ARMENIA: SOCIAL WORKERS AND PSYCHOLOGISTS VITAL IN HELPING DR TB PATIENTS THROUGH TREATMENT
Medecins Sans Frontieres (Doctors Without Borders)
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March 24 2010
France
"If a patient is not healthy psychologically, it will be very difficult
for him to overcome this disease," said Hasmik Hakopjanyan, the MSF
psychological support supervisor.
Yerevan, Armenia. February 2010 – In the MSF-supervised drug-resistant
tuberculosis (DR-TB) programme in Armenia, the adherence of patients
to the treatment is a major issue. Among the patients admitted to
the programme in 2007, some 21 percent failed to complete treatment.
Treatment can take up to two years and patients must take a daily
cocktail of toxic pills, injections and powders. Side effects are
often severe, and range from nausea and disorientation to aggravating
pre existing medical complaints – particularly those associated with
the kidneys and liver – to the extent that doctors are forced to take
patients off the drugs and declare them medical failures.
As well as the medical staff treating DR-TB patients, social workers
and psychologists are an integral part of the MSF team, as they fulfill
a vital role in encouraging patients to see their difficult treatment
through to the end.
"If a patient is not healthy psychologically, it will be very difficult
for him to overcome this disease," said Hasmik Hakopjanyan, the MSF
psychological support supervisor.
TB carries huge stigma in Armenia, and the feelings of isolation
caused by disease, hospitalization and follow-up treatment have to
be addressed for the patient to be successful.
"Its common for people to be depressed, stressed and have a lack
of confidence," said Hasmik, who with her team of psychologists,
visits patients at all stages of treatment from hospitalization to
home-based treatment, when patients attend a clinic to take their
medication six days a week.
Relationships within families can often change dramatically, and
patients often need counseling to help them adjust.
"If the patient is male and the only one who works in the family,
he can develop feelings of uselessness," said Hasmik.
"We have a patient who now does not work, and he says that he now
cannot say anything to his children because they have to support him."
Patients usually start out motivated to complete the treatment,
but once side effects begin they can get deterred.
"When they start to take the drugs they start with the hope that they
will be cured, suddenly they face the development of side effects
which cause problems in their body, they can start to become hopeless,
thinking that maybe the drugs will not work," said MSF social worker,
Margarita Zalibekyan.
As well as needing help with psychological issues related to DR TB,
many patients need practical assistance in coping with the disease.
Social workers assist patients in getting the correct paperwork to
be admitted, help them with hygiene kits and food supplements during
hospitalization as well as assisting once they are discharged from
hospital to continue treatment while staying at home.
For those who need it, MSF gives patients coupons for food, as well
as fuel in the winter and a transport allowance ensure patients can
come to the clinic to receive their six-day-a week treatment once
discharged following the initial period of hospitalization.
Given the difficulties in completing treatment, every patient cured
is a cause for celebration.
"Of course I am happy when a patient gets cured," said Margarita,
the social worker.
"We feel we helped the patient get to the end of the treatment, but
it’s the combined work of the whole team to see the patient through
to the end of treatment," said the MSF social worker.
From: Emil Lazarian | Ararat NewsPress
