Why are we there?
- Armed conflict
- Healthcare exclusion
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Our work
This is an extract from our latest Activity Report, looking back on our work in the previous year.
2012
A health crisis persists in the north Caucasus region, exacerbated by devastating illnesses such as tuberculosis (TB).
Years of war, the destruction of the health system and social stigma associated with TB have contributed to a lack of diagnosis and treatment in the north Caucasus, especially for drug-resistant TB (DR-TB).
Médecins Sans Frontières/Doctors Without Borders (MSF) has worked with the Chechen Ministry of Health to implement a comprehensive TB programme in the republic, including rapid diagnosis and treatment for people with DR-TB, those not responding to standard first-line drugs for TB.
Patients receive counselling and practical support to help them complete their lengthy, isolating and often arduous treatment. The MSF team is developing a special focus on children, as well as on HIV–TB co-infection.
Improving cardiac care
One in six people in Chechnya has heart disease but the scale and quality of medical services do not meet the needs for acute coronary syndromes and other cardiovascular emergencies.
In Grozny, Chechnya’s capital, MSF is working to improve the cardiac unit in the Republican Emergency Hospital through staff training and the purchase of medical equipment and essential medicines for carrying out specialist treatment. The number of patients receiving emergency care rose to almost 750 in 2012, as the unit increased its capacity.
Attention to mothers and children
Since 2007, MSF has provided medical care for women and children through three outpatient clinics in Grozny and rural areas in northern and southern Chechnya.
After a total of 15,700 paediatric consultations and 8,800 gynaecological consultations, MSF closed the programme at the end of 2012, because of decreasing patient numbers and low levels of disease.
Mental health support in Ingushetia ends
Since 2002, MSF teams have provided psychological support to communities in the remote, mountainous regions of Chechnya and Ingushetia, where violent conflict has had a serious impact on people’s mental health.
Counsellors have worked with individuals suffering from anxiety, mood-related problems and grief caused by psychological and physical violence, abuse and the deaths of loved ones.
The programme in Chechnya continues. Services in Ingushetia, however, ended in September. Following extensive discussions with the government of the republic, senior officials in Ingushetia thanked MSF for its efforts but indicated that further assistance through this programme was no longer required.
MSF has been working in the Russian Federation since 1988, and in the north Caucasus since 1995. At the end of 2012, MSF had 189 staff in the region.
Patient story
Khadija, 32 years old, from Grozny, is being treated for DR-TB.
“Around July, I started coughing. It happened to be Ramadan and I was fasting. My mother was very worried. My brother had been ill and so we already had an understanding of what TB was.
She told me that I should stop fasting as it lowers your immunity and I would end up getting ill like my brother. When the month ended my cough had got worse and I went to see a doctor about it.
I teach English at a school and I lost my voice completely. I live 10 minutes’ walk away from my work and one day I had to phone up my husband to ask him to come and drive me home. I didn’t have the strength to walk those 10 minutes.
As soon as I started treatment I started suffering from unpleasant side effects – dizziness and nausea – but now it’s getting better. The sheer number of pills I have to take makes me very depressed. I don’t have severe side effects but when I see the amount of medication I have to take it makes me really depressed.
There is a good Russian proverb: ‘A kind word heals’. Amina’s personality and manner of speaking is very calming [Amina is a TB counsellor].
When she comes to talk to me, we don’t just limit ourselves to the medical questions that are on her list. She does very well! Her counselling calms me down, it helps me.
I have to live for my children, because if I’m not there their lives will be very different. It’s not the same if your mother is not beside you. I can advise other patients to have faith and hope, and not to give up; this disease is curable.”
Médecins Sans Frontières first started work in the Russian Federation in 1992. In 2017, MSF wound down its projects, which focused on tuberculosis (TB), mental health assistance for victims of violence, and cardiac care
Our focus had been on multidrug-resistant tuberculosis (MDR-TB) and extremely drug-resistant tuberculosis (XDR-TB) in Chechnya, a war-torn region of the Caucuses.
Tuberculosis
Since 2004, MSF had been working closely with the Chechen Ministry of Health to implement a comprehensive TB treatment program.
MSF teams provided appropriate medication to develop more effective regiments for XDR-TB patients, in the place of failed conventional treatments. Our program included laboratory support, health promotion, and psychosocial assistance for patients and their families.
The project ensured care for XDR-TB patients with diabetes co-morbidity - regularly monitoring their blood sugar, adjusting their treatment as required, and helping them manager their condition.During 2017, the team gradually handed over its TB activities to the ministry, admitting its last patient at the end of August.
The Ministry of Health has committed to ensuring continuity of care for patients still receiving treatment.
Cardiac Care
After seven years of activity, the cardiac care project in the emergency hospital in the capital, Grozny, was closed in December 2017. During the last year, MSF focused on ensuring the technical autonomy of the interventional cardiology team.
MSF continued to support cardiac care by supplying drugs and medical equipment, improving the quality of treatment for acute patients, and training doctors and nurses.