Speranta Terrei is featured in “Tuberculosis: Voices in the fight against the European epidemic,” a report published in September by ACTION (Advocacy to Control Tuberculosis Internationally) and the TB Europe Coalition (http://c1280352.r52.cf0.rackcdn.com/FINAL_TB_VOICES_EUROPE_REPORT.pdf). The report contains stories and photos from 7 European countries to highlight the human face of TB. Our very own Feodora Rodiucova (Dora) speaks of why treatment support should become the norm and not the exception for Moldovan TB patients. Igor Tcaci, Speranta Terrei’s coordinator for ex-prisoners and a cured MDR-TB (multi-drug resistant tuberculosis) patient, describes the sense of alarm when a patient hears the diagnosis and the psychological healing that must be part of the treatment.
Our psychologist, Lica Jicrivetcaia, is much in demand by TB patients. She says listening to patients is critical, to allow them to express their anxieties and fears. She explains the purpose of psychotherapy is to reduce fear and to restore the patient’s innate ability to respond to adversity. In the attached photos, Lica and the back of a female patient, S.N., are visible. Lica pets a cat during this discussion, a technique she has found to be soothing to some patients.
S.N. was diagnosed recently with MDR-TB, a condition for which her husband was being treated. He had hidden his illness from her and the revelation was a jolt to her. MDR-TB requires 24 months of treatment and S.N.’s doctor has recommended hospitalization at the MDR-TB ward in Chisinau, the capital located 145 kilometers from Balti. She is apprehensive for her 3 young children’s health and reluctant to leave them in Balti with her aged mother. Her predicament is only one of many around us. S.N. says, “Tuberculosis is frightening. But, I am not alone and Lica is nearby. This warms my heart. With her help, I understand I must overcome this disease for the sake of my children and their future.”
Speranta Terrei’s first office will be two rooms at the Training Center for Medical and Pharmacy Assistants instead of at the training center “Miracol.” One small, private room will be for counseling patients and the second, larger room will be for meetings and training of our moderators and patients. We have delayed the development of our web site and plan to renew it once we find funds for this purpose.
Thanks to your continuing donations, Speranta Terrei has increased the number of patients in the Global Giving project to 40. We have extended our treatment support to Riscani village, which is 45 kilometers from Balti. Irina Gribeniuc, a new moderator who lives in Riscani, has started giving treatment support to 4 patients with drug-susceptible TB and MDR-TB.
We are sending a special thanks to those of you who donated on Bonus Day and gave us the means to expand services. The new items in our budget, which is attached, are rent for an office and TB treatment support for an extra 3 months.
Our first office will be a room at the training center, “Miracol,” in Balti. This is the center where former prisoners with TB were given job training under another project. Patients, moderators, and staff can walk or ride the bus to this central location. Because it is only one room, we will schedule the time carefully to make the most use of it. Speranta Terrei’s psychologist, Lica Jicrivetcaia, will now be able to counsel patients in a private place. Currently, the counseling is given at the Balti TB dispensary and dispensary personnel come and go from the room. Lica has said these interruptions and lack of privacy are a hindrance as patients who are opening up then stop speaking. With an office, our patients will receive better psychological support and we will have a place for meetings, preparing reports, and reviewing records.
Speranta Terrei will give treatment support to 30 patients with funds raised through the Global Giving project. Our new moderator, Igor Zaporajan, was one of our early patients in 2006-2007. For Speranta Terrei, it is gratifying to have so many former patients acting as moderators. They understand from their own experience the feelings of despondency after being diagnosed with TB and the benefits of a persistent and caring moderator who stays with them through the ups and downs of treatment. Former patients are not only returning the favor, they are building goodwill and trust in the community without which Speranta Terrei could not function.
Iurii is nearing the end of treatment for drug-susceptible TB. His TB doctor, Pavel Ciobanu, requested a moderator when Iurii completed 5 months of hospital treatment and started continuation phase treatment at home. Iurii has a leg condition from his time in prison and cannot walk to the dispensary. Our moderator, Nadejda Priscu, visits Iurii 5 times per week to administer TB drugs and discuss treatment as well as his and his family’s other concerns. Nadejda explains TB laboratory tests for monitoring treatment, such as sputum and culture tests at the Balti TB laboratory, where she is a physician’s assistant.
The attached photos show Nadejda arriving at Iurii’s house and giving him anti-TB drugs. The interaction with Nadejda has made a huge difference in Iurii’s outlook. He said, “Every day in the hospital felt like 10 days. I was relieved to be at home again, but hesitant about the offer of assistance from Speranta Terrei. After 2 weeks of Nadejda’s visits, I could speak to her about the many turns in my life. She gives me advice on the regimen and listens attentively. For me, I think fortune has smiled on me and I can win against TB.”
