Afghanistan: Conquering of TB pentagon as dilemma in Afghanistan
By:Najib Amiri and Sayed Baqir
25 March 2009
Having an ever expanding rate in poppy cultivation, vast poverty and huge stigmatizations towards Tuberculosis (TB), number of positive cases is soaring by time. On cue of the points in absence of enough therapeutic TB center , lack of TB experts and health workers can we count on Ministry of Public Health (MoPH) of Afghanistan declaration on increase of detection rate to 50% till 2011?
Najib Amiri and Sayed Baqir have tried to study the implementation of this declaration possibility in this report.
In isolated and humid room in center of Samangan north of Afghanistan, 12 years girl Zamarud‘s constantly coughing had a special music. Flinching while interview she was not able to hide ample of poverty and expressing her obligation to work here.
Her black, pale and thin body building was indications for TB smear positive cases. She was complaining from loss of appetite; constantly cough with blood, early getting up in the morning, night sweating as well. Her co-worker 20 years Nider who is under TB treatment process for 7 months cannot hide his anxious and recalls his bitter memo of his parents deaths and her last advice of his mother “ my son , go to doctor . But be care full that villager did not know that.”
He does not claim any one guilty in the adventure unless their self- stigmatization. He remembers his father strong negating on going to doctor and usual treatment of him by eating poppy directly.
According to experts smoke of poppy and cannabises affect lungs and branches and causes abnormality in follow of blood in body .Not speaking of carpet industry workers, but also addicts are in front line of the illness. Being 1.5 million edicts in the country can we count all edicts as TB positive cases? Dr.Abdullah Fahim spokesman of the MoPH certifies the clue indirectly saying most of the edicts are in a vulnerable condition Cancer, HIV/AIDS, Hepatitis, and TB.
Living with a group of edicts Ghulam Rasol expresses himself as lost and ill one .He is positive with TB and his doctor has refuted him thanks insufficient money. Currently Afghanistan ‘s health sector is run by private sector , free governmental hospitals and human train aids implemented by some medical None Governmental Organization in frame work of Basic Package Health based on Community (BPHS). The associations plus some special therapeutic centre on detection and treatment of TB are dealing in Direct Observation Treatment System (DOTS) outline.
According to the system every patient should spend two months under doctor in health facility and the rest will be supervised by one his/ her close person(Family member , friends ) calling support groups.
Referring to Dr.Friad TB program responsible of Aide Medicale Internationale (AMI) in Samangan province, though DOTS is effective on change of community thoughts and TB treatment, “still the problem is committed is a stigma.” But can we count on the MoPH assumptions on reducing of TB in presence of vast stigmatization, lack of drugs, health workers and experts and slapdash behaviors of men towards women – whom are the majority of TB victims-?
Khadija Haidari a midwife and psychosocial worker shakes hand in refusal by recalling one of her memories in Dahni Manjo special TB therapeutic center in Lal and Sari Jangal of Ghour province. She remembers a mother of 8 children fleeing home for the health center by night and aggressive attitude of her husband while expelling of the dying mother from the center ward.She admitted a huge gap in process of the mother TB case treatment and its changing to Multi Drug Resistant Tuberculosis (MDR-TB). This is one of the most problems on the way of anti TB campaign thanks to bulky amount of unqualified and even expired medications in black markets.
Mr.Safi the pharmacy of AMI NGO claims that “there was no efficiency and real quality in TB drugs like Septromicine and other drugs sold in black markets any longer.”
Not existing of any resettlement program here the rate of population growth is getting up rapidly. While there is not any national tightly done strategy on family planning and birth spacing and mostly populated families or sweet haunt of TB.
Malali (mother of 9 children) lives with her husband and her rival wife in one room. She says that she and her three children are TB affected. His husband is an addict framer in poppy framer of Zhili district of Kandahar in south of Afghanistan. He did not use poppy, cannabises, but by joining to the poppy farmers now he is addict and TB positive. Her home was bombarded in military operation getting them shifting to Kabul the capital of Afghanistan where the doctors admit her staying at least five months in clinic.
But Ghulam Ghus (her husband) negates the proposition thanks to their tight code of clans. He said “It was a shame to leave his wife there alone.” Doctors have diagnosed the mother as MDR-TB owner due to some delay in referral and constantly defaulter and stoppage in her treatment process.
Having eyes on the aforementioned cases the MoPH spokesman informs from 1031 TB therapeutic centers in all over country while the minister of MoPH demanded strengthened campaign against TB in Brazil on TB international seminar recently.
Anyhow , poverty , self – stigmatizations, low rate of medical information , lack of regular medications supply and scientific researches , poppy cultivation are angles of TB pentagon which bitterly break down speed of health sector in the country and remain them failed.
