Support 150 Tuberculosis Patients in Moldova

by Speranta Terrei
Support 150 Tuberculosis Patients in Moldova
Support 150 Tuberculosis Patients in Moldova
Support 150 Tuberculosis Patients in Moldova
Support 150 Tuberculosis Patients in Moldova
Support 150 Tuberculosis Patients in Moldova
Support 150 Tuberculosis Patients in Moldova
Support 150 Tuberculosis Patients in Moldova
Support 150 Tuberculosis Patients in Moldova
Support 150 Tuberculosis Patients in Moldova
Support 150 Tuberculosis Patients in Moldova
Support 150 Tuberculosis Patients in Moldova
Support 150 Tuberculosis Patients in Moldova
Support 150 Tuberculosis Patients in Moldova
Support 150 Tuberculosis Patients in Moldova
Support 150 Tuberculosis Patients in Moldova
Support 150 Tuberculosis Patients in Moldova
Support 150 Tuberculosis Patients in Moldova
Support 150 Tuberculosis Patients in Moldova
Support 150 Tuberculosis Patients in Moldova
Support 150 Tuberculosis Patients in Moldova
Valerii Counsels Vitalii After DOT
Valerii Counsels Vitalii After DOT

Speranta Terrei practices tuberculosis (TB) control from many angles, from supporting patients to stay on top of treatment to active case finding among high-risk populations. With widespread multi-drug resistant tuberculosis (MDR-TB) in Moldova, screening and identifying a case of TB is critical to reducing transmission and numbers of patients who fall ill with this preventable infectious disease.

TB patients we serve are mostly poor and depend on vouchers from the National Medical Insurance Company (CNAM) to purchase food during treatment. TB is another jolt in their unsettled circumstances. Speranta Terrei offers counseling along with Directly Observed Therapy (DOT) to help patients understand what treatment entails and to encourage them to continue prescribed drug regimens until they are cured. Valerii, our psychologist, accompanies Angela, our treatment supporter (moderator), on DOT home visits around our city, Balti.

Valerii counsels Vitalii, who contracted TB while in a penitentiary, a common occurrence in Moldova. After he was released, Vitalii’s sister allowed him to stay in an apartment she owns. Because he was unable to pay bills, utilities were disconnected and Vitalii lives without electricity, gas, or heat. His only means of purchasing food are the vouchers. 

Igori is another TB patient living in an unsanitary apartment. And, he and Vitalii share another unfortunate common occurrence among Moldovan TB patients, tobacco and alcohol addiction. Speranta Terrei sees how these addictions impede TB control, yet our organization does not have means to offer addiction counseling or treatment. Angela gives Igori sterile test tubes to collect sputum samples. He will carry his samples to the TB dispensary for his upcoming 5-month visit to monitor results of drug-susceptible TB treatment.

When Maria applied for a job at a public institution, mandatory chest x-rays at her family doctor’s clinic led to a TB diagnosis. Maria’s first thoughts were, “I do not want to infect my husband and my young daughters,” who are 3 and 5 years old. She has been a compliant patient since March and is relieved to be completing treatment in November. 

In cooperation with the health center in Calarasi district, Speranta Terrei is conducting TB screening under a CNAM project. Using a symptom questionnaire, staff visit residents at risk for TB, such as the homeless, the unemployed, those with low incomes or of Roma ethnicity. If their answers indicate TB, they are taken to the health center for x-rays. Staff explain to them about DOT and sign agreements on treatment support and confidentiality. Speranta Terrei distributes second-hand clothing and shoes to those undergoing x-rays. Since August, 310 Calarasi residents have been screened and 250 x-rayed. Four await further confirmatory TB test results.

As the war in Ukraine grinds on, we continue to distribute products to Ukrainian refugees at our Centre for Tuberculosis Patients. Sadly, one of our staff organizing distribution, Alla, passed away suddenly in August. We miss her capable and quiet help to those in need.   

