is receiving the right treatment, and taking all of their drugs, there is nothing for anybody else to be worried about. Once the active stage of the TB has finished, and a doctor has cleared you officially, you can’t pass it on to other people, and won’t be any danger to your friends, family or community.

    So when I was hospitalised, I was trying my best to find places that I could hear other patients talking about their own experiences, but there were only a couple of websites I could find where people shared their own TB stories. Most of the better sites cover broad medical situations, and it was rare that I would find people talking about TB or their own personal experiences with it.

    I was lucky that because of the online Fully Sick Rapper videos I made, people from all over the world started contacting me directly through Youtube and Facebook. I began to have lots of conversations with strangers from the other side of the world, and lots of people were writing me online telling me about their own situations, so it was kind of like support counselling for me. Many people aren’t so lucky, and it is very important that throughout your treatment, you understand that it is very curable, and that there are a lot of happy success stories out there. People who finish their treatment, and comply with their drugs, generally have positive outcomes. When you’re at your lowest point, it is really nice to grab hold of any positive stories, and take advantage of anything that makes you feel hopeful. It’s always good to know that you’re going to be okay!

    So when Médecins Sans Frontières asked me to write on this Blog and share some of my own experience with TB, I logged strait on and started typing, because I think that it’s important for people with TB to see that there are other people out there who are going through, and have been through, the same thing that they are. I hope that by reading about my own situation, it helps you feel better about your own. Please feel free to write any questions or comments below, and I will do my best to write back to you.

    It has now been 18 months of taking my medicines, and I have complied in every way, shape and form to the treatment. I’ve not missed a single dose in the time that I began treatment, I’ve not had a single night where I have had more than a drink or two, and I’ve tried my best to eat as healthy as possible. I have got two weeks left of my medications, so here’s to hoping it’s a happy ending!

    Christiaan, AKA the Fully Sick Rapper, was diagnosed with tuberculosis in December 2009. In 2010 it was discovered that Christiaan actually had multidrug-resistant tuberculosis. After spending nearly seven months in isolation, plus many more taking a host of TB drugs, Christiaan is nearly at the end of his treatment.

    To read more real stories of people living with multidrug-resistant tuberculosis from the TB&ME blog, refer to http://msf.ca/blogs/tb.

    For more about Médecins Sans Frontières / Doctors Without Borders, refer to www.msf.org.
  • My Life With HIV: A Photographic Project

    Charles Sako, Catherine Atieno and Siama Musine live and work in Kibera, a deprived area of Kenya’s capital Nairobi. They are also all HIV positive and receive treatment through Medecins Sans Frontieres/Doctors Without Borders' clinic in Kibera.

    Six years ago, they were given disposable cameras for a week to document their lives on HIV treatment. From those photos, MSF created a project called ‘My Life with HIV’.

    Now, to coincide with a United Nations Summit on HIV/AIDS in New York, we’ve been back to visit them and to hear how their lives have moved on.

    The latest scientific research shows that treating people with HIV/AIDS not only saves lives but also can prevent the virus from spreading. The full, busy and vibrant lives you’ll see portrayed here are the living proof of the benefits HIV treatment has brought to individuals, their families and wider communities.

    Visit: www.msf.org.za to learn about the MSF's work around the world.

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