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
Stroll to Park with Liudmila
Stroll to Park with Liudmila

Thanks to our regular GlobalGiving donors, Speranta Terrei can count on giving treatment support to tuberculosis patients from start to finish. We are especially grateful to donors who give every month to our programs.

A year ago, we reported on nine-year old Vladislav, who was undergoing lengthy treatment for multi-drug resistant tuberculosis (MDR-TB). Now a year later, we are pleased to report ten-year old Vladislav will complete TB treatment at the end of June. Last September, he was able to return to school. 

After his doctors adjusted his treatment regimen and the painful injection part of the regimen concluded, Vladislav started to feel fewer side effects. He no longer vomited or felt dizzy after taking medication. His doctors said he could be given medication at home and his daily visits to the TB dispensary could end. Speranta Terrei replaced his moderator Angela with Liudmila, who was able to take anti-TB drugs to his home for Directly Observed Therapy (DOT).

At the beginning of the last school term, Vladislav returned to the same school he had attended before he had MDR-TB. He recently graduated the third form. Although he is happy to return to school, he can sense his classmates are afraid to be near him. Some even say offensive words. Vladislav knows studies are important and he wants to be in school. He says, “I want them to forget I had TB and treat me normally.” Vladislav is not infectious, but TB carries a heavy stigma for patients in Moldova and people avoid them from fear of being infected.

Fortunately, Vladislav has friends in his neighborhood and often plays with them. He likes active games, games full of running and jumping, and this is how he broke his right arm. Seeing Vladislav brimming with energy, Liudmila took him to a park to play after a recent DOT visit (photos). 

Liudmila says, “Vladislav is close to my son’s age and they became friends. We are so happy he withstood treatment and recovered from MDR-TB.”

 

Should I Go Up?
Should I Go Up?
Vladislav on Swing
Vladislav on Swing
One-Handed Push
One-Handed Push
Liudmila Gives Vladislav a Whirl
Liudmila Gives Vladislav a Whirl
I Conquered TB
I Conquered TB
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Ladling Borscht
Ladling Borscht

Donations through GlobalGiving are critical for our Centre for Tuberculosis Patients to remain open through the winter. Speranta Terrei economizes and watches the thermostat, but heat, electricity, and water expenses have soared in recent months. Since December, our staff has been preparing and serving hot lunch to homeless persons at our Centre three times per week. This supports Speranta Terrei’s program of active case finding for tuberculosis among the homeless, a group at high risk for contracting TB. “We screen them for symptoms and take them for diagnostic tests at the TB dispensary”, explains Galina, who has a special rapport with the homeless of Balti after 12 years of conducting outreach among them. She finds them near garbage bins and outside churches, where they scavenge for food and clothing to ward off the cold.

Galina asks them as well about their acquaintances, if any of them have persistent cough or fever, if they need to be examined. When a homeless person is diagnosed with TB, Galina and other Speranta Terrei moderators (treatment supporters) give them Directly Observed Therapy (DOT), bringing medicine from the TB dispensary and observing them ingest it. 

On a cold February day, homeless persons who had undergone TB control to rule out infectiousness came to Speranta Terrei’s Centre for Tuberculosis Patients to warm up and fill up with steaming borscht and pelimeni (photos). The Moldovan soup and dumplings served at a dining table were a rare respite from scavenging for food. Alexandr (in photo) said, “To smell and eat fresh food you made, we thank you. These are the only hot meals we eat and we have not eaten so well for a long time.” The homeless related stories of being evicted from apartments or returning from a stint of migrant labor in other countries to find their family and house were no longer theirs. Some of the homeless stay temporarily in an overnight shelter called Reintoarcere, others are constantly out in the cold, on the street.  

After lunch, Speranta Terrei’s president, Dora, talked to them about how to prevent TB transmission and where and how to consult a doctor if they develop TB symptoms. The vice mayor of Balti, Mr. Smulschii, has expressed his appreciation to Speranta Terrei for controlling TB among the homeless. He said homeless citizens have told him, “the hot lunches make a big difference in our lives”.

Speranta Terrei’s staff are grateful for your contribution to the operation of our Centre. This Centre is a place to combat TB and to offer the homeless a hot lunch on a cold day.

 

Boiling Pelimeni
Boiling Pelimeni
Alexandr Eating Borscht with Cream
Alexandr Eating Borscht with Cream
Mircea & Serghei Eating Borscht and Bread
Mircea & Serghei Eating Borscht and Bread
Galina Serving Pelimeni to Stepan & Alexandr
Galina Serving Pelimeni to Stepan & Alexandr
Galina & Dora in Centre's Kitchen
Galina & Dora in Centre's Kitchen
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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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Organization Information

Speranta Terrei

Location: Balti - Moldova, Republic of
Project Leader:
Feodora Rodiucova
Balti, Moldova, Republic of
$131,745 raised of $180,000 goal
 
662 donations
$48,255 to go
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