We are grateful to our GlobalGiving donors for their loyal support. On Giving Tuesday, which falls on November 29 this year, GlobalGiving will offer matching funds for online donations. On November 29, your and your friends’ donations will go further towards TB control and refugee relief.

Angela Gives Igori Sputum Test Tubes
Angela Gives Igori Sputum Test Tubes
Maria Relieved at Recovery
Maria Relieved at Recovery
Arriving for X-rays at Calarasi Health Center
Arriving for X-rays at Calarasi Health Center
Filling Agreement Forms
Filling Agreement Forms
Nina Answering Questions
Nina Answering Questions
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Albina Gives Gavrecki a Hand
Albina Gives Gavrecki a Hand

In February, our world was turned upside down with the invasion of Ukraine. Flows of refugees arrived on our doorstep, some in transit to more prosperous western European countries and some staying put in Moldova, closer to home. Ukrainians have been coming to Balti, our city in northern Moldova, from Odesa, Irpin, Kherson, Melitopol, Nicolaev, and Dnipro. Our national and local governments have mobilized to assist them, as have Speranta Terrei’s staff, who fielded desperate calls from Ukrainians as the war began. Balti City Hall is housing about 250 refugees in hotels and student hostels and another 1,000 are living with Balti residents.

Moldova is a small, vulnerable country with the breakaway region of Transnistria right along the Ukrainian border. Transnistria hosts a Russian military base and ammunition depot and is not far from the Black Sea port of Odesa, shelled and blockaded these past weeks. Moldovans have opened their doors to Ukrainians and Speranta Terrei has opened its Centre for Tuberculosis Patients to distribute products to Ukrainians. 

Thanks to our GlobalGiving donors and our partners, Ukrainians can select cereals, flour, cooking oil, milk, soap, baby food, diapers, and clothes at our Centre. They can come every 10-14 days to fill a box or bag according to their needs. We serve about 120 Ukrainians each weekday. Speranta Terrei receives products through David, a former Peace Corps volunteer in Balti, and local NGOs Healthy City and Friends of Moldova. The French organization promoting access to education, Solidarite Laique (https://www.solidarite-laique.org), gave Speranta Terrei funds to purchase basic necessities for Ukrainian refugees, such as coffee, tea, honey, towels, pillows, underclothes, t-shirts, and socks. Alla, Svetlana, and Valentina organize the products in our conference room and offices and keep track of the distribution. We are gratified to be a conduit of generosity towards our Ukrainian neighbors.

David transformed his closed restaurant in the capital Chisinau, BBQ Smokehouse (https://www.facebook.com/Smokehouse.Moldova/), into a depot and distribution hub for Ukrainian refugees. Miscoi of Healthy City and Gavarecki of Friends of Moldova deliver products from David’s depot to our Centre and distribute at their own NGOs. On a sunny spring day, Miscoi’s high-school aged daughter, Albina, gave Gavarecki a hand in unloading at our Centre. 

Amidst the Ukraine crisis, “we have not forgotten our main purpose, controlling tuberculosis,” says Speranta Terrei’s president, Feodora. Moldova and Ukraine share not only borders, they share high rates of multi-drug resistant tuberculosis (MDR-TB). Speranta Terrei has continued to screen high-risk groups for TB and to give Directly Observed Therapy (DOT) to TB patients.

On the outskirts of Balti, our treatment supporter (moderator), Angela, administered TB drugs to Vasilli, Maria, and Olesia and answered their questions, encouraging them to persevere until the end of treatment. Vasilli is undergoing prolonged treatment for MDR-TB and expressed his thanks for Angela’s visits, saying, “Angela is our angel and her name signifies this.”

