Anne Johnstone is a medical scientist and has worked in Abkhazia.
Tuberculosis is a major public health problem in the south Caucasus where I have worked as Regional Laboratory Supervisor for the past seven months. To combat this killer disease, Médecins Sans Frontières has set up labs for diagnosis and follow–up treatment in Abkhazia and Nagorno-Karabakh. I have found it fascinating to work in two such interesting and culturally rich areas. As well as monitoring the quality of work done in the labs, I supervised and encouraged the local staff whose Ministry of Health salary ($30 a month) wasn’t much incentive to do a good job. Despite being underpaid (and enjoying more coffee breaks than I was used to!), my staff took pride in their work and achieved impressive results.
On weekends I joined the TB teams to supervise DOTS (Directly Observed Treatment Short Course) in the prison and in the hospital. The inmates infected with TB were considered to be the "lucky" ones. They were removed from the dreadful conditions of the prison and placed in the infirmary. Our visits were a welcomed relief from their daily routine, and they responded extremely well to treatment.
"Nikolai, who won my heart with his charm and humour, had been at the hospital for two years. He joked with Matthew, an Australian nurse, and myself about coming back to Australia with us to continue his twice-daily DOTS treatment!"
Our hospital patients were less amenable. They longed to escape the enforced inpatient stay of two to three months (or until they became sputum smear negative). Some patients who were multi-drug resistant had remained at the hospital for years. Nikolai, who won my heart with his charm and humour, had been at the hospital for two years. He joked with Matthew, an Australian nurse, and myself about coming back to Australia with us to continue his twice-daily DOTS treatment! After I left Abkhazia, I was pleased to learn that Nikolai did eventually respond to treatment and was finally cured. My time in the Caucasus was challenging and rewarding. It was a pleasure to work with the warm and welcoming people of this region, and I will always remember them and wish them well.
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