It is estimated that more than 7000 people are diagnosed with tuberculosis (TB) each year in Swaziland, and of these, close to 900 have multi drug resistant TB (MDR-TB). To help patients continue their treatment in spite of the often challenging side-affects including deafness and nausea, MSF help patients cope by providing in-home care when possible and offering individual medical follow up and adherence counselling, group peer counselling, transport allowances, and housing support. This extends to food packages, occupational therapy and sign language training. We use shorter treatment regimens (9 months instead of the usual 2 years), and for eligible patients, the newest drugs for the hardest to treat symptoms. These new drugs: Bedaquiline and Delaminid, are the first new tuberculosis drugs in almost 50 years, giving new hope of a cure to patients who previously had none.
“You see, I am healed. Even my legs don’t give me problems anymore. I walk around the hospital,” says an elated Tholakele as she walks around her ward demonstrating her recovery. Tholakele, 39, has DR-TB and started treatment in May 2016 at the MSF supported Moneni National TB Hospital in Swaziland. Swaziland has one of the highest rates of TB and MDR-TB worldwide while 80% of people in Swaziland who contract TB are HIV positive. Tholakele lives in Lwandle, about 15 kilometres away from the Moneni TB hospital, where she receives her treatment. For three months, she travelled by herself every day to and from the hospital for her injections, a routine she completed in August 2016. Despite this, she is not yet cured of TB and continues her treatment at home, taking tablets daily. It was while receiving injections that Tholakele suffered from severe leg pains, which eventually affected her ability to walk. Because she lived alone, and did not have anyone to help look after her, for two months, she was admitted to Moneni hospital in November 2016.
For many DR-TB patients like Tholakele, treatment is a long and gruelling two year journey involving between 15 to 25 toxic tablets every day and daily injections for the first six months. In some cases treatment can take longer if patients do not respond to the drugs. In a bid to help patients who’ve gone deaf or partially deaf from the treatment, in Matsapha eleven DR-TB patients and 30 MSF staff recently completed sign language training. “Our DR-TB patients are often confronted by deafness as a side effect from Kanamycin, one of the DR TB drugs. Because of this, they can become isolated from their families and communities. This can easily affect their social life if not faced with proper support. By empowering them with this new communication skill, we hope to reintegrate them into society,” says Fundzile Msibi, MSF’s Psychosocial Coordinator. This has proved true for Winile, an XDR-TB patient who lost her hearing in 2013, six months into her MDR-TB treatment. “I now use sign language to communicate with my children. I try to teach them what I have learned and we are able to communicate. My children are still young and they need me. Being able to use sign language will help me to continue to be a part of their lives.”