 

Svetlana & Valentina Organize Conference Room
Svetlana & Valentina Organize Conference Room
Ukrainian Selecting Socks
Ukrainian Selecting Socks
Vasilli Asks When His Treatment Will End
Vasilli Asks When His Treatment Will End
Angela Hands Maria TB Drugs Through Gate
Angela Hands Maria TB Drugs Through Gate
Angela Gives Olesia TB Drugs
Angela Gives Olesia TB Drugs
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Nadejda at Centre's Opening in 2015
Nadejda at Centre's Opening in 2015

This past year has been marked with losses, Covid-19 hitting hard in Moldova and among health care professionals in Speranta Terrei’s home city, Balti. Our colleagues lost family members and we lost our dear colleague, Nadejda. In October, she succumbed to Covid-19 after an outbreak at the Balti Regional Tuberculosis Laboratory, which she headed. Nadejda and our colleague, Alexandra, are responsible for keeping track of patients Speranta Terrei serves.

We remember Nadejda for her warmth, for animated discussions on how to persuade tuberculosis (TB) patients to stick to treatment or poor workers to not delay diagnostic tests. Nadejda was a master of the Gene Xpert, a machine that has improved substantially TB diagnosis in Moldova. As featured in an earlier report, Nadejda delighted in how its rapid results reduced patients’ worry and shortened the time when doctors could start patients on multi-drug resistant TB (MDR-TB) treatment based on a positive result. The attached photo from the March 2015 opening of Speranta Terrei’s Centre for Tuberculosis Patients shows Nadejda instructing young greeters to hand welcome bags to guests and shows her very own traditional welcome bread in the foreground. We dearly miss her. 

Doctors in Riscani district in north Moldova have been supporting TB patients to stick to treatment. Dr. Alla, a TB doctor, has been cooperating with Speranta Terrei’s Directly Observed Therapy (DOT) program, as has her psychologist husband, Dr. Alexandr. Their patient, Rodica, has MDR-TB and they included her in home DOT after she missed taking TB drugs. Dr. Alla and the family doctor, Dr. Tatiana, visit Rodica for DOT and to ask her about drug side effects. Rodica lives in Zaicani village and is a seasonal worker on a potato farm. She twice missed treatments since being diagnosed last October. As she explains to Drs. Alla and Tatiana during their visit, “the drugs make me nauseous, I feel depressed and I all I want to do is sleep.”

After Rodica took the daily regimen in their presence, the doctors confirmed her next counseling appointment with Dr. Alexandr and explained how this will help her to continue with the long MDR-TB treatment. Dr. Alla monitors Rodica’s drug regimen and interactions with drugs for other medical conditions. She prescribed her treatment for nausea and depression. Rodica has a long road ahead of her and the doctors in Riscani say, “we are here to support her.” 

At Speranta Terrei, we look ahead to the renewal of a New Year while we mourn losses of the past year. We thank our GlobalGiving donors for sticking with us while we help TB patients to continue treatment. 

 

Drs. Alla & Taiana Knock on Rodica's Door
Drs. Alla & Taiana Knock on Rodica's Door
Drs. Alla, right, & Tatiana, left, at Rodica's
Drs. Alla, right, & Tatiana, left, at Rodica's
TB Drugs on Plate
TB Drugs on Plate
Rodica Takes TB Drugs
Rodica Takes TB Drugs
Rodica Tells Doctors of Side Effects
Rodica Tells Doctors of Side Effects
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Boxes of Donated Clothes
Boxes of Donated Clothes

Speranta Terrei is fortunate to have Alla working at our Centre for Tuberculosis Patients since July. She turns boxes of donated clothes into clean, ironed clothes ready to be worn. Speranta Terrei receives second-hand clothes and shoes from churches, schools, and our neighbors and friends. We must sort and clean these before giving to the tuberculosis (TB) patients we serve. Alla carefully washes and irons clothes and hangs these up in the front room for patients to select.

When Speranta Terrei’s moderator, Galina, screened Nicolae and his wife, Natalia, for TB, she found them living in poor conditions. Nicolae answered yes to Galina’s screening questions on TB symptoms and she referred him for an x-ray test. He is awaiting the result. Galina arranged for Nicolae and Natalia to come to Speranta Terrei’s Centre on a recent Saturday to select clothes for winter. They were grateful for this chance, saying “we need warm clothes and prices are so high, even in the second-hand market.”

