Umkhuseli Fund Management, South Africa: Confronting MDR-TB with Community-based Treatment
The Izumi Foundation is working with Umkhuseli Fund Management to slow the spread of multi-drug resistant tuberculosis (MDR-TB) in South Africa. Together with the Department of Health in KwaZulu-Natal, Izumi and Umkhuseli Fund Management are treating TB patients that fall outside the capacity of the conventional in-patient program, allowing the two patients below to receive MDR-TB treatment in their homes.
Nurses travel daily to remote areas such as the one pictured above to give MDR-TB patients their injections.
Baby is a 41-year-old teacher in a village near Greytown, South Africa. She lives in a rural area and has two children, daughters of 17 and 12. Baby was working as a teacher and already on antiretroviral therapy for HIV when she was diagnosed with MDR-TB in April 2008.
Upon diagnosis, Baby was admitted to the Greytown decentralized MDR-TB unit and immediately started treatment. After two months of hospitalization she was discharged. For four months after she was discharged she was visited on a daily basis by a nurse who drove over very rough roads to reach her house. The nurse injected her daily with one of the six drugs in the treatment regimen, and made sure she took her five other MDR-TB drugs as well as her antiretroviral therapy.
Baby's treatment continued for a further 18 months. As Baby made progress, she no longer required daily injections and visits by a nurse. Instead, she traveled to Greytown Hospital each month for her checkup and to receive medication for the next month.
Baby was cured and completed her treatment on April 21st, 2010. She has returned to her teaching post.
A patient being tested for hearing loss, a common side-effect of MDR-TB drugs.
Nomonde Zungu is a 38-year-old female teacher in a remote rural area of KwaZulu Natal, South Africa. She is HIV-positive and on antiretroviral therapy. Nomonde was diagnosed with MDR-TB in June 2008 and commenced treatment on the 25th of that month.
Like Baby, Nomonde was discharged from the Greytown decentralized MDR-TB unit after two months to receive treatment in her home. Once her daily injections were completed, Nomonde traveled to Greytown for her checkup and medications. Nomonde was cured in May 2010. Unfortunately, Nomonde suffered from considerable hearing loss, a common side-effect of the injectable drug with which MDR-TB patients are treated.
Izumi's support enabled the Umkhuseli Management Fund to supply Nomonde with a hearing aid. This hearing aid has made it possible for her to return to her teaching job. She has recently become pregnant with her first child. Nomonde is very excited and will take the first 6 months of 2011 as maternity leave before returning to her teaching job.
Without the community-based option for MDR-TB treatment, Baby's and Nomonde's stories would likely have had very different endings. The Izumi Foundation is very happy to have been able to play a key role in bringing the treatment that they needed to their homes, allowing them to care for their families and eventually return to their jobs.
Photo credit: Jonas Steengaard