Every cloud has a silver lining
 
Assalam Alaykum!  Greetings from Tajikistan.  
 
I remember when I was the Director of Fundraising, TB was a topic that I was always shy of talking about to our supporters because many donors thought that treatment of TB is a long process, especially if it is multi-drug resistant tuberculosis (MDR-TB), and it is very costly. Donors would prefer to see MSF using their donations in medical actions that produce instant results and with massive impact, like vaccination campaigns.  
 
Indeed, MDR-TB treatment takes two years to complete, which is a very long process. There are a lot of side effects, causing both physical and emotional discomfort, pain, and even suffering.  Even adult patients find it difficult to stick to the treatment and many would give up, let alone young patients. With a long and costly treatment process and a relatively high chance of failure as patients drop out, what hope is there to offer to our donors and attract their support?
 
Until I met Michkona.  
 
Just a few days after my arrival in the project, the team threw this modest but very delightful “party” for Michkona – she is our first patient and her medical file is numbered “001”.  Two years ago when we first started treatment with her, she was just 15 years old – and like any other teenagers, Michkona went to school, liked to hang out with her friends and wear beautiful dresses to make herself pretty.  But when she was found out that she was infected with MDR-TB, she was kept away from school. One of the drugs she had to take had to be injected and it was very painful. The side effects of the other drugs made her even sicker as she was having nausea and serious headache. She didn’t have energy to make herself pretty any more. In fact, she felt really miserable, and she didn’t want to see anyone.
 
And just like any other teenager, she wanted to prove and establish her individuality by being “rebellious” – she put up big fights with her mother, ran away from our counselors and tried to skip treatment…all these behaviors are very “normal” and “reasonable” if I think of myself having to go through a similar treatment process.
 
But with the help of MSF doctors, nurses and counselors, together with the support from her family, Michkona finally completed her two full years of treatment and she is now entirely cured from MDR-TB!  It was such a joyful moment! 
 
On the day of her “party”, many other kids infected with TB came to celebrate with Michkona. They came to witness her joy, and more importantly, the fact that there is indeed hope of being cured of this horrible disease. 
 
Beatrice LAU is a financial and administration coordinator from Hong Kong. She has served on missions in Niger and Haiti. She was formerly the Director of Fundraising in MSF-Hong Kong. In September 2013, she departed to Tajikistan as a Project Coordinator for 2 years.
 
In 2011, MSF and the Ministry of Health in Tajikistan started a paediatric TB programme. Under the holistic approach family members as well as the children are being treated. The programme promotes the use of sputum induction, a rapid test for every child with suspected TB, the scale up of contact tracing activities and paediatric drug compounding.
There are 450,000 people infected with drug-resistant tuberculosis (DR-TB) in 2012. They face similar challenges as patients in Tajikistan do, and are in urgent need for shorter, safer and more effective treatment. MSF has launched the “Test me, treat me” manifesto (http://msf-seasia.org/tb) to ask for global support in urging key power brokers, including governments, funders, pharmaceutical companies and policymakers, to radically transform DR-TB care.
 
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