By:Najib Amiri and Sayed Baqir
25 March 2009
Having an ever expanding rate in poppy cultivation, vast poverty and huge stigmatizations towards Tuberculosis (TB), number of positive cases is soaring by time. On cue of the points in absence of enough therapeutic TB center , lack of TB experts and health workers can we count on Ministry of Public Health (MoPH) of Afghanistan declaration on increase of detection rate to 50% till 2011?
Najib Amiri and Sayed Baqir have tried to study the implementation of this declaration possibility in this report.
In isolated and humid room in center of Samangan north of Afghanistan, 12 years girl Zamarud‘s constantly coughing had a special music. Flinching while interview she was not able to hide ample of poverty and expressing her obligation to work here.
Her black, pale and thin body building was indications for TB smear positive cases. She was complaining from loss of appetite; constantly cough with blood, early getting up in the morning, night sweating as well. Her co-worker 20 years Nider who is under TB treatment process for 7 months cannot hide his anxious and recalls his bitter memo of his parents deaths and her last advice of his mother “ my son , go to doctor . But be care full that villager did not know that.”
He does not claim any one guilty in the adventure unless their self- stigmatization. He remembers his father strong negating on going to doctor and usual treatment of him by eating poppy directly.
According to experts smoke of poppy and cannabises affect lungs and branches and causes abnormality in follow of blood in body .Not speaking of carpet industry workers, but also addicts are in front line of the illness. Being 1.5 million edicts in the country can we count all edicts as TB positive cases? Dr.Abdullah Fahim spokesman of the MoPH certifies the clue indirectly saying most of the edicts are in a vulnerable condition Cancer, HIV/AIDS, Hepatitis, and TB.
Living with a group of edicts Ghulam Rasol expresses himself as lost and ill one .He is positive with TB and his doctor has refuted him thanks insufficient money. Currently Afghanistan ‘s health sector is run by private sector , free governmental hospitals and human train aids implemented by some medical None Governmental Organization in frame work of Basic Package Health based on Community (BPHS). The associations plus some special therapeutic centre on detection and treatment of TB are dealing in Direct Observation Treatment System (DOTS) outline.
According to the system every patient should spend two months under doctor in health facility and the rest will be supervised by one his/ her close person(Family member , friends ) calling support groups.
Referring to Dr.Friad TB program responsible of Aide Medicale Internationale (AMI) in Samangan province, though DOTS is effective on change of community thoughts and TB treatment, “still the problem is committed is a stigma.” But can we count on the MoPH assumptions on reducing of TB in presence of vast stigmatization, lack of drugs, health workers and experts and slapdash behaviors of men towards women – whom are the majority of TB victims-?
Khadija Haidari a midwife and psychosocial worker shakes hand in refusal by recalling one of her memories in Dahni Manjo special TB therapeutic center in Lal and Sari Jangal of Ghour province. She remembers a mother of 8 children fleeing home for the health center by night and aggressive attitude of her husband while expelling of the dying mother from the center ward.She admitted a huge gap in process of the mother TB case treatment and its changing to Multi Drug Resistant Tuberculosis (MDR-TB). This is one of the most problems on the way of anti TB campaign thanks to bulky amount of unqualified and even expired medications in black markets.
Mr.Safi the pharmacy of AMI NGO claims that “there was no efficiency and real quality in TB drugs like Septromicine and other drugs sold in black markets any longer.”
Not existing of any resettlement program here the rate of population growth is getting up rapidly. While there is not any national tightly done strategy on family planning and birth spacing and mostly populated families or sweet haunt of TB.
Malali (mother of 9 children) lives with her husband and her rival wife in one room. She says that she and her three children are TB affected. His husband is an addict framer in poppy framer of Zhili district of Kandahar in south of Afghanistan. He did not use poppy, cannabises, but by joining to the poppy farmers now he is addict and TB positive. Her home was bombarded in military operation getting them shifting to Kabul the capital of Afghanistan where the doctors admit her staying at least five months in clinic.
But Ghulam Ghus (her husband) negates the proposition thanks to their tight code of clans. He said “It was a shame to leave his wife there alone.” Doctors have diagnosed the mother as MDR-TB owner due to some delay in referral and constantly defaulter and stoppage in her treatment process.
Having eyes on the aforementioned cases the MoPH spokesman informs from 1031 TB therapeutic centers in all over country while the minister of MoPH demanded strengthened campaign against TB in Brazil on TB international seminar recently.
Anyhow , poverty , self – stigmatizations, low rate of medical information , lack of regular medications supply and scientific researches , poppy cultivation are angles of TB pentagon which bitterly break down speed of health sector in the country and remain them failed.
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