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
Olga Knocks on Anna's Front Door
Olga Knocks on Anna's Front Door

Anna says, “I cried for three days when the doctor said I had TB, I was shocked.” She was at a hospital in the capital, Chisinau, and the doctor had confirmed the diagnosis through bronchoscopy. Earlier x-ray and sputum tests had not been confirmatory for tuberculosis and Anna had thought her fever and cough were due to a cold. The doctor tried to reassure her, telling her, “it is not the end, TB can be treated.” Hearing those words sparked Anna’s decision, she set herself the goal to be treated and cured of TB. 

Anna has multi-drug resistant tuberculosis (MDR-TB), requiring longer, more painful and more toxic treatment than drug-susceptible TB. In March, she started a daily regimen of 22 pills and an injection. For three months, she suffered severe side effects, vomiting and aches in her shoulders, arms, and back. She reminded herself of her goal and did not give up on treatment. Dr. Vladimir at the polyclinic in Sadovoe, where Anna lives on the outskirts of Balti, and Dr. Aliona at the TB dispensary in Balti, reviewed and adjusted her drug regimen. This eased Anna’s side effects and she started to recover. She says, “I stopped vomiting and regained 4 kilos”. At the end of October, she endured her last painful injection and her daily regimen is down to 12 pills and 2 packets of powder. 

Throughout the anguishing TB treatment, Olga, a medical assistant at the Sadovoe polyclinic, has assisted Anna as her moderator, with the support of Speranta Terrei. Olga goes to Anna’s house 6 days a week with pills, powders, and injections (photos) and takes word back to Dr. Vladimir on Anna’s condition. In only her second year as a medical assistant, Olga notes with equanimity, “I explained Anna’s side effects to Dr. Vladimir and he conferred with Dr. Aliona and during Anna’s next TB control visit, they changed drugs and added a drug to reduce liver toxicity”. Olga’s visits have kept Anna directed towards her goal. Anna need not walk to the polyclinic when she is drained from TB drugs and she can lie down at home after injections. She remarks on Olga’s attentiveness, “She sensed me wincing from injections and said she was sorry to inflict those on me.” 

Because Anna worked at a bread factory in Sadovoe, Olga and Dr. Vladimir had another job on their hands, screening the factory’s workers for TB. Thanks to a TB awareness campaign Speranta Terrei had organized earlier, Olga and Dr. Vladimir had given information on TB to Sadovoe’s residents. Following Anna’s MDR-TB diagnosis, Olga went to the home of each bread factory worker and screened the family for TB symptoms. For those answering yes to three TB symptoms, she gave an x-ray prescription. Speranta Terrei arranged its van and driver to take 118 bread factory workers and family members for x-rays at the TB dispensary in Balti. If x-ray results indicated it, they then underwent sputum tests. From this systematic screening, Olga and Dr. Vladimir identified two more cases of MDR-TB in Sadovoe. 

Thanks to your Global Giving donations, Speranta Terrei can bolster Anna’s chances of reaching her goal of being cured. And, it can detect more TB cases and give those patients a chance to start treatment and not infect others. We wish our donors Happy New Year, in Moldavian, An Nou Fericit!

 

Olga Brings Powders & Pills for Anna
Olga Brings Powders & Pills for Anna
Anna Drinks First the Powder, Then the Pills
Anna Drinks First the Powder, Then the Pills
Anna Points to Shoulder Pain, a Side Effect
Anna Points to Shoulder Pain, a Side Effect
Olga & Anna Discuss How Different Drugs Helped
Olga & Anna Discuss How Different Drugs Helped
Anna Happy to be Recovering
Anna Happy to be Recovering
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Alexandra and Sofia Discuss with Marina, center
Alexandra and Sofia Discuss with Marina, center

Tuberculosis is the reason Marina and Alexandra met and now they are friends.

Marina was diagnosed with multi-drug resistant tuberculosis (MDR-TB) and was hospitalized for two months during the initial phase of treatment. When she came home to continue ambulatory treatment, she felt weak. Then, she found out she was co-infected with Human Immunodeficiency Virus (HIV). Marina had watched her alcoholic husband interrupt MDR-TB treatment and she was determined to complete treatment, become well, and take care of her children. She asked for a moderator (treatment supporter), who could bring her TB medicine at home. Speranta Terrei sent Alexandra, who began to give Marina treatment support in 2014.

Marina left her husband and moved to her parents’ house along with her teenaged daughter, to protect her from being infected. Marina expresses gratitude for her parents and relatives who tended to her and her younger daughter during the lengthy MDR-TB treatment. She praises her moderator, Alexandra, for coming daily with TB medicine, ready to answer questions and to watch Marina take medicine, according to the tenets of Directly Observed Therapy (DOT). Alexandra in turn praises Marina, saying “She was a diligent and responsible patient, she consulted the doctor systematically and followed her treatment regimen.” Alexandra adds, “she is a caring mother as well as grandmother for her elder daughter’s child.”

