I was reading about a story of a 14 year old Afghan girl called Fazilla. She had started complaining about pain in her legs. The doctors said it was rheumatoid arthritis. They gave her medicine but it didn’t help her pain. There were more tests and more prescriptions. X rays revealed a serious scoliosis of the spine. After a point she was unable to sit properly. In 2006, she was finally diagnosed with a very rare form of tuberculosis, known as tubercular spondylitis. She was put on standard treatment for tuberculosis. After nine months of treatment she was tested again, this time results were negative for tuberculosis. Unfortunately, her spine was permanently damaged. But she is still alive. On the downside, she has lost three years of schooling and her good health. It is sad as we know if she was diagnosed on time, all of this was preventable.
Afghanistan is one of the 22 high TB burden countries, and TB is a major public health problem. As per the World Health Organization (WHO) estimates, each year 37,313 to 42,593 new cases of TB occur in Afghanistan, with more than 10,000 people dying from TB each year. Furthermore, over 32,500 TB cases are women, a highly vulnerable group, which accounts for 65% of all cases of TB presenting to public clinics.
Today the detection trend in Afghanistan has greatly improved. Our advocacy and social mobilisation through awareness campaigns in television, radio, and billboards has raised social awareness on TB. We trained 6,700 community health promoters to implement TB DOTS. Training for service providers and private practitioners proved a success. BRAC has also ensured procurement and regular supply of Anti-TB drugs through Global Drug Facility (GDF). We have worked closely and organised meetings with BPHS implementers and NTP personnel at the provincial, national and regional level to strengthen our stance against TB.
Today we have renewed hope as TB is being defeated. The World Health Organisation introduced DOTS to treat TB in 1993. In 2001 there were only 36 health facilities applying DOTS and now in 2011, there are 582.
We saw Fazilla suffer because she was not detected in time. Today, we can talk about a better, brighter situation. The latest statistics by WHO published in 2011 are encouraging. In 2001, the detection rate of TB was only 26%. After the hard work of many, today 66% of TB cases are detected, and more than 85% of the cases are treated successfully. The graph below shows the progress in the last ten years. Only 34% TB cases remain undetected now compared to 74% in 2010.
(Story of Fazilla: From the book Tuberculosis: Voices of the Unheard by the WHO in 2008)
– Faisal Rezwan, BRAC Communications