Alla likes to make the clothes look presentable, to give patients a bit of a lift. She says, “our TB patients lack running hot water for washing clothes at home, some are homeless with no place to wash. Wearing a crisp, clean sweater or shirt brightens their mood.” Alla’s own father had TB years ago and she thinks of how he suffered with the disease. She said she knows clothes are a small thing, Nicolae and Natalia are not employed, but this is what we can offer them at this time. 

We thank you, our GlobalGiving donors, for helping us to help our patients in small and large ways. 

 

Alla Washes Clothes
Alla Washes Clothes
Alla Dries Bedding
Alla Dries Bedding
Alla Irons Clothes
Alla Irons Clothes
Nicolae Selects Jacket with Alla
Nicolae Selects Jacket with Alla
Alla Shows Natalia Sweater
Alla Shows Natalia Sweater
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Lidia Arrives at Natalia's House
Lidia Arrives at Natalia's House

Lidia’s daily rounds of Directly Observed Therapy (DOT) to tuberculosis (TB) patients take her from a patient’s house to a patient living on the street to a patient in the hospital. Lidia is a nursing assistant at the TB dispensary in Balti and a treatment supporter, called moderator, for Speranta Terrei. She prepares a separate bag of each patient’s drug regimen before setting out every morning to give community-based DOT. 

Arriving at Natalia’s house on the outskirts of Balti, Lidia waits for her to put on a mask and come into her front garden. Natalia is in her mid-30s and likely contracted multi-drug resistant TB (MDR-TB) through contact with a relative who had it. Lidia says that Natalia exudes kindness and gratitude and says, “thank you for bringing me TB medicine, I live so far away and worry I will get Covid if I go out”.  Lidia reassures her Speranta Terrei plans to continue home treatment support until the end of Natalia’s two-year treatment in October.

Gavriil is homeless and Lidia finds him in the area where he stays on the street. A friend of his was screened for TB and he recognized his own symptoms of fever and blood in sputum and went to the TB dispensary. When the test confirmed drug-susceptible TB, Speranta Terrei arranged for Lidia to give him DOT and for Viorica to assist him to complete applications for social assistance and a residency permit. Without the residency permit required of all Moldovans, he cannot apply for a job or a national insurance card.

After administering Gavriil’s drug regimen, Lidia heads to Liubovi’s apartment to give her her MDR-TB drug regimen. As Lidia leaves, Liubovi’s words to her are, “I wish for Lidia and all Speranta Terrei’s moderators to stay healthy because they are our only hope.”  

Lidia ends her daily rounds at the psychiatric ward of Republican Hospital Balti to pass along Ruslan’s (not pictured) drug regimen to the ward nurse, Alena. Ruslan suffers bouts of psychiatric instability and is hospitalized periodically to receive rehabilitation therapy. Because he remains under the TB dispensary’s supervision for TB treatment, the hospital depends on the dispensary to bring TB drugs for him. Lidia reviews Ruslan’s drug regimen with Alena, who will administer the drugs and report back to Lidia on side-effects and Ruslan’s questions.

Thanks to you, our GlobalGiving donors, Speranta Terrei sends 9 capable moderators for daily rounds of DOT and commits to continuing support to TB patients for the duration of TB treatment. 

 

Natalia Thanks Lidia After Taking TB Drugs
Natalia Thanks Lidia After Taking TB Drugs
Lidia Places TB Drugs in Gavriil's Hand
Lidia Places TB Drugs in Gavriil's Hand
Liubovi Takes TB Drugs
Liubovi Takes TB Drugs
Lidia Presses Bell at Hospital Psychiatric Ward
Lidia Presses Bell at Hospital Psychiatric Ward
Lidia Reviews Ruslan's TB Drugs with Alena
Lidia Reviews Ruslan's TB Drugs with Alena
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Organization Information

Speranta Terrei

Location: Balti - Moldova, Republic of
Project Leader:
Feodora Rodiucova
Balti, Moldova, Republic of
$136,472 raised of $180,000 goal
 
686 donations
$43,528 to go
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