After two years of treatment, Marina was cured of MDR-TB. She found a job as a postwoman, a job she says she loves and that suits her. “I am a friendly and sociable person” says Marina, “I have many friends among people I deliver the post to, they wait for me to arrive.” 

She counts her moderator Alexandra among her best friends. They call each other and ask about the other’s health and family. Recently, Alexandra arranged for Marina to meet Sofia at Speranta Terrei’s Centre for Tuberculosis Patients. Sofia works at the Balti TB community center and follows up on patients who have been treated for TB. In the photos, they are discussing Marina’s last medical check-up results. Marina is free of TB, but she continues treatment for HIV. Marina spoke happily about her younger daughter, who is healthy.

Speranta Terrei would like to thank you, our Global Giving donors. Your donations pay for an allowance to cover meals and transport for moderators, moderators who support TB patients through treatment and along the way form friendships.

 

Alexandra Listens to Marina
Alexandra Listens to Marina
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Vladislav in the van
Vladislav in the van

Vladislav did not stand much of a chance to escape tuberculosis given his prolonged exposure to relatives with this infectious disease. His grandparents and parents all had multi-drug resistant tuberculosis (MDR-TB), which is widespread in Moldova. As a close contact of TB patients, Vladislav was tested for TB and, alas, the diagnosis was MDR-TB. At the tender age of 9, Vladislav is undergoing the prolonged and grueling daily regimen of 5 anti-TB drugs.

His treatment began 14 months ago, with a 6-month stint at children’s hospital in the capital, Chisinau. During the intensive phase of treatment at the hospital, he endured painful injections. When he returned home to Balti for continuation phase treatment, Speranta Terrei arranged for Angela to be his moderator (treatment supporter), to bring him anti-TB drugs and conduct Directly Observed Therapy (DOT) at home. Because Vladislav suffers severe side effects from anti-TB drugs, his doctors, Lidia and Elena, insisted on monitoring him daily at the TB dispensary. This was not an easy task for his family, afflicted with conditions common in Moldova, poverty and alcoholism. Vladislav’s father abuses alcohol and is unable to take his son daily to the dispensary. Vladislav’s parents are divorced and his mother lives elsewhere with his older sister.

Angela, Vladislav’s moderator, asked Speranta Terrei if Vladislav could be taken every day in the van Speranta Terrei has, a van thanks to another moderator, Galina, winning the Kochon Prize last year. Speranta Terrei agreed readily because of how vulnerable Vladislav is. He sometimes vomits the pills, he has headaches and dizziness, and faces a high risk of abandoning the two-year long MDR-TB treatment.  

The attached photos show Vladislav’s daily odyssey of MDR-TB treatment. In the morning, Speranta Terrei’s driver, Alexandr, picks him up for the ride to the dispensary. Vladislav knocks on the door of the DOTS cabinet. Angela prepares the pills, crushing ones too large for him to swallow and mixes these in a glass of water. Vladislav holds his nose while swallowing the pills because, he says, “it is easier to get them down my throat”.

Dr. Elena checks Vladislav after he has taken the anti-TB drugs, listens to his lungs and enquires about side effects. When she gives him the all-clear, a relieved Vladislav heads home. Unfortunately, he does not have other outings than the dispensary. He does not attend school or play with other children. He is isolated because children and their parents fear TB infection. Children at school knew he went to the hospital for TB and were aggressive towards him and he is afraid to interact with other children. He languishes at home watching cartoons and playing games on a phone. Vladislav says, “I know TB is dangerous and the treatment is long and hard to bear, but if I do not follow it, I may die.” He follows his treatment and hopes to be a healthy child once again.

From Speranta Terrei and Vladislav, we send thanks to our Global Giving donors for making it possible to give special assistance to young, vulnerable TB patients.

Knocking on the door to the DOTS cabinet
Knocking on the door to the DOTS cabinet
Angela puts crushed pills in glass
Angela puts crushed pills in glass
Holding his nose to swallow pills
Holding his nose to swallow pills
Dr. Elena listens to his lungs
Dr. Elena listens to his lungs
Relieved to head home
Relieved to head home
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Galina Finds Victor
Galina Finds Victor

Victor was diagnosed with drug-susceptible tuberculosis three years ago. Speranta Terrei’s long-time moderator (treatment supporter), Galina, found Victor and his brother, Nicolai, while they searched through garbage bins for food. She took them to the TB dispensary for a diagnostic test and the result was positive. As their moderator, Galina brought them anti-TB drugs and took them to follow-up tests until they were cured 8 months later. Since then, she has taken them systematically for chest x-rays, the last time in August. 

On a recent rainy day in March, Galina gathered Victor (see photos) and other TB patients to invite them to Speranta Terrei’s Centre for Tuberculosis Patients in Balti. She asked them about TB symptoms, whether they had cough or fever, and they responded they did not. Victor’s brother, Nicolai, did not go to the Centre because his legs were hurting and he could not even walk to the waiting van.