Feodora Rodiucova, Speranta Terrei’s president, wrote a guest blog post for Results UK to promote the Global Giving project. Feodora writes about her motivation for starting Speranta Terrei and the importance of reducing treatment abandonment. You can read her blog post at: http://blog.results.org.uk/2011/07/29/support-moldovan-tb-patients-on-global-giving-uk/#more-6143
Speranta Terrei’s 40 donors have contributed $6,030, giving a large boost to our small organization. We purchased a computer and started treatment support for 25 patients with these funds. The computer is dedicated to our patient database, for analysis of our patient population and treatment outcomes. Paper records, going back to late 2006, are being transferred into the database. After the transfer is completed, we will enter new data directly into the database and be able to monitor results quickly. The Lilly MDR-TB Partnership has funded the database development and the Global Giving project so we are doubly grateful!
One moderator, Vladimir Alesin, could no longer spare time for daily patient visits and Vera Rusnac, a medical assistant, replaced him. The 5 moderators are giving treatment support to these 25 tuberculosis patients:
13 male and 3 female adults and 1 female child with drug-susceptible TB
4 male and 1 female adults with TB/HIV co-infection
3 male adults with MDR-TB (multi-drug resistant TB)
The one female child is 13-year old Iana, who is disabled and relishes conversations with her moderator, Irina Suparscaia. Irina’s home visits are healing not only for TB. Iana said, “Because I am ill, I do not have the possibility to see many people. Irina’s visits are a happy time for me, even though I have to take pills when she comes.” You can see Iana and Irina sitting after that day’s dose and saying farewell in the attached photos.
Our coordinator, Galina, is never far from patients or moderators. She accompanies moderators on patient visits to explain procedures and patient education techniques. In the attached photo at the Balti TB dispensary, Galina is training her former patient, Mariana Armas-Bernavsky, how to give anti-TB drugs to patients.
Galina, Mariana, and other patients are featured in the Winter 2011 issue of Global Health. David Rochkind, an award-winning photojournalist, produced the article, “Moldova: What Happens to MDR-TB Patients?” from his reportage in Balti. The article contains a video, which captures vividly the conditions of patients: http://www.globalhealthmagazine.com/cover_stories/moldova_mdr-tb_patients
Speranta Terrei thanks you for expertise and donations through the Global Giving project. Sites of Change at the University of British Columbia is continuing to assist on website design. A donor gave us valuable advice on the design of the database, which is being developed by a software designer in Balti.
The next Bonus Day on Global Giving is June 15, when donations made online between 12:01 a.m. and 11:59 p.m. Eastern Daylight Time will be matched at 30%. If you would like to donate again, this is the day to do so.
Speranta Terrei is grateful to our 37 donors who contributed $5,880, including matching funds from the Lilly MDR-TB Partnership. We placed fourth in the Lilly Challenge on Global Giving and were glad for this platform to share the lives of tuberculosis patients in Balti.
Because we are far short of our initial budget, we have revised the project to fit the amount available. After subtracting fees for Global Giving's services, Speranta Terrei has about $5,000 for our project.
Our revised project will support 25 tuberculosis patients with 5 moderators. For the time being, we removed the largest item, the community center, and reduced personnel time and operations expenses. The revised project budget is attached.
Galina Zaporojan, featured on our project page, is coordinating treatment support given by these 5 moderators:
Mariana Armas, a patient who is nearing completion of treatment for drug-susceptible TB.
Vladimir Alesin, who knows firsthand the plight of families with TB patients.
Nadejda Priscu, a physician's assistant who witnesses many tears when she has to inform patients they have been diagnosed with TB.
Constantin Khihai, who has been a moderator for 2 years and has assisted 18 TB patients to complete treatment.
Irina Suparscaia, who had TB in her family and has been a moderator for 21 patients.
Our new moderator, Mariana, was pregnant when she began treatment and now has a healthy 5-month old daughter. Mariana told Galina, "I want other patients to understand what TB treatment is, now that I understand it better." Mariana lost her father to TB and wants to prevent her 2 children and other children from being infected. You can see Mariana in the attached photo.
You saw Valentin Guivan on our project page, sitting on the ground while taking anti-TB drugs. Valentin has been cured of TB, but he continues to be homeless. For the winter, a resident of Balti is allowing Valentin to stay in his garage. We are trying to find ways to keep Valentin from returning to the street, where he is more susceptible to re-infection.
The staff of Global Giving has been responsive and practical, answering our questions and advising us. Through Global Giving, Speranta Terrei has the help of Sites of Change, at the University of British Columbia in Canada, for designing a web site. We welcome your suggestions for our upcoming web site, especially from those of you with a penchant for design!
Feodora Rodiucova and Asma K. Henry
Project Reports on GlobalGiving are posted directly to globalgiving.org by Project Leaders as they are completed, generally every 3-4 months. To protect the integrity of these documents, GlobalGiving does not alter them; therefore you may find some language or formatting issues.
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Moldova, Republic of
Moldova, Republic of