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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
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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Dr. Ditiu & Colleen Taste Welcome Bread
Dr. Ditiu & Colleen Taste Welcome Bread

Balti municipality signed onto the Zero TB Declaration, committing Speranta Terrei’s home town to reducing TB prevalence and mortality. Zero TB is an international initiative to apply proven, community-based tuberculosis control measures to meet the goal of ending TB. Speranta Terrei’s and Tineri pentru Dreptual la Viata’s (TDV, Youth for the Right to Live) staff greeted Stop TB Partnership’s executive director, Dr. Ditiu, and human rights, gender & TB/HIV advisor, Colleen, with traditional Moldovan bread and wine upon their arrival in Balti (photo).

Dr. Ditiu and the acting mayor of Balti, Mr. Sheremet, signed the declaration at Balti City Hall on 29 June (photos). Mr. Sheremet underlined local and international cooperation in reducing TB, saying, “The signing of the Zero TB Declaration is of major importance for the local public administration of Balti, in the context of the severe tuberculosis burden and the success of the fight against tuberculosis…” Dr. Ditiu was impressed to see so much cooperation, noting, “The Acting Mayor and his team, the TB program representatives, the NGOs Tineri pentru Dreptul la Viata, Speranta Terrei, and the Moldova National Association of TB (SMIT) all came together and committed to join efforts to make the city TB-free.” To implement Zero TB, Speranta Terrei and TDV will combine their respective expertise on TB and HIV to strengthen services to co-infected patients.

The Moldovan Orthodox Church added its authoritative voice to achieving Zero TB. A few days after the Zero TB Declaration was signed, Archimandrite Balti-Falesti Markel led a gathering of priests at Cathedral Constantin si Elena in Balti. Municipal councilor, Elena, and Archimandrite Markel spoke to the priests about their role in combating tuberculosis. He encouraged them to raise awareness of TB among their parishioners and to facilitate programs of NGOs on TB and HIV. A BaltiTV story on the gathering is at:

https://www.youtube.com/watch?v=Zlc9MJksqes

Speranta Terrei's talented and dedicated photographer, Alexandr (1960-2017), passed away in August. His photos depicted vividly the human face of TB and he eagerly brought Speranta Terrei’s work to audiences far from Moldova. As in many previous GlobalGiving reports, this report features Alexandr’s photos. In his honor, we attach an early photo he took during a TB awareness campaign in schools based on the Luis Figo and the World Tuberculosis Cup comic book. Because of Alexandr, we feel Jaroslav’s unbounded joy as he kicks the Stop TB ball (photo) and we feel the profound grief of Alexandr’s family.

We at Speranta Terrei would like to thank you, our GlobalGiving donors. Your generosity is critical to all our endeavors.

 

Discussing Zero TB
Discussing Zero TB
Mr. Sheremet & Dr. Ditiu Exchange Declarations
Mr. Sheremet & Dr. Ditiu Exchange Declarations
Shaking Hands on Zero TB
Shaking Hands on Zero TB
Jaroslav Kicks TB
Jaroslav Kicks TB
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Alexandra Cooks Borscht for Homeless
Alexandra Cooks Borscht for Homeless

Tuberculosis is transmitted through the air and it can infect anyone. In Moldova, TB has a deep foothold because of individual risk factors and general socioeconomic and public health factors. At Speranta Terrei, we counter some of those risks thanks to the generosity of our GlobalGiving donors and other funds. We support TB patients to complete treatment so that they do not infect others, we assist individuals at high risk to be tested for TB, and we raise awareness of behavior which increases TB risk.

Homelessness and cigarette smoking increase the risk of TB. When Galina, Speranta Terrei’s long-time moderator (treatment supporter), won the Kochon Prize last year, she saw a chance to expand Speranta Terrei’s assistance to the homeless. Poor living conditions and nutrition contribute to TB risk for the homeless. Thanks to the Kochon Prize funds, Speranta Terrei serves lunch to the homeless (photos) at our Centre for Tuberculosis Patients and has a car to transport the homeless for medical tests. Galina recently went with Vitalii and Vasilisa (photo) in the car to the TB dispensary and clinic for diagnostic tests. Although Vitalii and Vasilisa were not diagnosed with TB, they were diagnosed with chronic pulmonary disease. They are among an estimated 450 homeless in Balti to whom Speranta Terrei gives special attention for TB control.  

Smoking prevalence among adults in Moldova is 25 percent and smoking is all too common among patients to whom Speranta Terrei gives TB treatment support. Tobacco smoking doubles the risk of a recurrence of TB and increases the risk of TB infection, of developing TB disease, and of TB mortality. This year we took a step to attack this huge risk with the help of Alexandre, a professor at Balti Medical College. He organized 25 students for an awareness campaign for World No Tobacco Day on 31 May. To reach aspiring medical professionals at the college, the students set up information panels entitled, “Smoking Kills” and “A Day Without Smoking”, and showed a film on the damage smoking causes. They asked students and workers to consider to, “Replace a cigarette with an orange”. Several students agreed to this exchange and put their cigarettes in the trash bin and took the orange (photo). One student said, “I found so much information about the damage of smoking, I realized I should give up.”  

Students set up a tent in Balti city centre with the motto “Let’s have a healthy life - stop smoking”. They discussed with passersby the dangers of smoking, exchanged oranges for cigarettes, and measured blood pressure (photo). The students spoke to 300 and measured the blood pressure of 73 people. One woman said, “I am glad the younger generation is trying to stop smoking, I could not convince my husband to stop and my whole family suffered because of it”. We want to do all we can to reduce the risk factors associated with TB and reduce the suffering it causes.

Lunch at Speranta Terrei's Centre
Lunch at Speranta Terrei's Centre
Vasilisa & Vitalii to TB Dispensary
Vasilisa & Vitalii to TB Dispensary
Alexandre and Balti Medical College Students
Alexandre and Balti Medical College Students
Student Replaces Cigarettes with Orange
Student Replaces Cigarettes with Orange
Health Tent in Balti City Centre
Health Tent in Balti City Centre
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Organization Information

Speranta Terrei

Location: Balti - Moldova, Republic of
Project Leader:
Feodora Rodiucova
Balti, Moldova, Republic of
$138,023 raised of $180,000 goal
 
698 donations
$41,977 to go
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