This van is at Speranta Terrei thanks to the Kochon Prize Galina received in 2016. Galina’s outreach to impoverished patients is much easier with the van, she can cover a larger area and take them in groups to the dispensary and conduct active case finding among them. “Many of these patients drink alcohol, though they have hardly a place to sleep,” sighs Galina. Victor and Nicolai live in the ramshackle house of their deceased parents. Galina says they were obedient patients and completed TB treatment, but whenever they have a bit of money, they buy alcohol. Victor told Galina that Nicolai and he have gone to the hospital several times to be treated for alcoholism. Galina persists in tracking these patients because she wants to stop TB from spreading to others and she knows all too well the link between alcohol and TB.

At Speranta Terrei’s Centre, Victor drank hot coffee and took a hot shower. Speranta Terrei’s president, Feodora, showed him how to turn the shower on and off and how to adjust the water temperature. Afterwards, Victor said, “Thank you very much. I feel much better. I haven’t had any shower for weeks. At least here I could have it. I am sorry my brother could not come.”

Victor and other patients selected clothes and shoes from donations laid out in the Centre’s conference room (photos). Maria, a homeless woman, exclaimed, “We are very grateful to this organization that helps people like us. We are poor and unhappy and I could tell you there are many of us who would like to get a job, but there are no possibilities, somebody doesn’t have the necessary papers, others don’t have a place of residence, or there are no jobs for us. And how could we live in such conditions? There is no way! We do our best to survive. Great thanks to all of you.” We at Speranta Terrei pass along Maria’s thanks as well as ours to you, our Global Giving donors.

Speranta Terrei this year commemorated World Tuberculosis Day, which occurs annually on 24 March, by inviting impoverished patients to our Centre and by being persistent in stopping TB.

Galina Asks Victor TB Symptoms
Galina Asks Victor TB Symptoms
Victor Drinks Coffee at Centre
Victor Drinks Coffee at Centre
Maria Selects Clothes
Maria Selects Clothes
Liudmila Selects Boots
Liudmila Selects Boots
Shower Ready
Shower Ready
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Selina and Zinaida with Donations
Selina and Zinaida with Donations

Alla sees the difference in the children’s behavior since they started coming to Speranta Terrei’s Centre for Tuberculosis Patients in Balti. Alla is Speranta Terrei’s child psychologist and counsels children affected by tuberculosis. Alla says, “At first meetings with them, discussing and observing, they were shy, inhibited, in an unbalanced emotional state, lacking self-confidence and trust in others, as a result of stigma.” After play therapy and interactions with high school students during the past year, Alla has seen the children become, “less inhibited, more open and more confident in their own powers. They are happy when they meet the students.”

The students are from “Ion Creanga” High School in Balti. They conducted activities with these children at Speranta Terrei’s Centre in the course of a civics education project on TB stigma. Their project won first place in the Balti city competition and they went on to the national Republican Tournament on Children’s Rights, held in the capital, Chisinau, on May 13, 2017. Their project, entitled, “Monitoring the right to equal opportunities for children who have had TB infection and who are in contact with TB patients”, won second place in the national competition! This recognition signaled that their topic had hit a nerve in a country where TB is common and stigma against those with TB is common as well.

In the competition, the students highlighted the community’s attitude towards these children, legislation that should protect them, and the lack of social integration. The competition judges commended the students on the quality of their research and their personal involvement in solving a social problem. 

At the start of this school year in September, their teacher, Olga, spoke to the school student council about the TB stigma project and the student council decided to organize a clothes and toy collection for the children. The students’ parents, of modest means themselves, responded generously and soon the student council had collected more than it needed. In November, the student council leaders gathered students to pack a box for each child. In the attached photos, the student council leaders, Selina and Zinaida, and other students can be seen with the donations and the packed, hand decorated boxes.

The children were delighted to receive a special box and even more delighted to dance and play games. In one of the games, the circle of players kneels, facing towards each other, and another player drops a handkerchief behind one of the players (photo). The chosen player then recites a poem or sings a song. And on it goes. When it was time to leave the party, the children kept asking, “When are you coming again to play with us?”

Speranta Terrei hopes to bring more play days for these children at our Centre, which stays open for these gatherings thanks to your donations. Our staff, the Ion Creanga High School students, and the children send their thanks and good wishes to you for the New Year!

 

Packed and Decorated Boxes
Packed and Decorated Boxes
Children Arriving at Centre for Party
Children Arriving at Centre for Party
Dancing at the Party
Dancing at the Party
Face Painting
Face Painting
Playing the Handkerchief Game
Playing the Handkerchief Game
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Organization Information

Speranta Terrei

Location: Balti - Moldova, Republic of
Project Leader:
Feodora Rodiucova
Balti, Moldova, Republic of
$119,669 raised of $135,000 goal
 
586 donations
$15,331 to go
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