Voices from Eurasia


Tuberculosis recovery requires more than just medicine

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Psychologist Bahar Bayramova checks on TB patients’ records. Photos: Nazik Avlyakulova / UNDP Turkmenistan

Tuberculosis (TB) treatment is a very long and complicated process. Often, patients are left to face the condition on their own because people are afraid of contamination. Many lose their jobs and contact with their friends and family.

Thanks to modern medical care, TB is curable, but only if the diagnosis is made and the treatment has started on time. The burden of a regular TB is no longer a burning issue in Turkmenistan, because there is rapid testing and free medical treatment for patients. But with its long treatment, MDR-TB poses a heavy burden. As a result, many patients drop the treatment which causes reappearance of the symptoms.

People living with TB have suppressed immune systems and must carefully follow treatment instructions and dietary prescription, and regularly visit their doctor. But that can become a challenge to patients over time. Some get lonely as family and friends drop out. Others go through depression because of the long process of treatment or the side effects of the medicines. They get tired and lose their motivation to become healthy. 

A patient’s moral and psychological state is an important aspect of their condition.  Their will, persistence and optimism matter. That’s why psychological counseling is an integral part of the treatment.

TB patients require an emotional boost that will increase their discipline and create positive thinking.

As a psychologist with the National Red Crescent Society of Turkmenistan (NRCS), I visit the TB hospital twice a week to consult with the doctors on the treatment and progress of their patients. Our support includes home visits and phone consultations with patients. If we see patients experiencing challenges with sticking to their treatment, we try to work together to find solutions. We also hold trainings for patients and their relatives, and provide qualified psychological counseling.

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I have witnessed the benefits of supporting patients first hand. I had a patient who regularly complained about depression and fatigue. She was always irritated and had a complicated relationship with her husband. I worked with her to build life skills that allowed her to create space for herself: to concentrate on her mood and relationships with relatives, to take long walks outside, to observe nature’s beauty and to pay attention to how unique her life was. I also encouraged her to start exercising. As a result of our counselling, the patient’s emotional status recovered and she has been continuing her treatment for over a year now.

Another woman was doing quite well with her treatment, but because it was taking so long, she started to feel down. She hoped the doctors would cancel her treatment since she showed good results. I explained the disease might return, since her immune system was still under TB’s influence. I encouraged her to continue, and we made an agreement that she comes back every week.

Of course, these are the simpler cases, and we encounter more complicated cases and help patients in various situations. 

But through the individual counseling sessions and thanks to commitment of the TB doctors and nurses along with the NRCS staff, more than 200 MDR-TB patients have returned and completed their medical treatment.

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Starting from 2013, UNDP in Turkmenistan and the NRCS have provided support to MDR-TB patients to complete the full course of medical treatment. The project, supported by the Global Fund, initially helped renovate TB labs and accelerated diagnostics across the country. Now, it is focusing on treatment.

In 2016, 611 MDR-TB patients were enrolled in treatment.

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