Supporting Vulnerable Populations to Complete Treatment for Tuberculosis in Kyrgyzstan
October 27th, 2021 | story
Boris Zubenko, 48, is a tuberculosis (TB) survivor-turned-volunteer. Boris provides peer-to-peer counseling to people who are released from detention and continue their treatment in the civil health care system, with the support of the civil society organization TB People in Kyrgyzstan. A former inmate himself, Boris draws from his own experience to give consultation and advice to TB patients at risk of treatment interruption and persuade them to continue TB treatment until completion.
Treatment for tuberculosis is long and challenging, and patients need support, including psychological support, to complete the full course. TB People, a sub-grantee of the USAID Cure Tuberculosis Project, facilitates access to medical services in the civil sector health system and offers psychosocial support to people with TB released from penitentiary facilities. As part of Cure Tuberculosis support for TB patients, TB People provides individual counseling, explains the challenges and the importance of completing treatment, assesses the needs of TB patients, and develops individualized care plans. TB People has an agreement with the Medical Service of the Kyrgyz Penitentiary System, which provides a schedule for the release of people with TB and shares their medical records to officially admit these patients to civil health care.
Boris provides peer counseling to six-to-eight people who are currently undergoing TB treatment with the support of TB People. This year, three of his counselees have completed their treatment. Boris is pleased with the result and remembers his own path to recovery, which was long and troubled. Boris was diagnosed with a multi-drug resistant form of TB in 2019, while he was in prison. By that time, he had suffered from HIV, hepatitis, and addiction to drugs and alcohol. People whose immunity is compromised by chronic or concurrent diseases or misuse of alcohol or substances often experience multiple side effects from TB drugs and have a more difficult time adhering to treatment. Boris’s treatment took a serious toll on his physical and psychological health, and the side effects made him want to quit. He was released from prison with three months left to go in his treatment and was on the brink of dropping out.
“The most difficult part is to take medicines every day, it makes you feel bad. Very heavy [TB] drugs. Bones ache terribly. I had no appetite, I felt very sick,” recalls Boris about his experience. Over the course of his treatment, he saw many who could not stand the side effects and refused treatment or threw away their pills.
Boris’s health situation was aggravated by dire personal circumstances: after his release, he had no place to live, no family, and no source of income. Just in time, he met a social worker from TB People, who educated him on the consequences of treatment interruption and persuaded him to continue treatment at a TB hospital.
Nuraiym Asanalieva, a TB People coordinator, explains that people released from correctional institutions are especially vulnerable. They are usually socially marginalized and have limited access to medical services. Many lack family support, misuse alcohol and drugs, and have problems with documentation and employment. In addition, many neglect their health and are at high risk of treatment interruption. TB People makes it a priority to help people with TB released from detention to take care of their health and complete treatment.
TB People social workers meet people with TB on the day they leave correctional facilities and accompany them to a TB or primary health care (PHC) organization. They follow up on their patients until they complete their treatment. Since December 2019, TB People has helped 52 such patients, 19 of whom have completed treatment—Boris Zubenko was one of them.
The social worker who met Boris at the steps of the penal colony in November 2020 accompanied him through the end of his treatment in February 2021. He repeatedly visited Boris and his physician to check in on his treatment progress. After completion of treatment, TB People helped Boris obtain a passport and find work with a friendly organization, Ranar, where he could also find temporary residence in a social hostel.
Behind this and other incredible results is the huge work of TB People employees, who also find people with TB who have interrupted treatment after release and return them to treatment in the civil health sector. We establish good relationships with TB and PHC organizations to provide treatment, psychological support and counseling to our patients at all stages. Most importantly, TB People staff speak to TB patients as equals and can offer their own experience-backed counseling,” says Dilshat Khaitov.
As part of its goal to reduce the TB burden in the Kyrgyz Republic, Cure Tuberculosis works through its sub-grantees to improve early detection and access to TB diagnosis and treatment for people from hard-to-reach groups, reduce stigma and discrimination against people with TB, and support patients through a full course of treatment.
