MANILA, Philippines - Life practically came to a halt for 18-year-old Meliza Kawai after she was diagnosed to have multiple-drug-resistant tuberculosis (MDR-TB) in September last year.
Meliza could not understand why it had to happen to her. She was afraid that people would avoid her, given the stigma associated with TB.
“There were so many questions in my mind. At 12, I was diagnosed with (juvenile) diabetes so I was thinking, ‘why should I have all of these illnesses?’” she told The STAR.
But things got worse when, after undergoing treatment for three months, her condition did not improve. In December 2014, she was advised to go to the Lung Center of the Philippines (LCP) where she was found to have, not regular TB, but MDR-TB.
MDR-TB is a form of TB infection that is resistant to treatment with at least two of the first-line anti-TB drugs. An MDR-TB patient could also evolve into extensively drug-resistant TB when it becomes resistant to at least one or three second-line drugs. MDR-TB takes up to two years to cure.
Meliza dropped out of college when she was in second year of a banking and finance course.
“I started avoiding my friends and our neighbors for fear that I would be stigmatized. I also stayed away from my family because I was worried that I would infect them,” she said.
Meliza had a “death wish” but her family persuaded her to seek free treatment through the Programmatic Management of Drug Resistant TB (PMDT) of the LCP.
She is now on the seventh month of her 18- to 24-month treatment protocol and she is looking forward to being declared free from MDR-TB so she could hug and kiss her nieces.
Maricel Buen, 38, also felt like she was given a death sentence when she was told she had MDR-TB in November 2011.
She feared for her two children, aged eight and nine, whom she did not want to undergo the life she had as an orphan.
Maricel’s mother died when she was just 10 years old, while her father passed away six years later. Maricel knew how hard life is for orphans.
“I don’t want that to happen to my children, living with relatives. My husband is supportive of us but still, I want to see my children growing up,” Maricel said.
But before Maricel was correctly diagnosed with MDR-TB at the LCP, she suffered from misdiagnosis and mistreatment by two private doctors who gave her different diagnoses, including pneumonia and bronchitis.
For six months she was unnecessarily taking antibiotics until she was told to go to a barangay health center that advised her to go to the LCP where she was found to have MDR-TB.
Maricel also availed of free treatment through LCP’s PMDT until she was cleared of the disease in January.
TB Malaya campaign
Meliza and Maricel are among the MDR-TB patients who volunteered as bloggers for TB Malaya (TB Free) campaign. It was launched last Wednesday by the Tropical Disease Foundation Inc. (TDFI) and project proponent Mildred Pancho and her husband John Stuart Pancho.
Mildred is also one of TDFI’s successfully treated patients from extensively drug resistant TB. She met and married Stuart, who served as her nurse when she was undergoing treatment at the TDFI.
TDFI chief operating officer Leilani Naval said TB Malaya was conceptualized by the couple to help raise awareness about TB, primarily by providing a medium for information-sharing and real-life experience of people affected by the disease.
Patients, their families and health workers could post their poems and other articles about TB on the website.
“The idea is to encourage other patients to talk about it. Many patients have many questions, but they opt to be silent and hide their condition because of the stigma,” Naval said.
Phl high-burdened for TB
According to Mamel Quelapio, consultant on TB for various organizations including the World Health Organization, the Philippines is a high-burdened country for the disease.
TB is the seventh cause of morbidity and mortality in the Philippines, which is eighth in the 22 high-burdened countries for the illness.
“For MDR-TB, the Philippines is 27th in the world. TB is not an ordinary infection that you just prescribe (a medicine) that patients will take for seven days, and then they get cured,” she noted.
It takes at least six “uninterrupted” months, or Directly Observed Treatment Short-Course (DOTS), to cure regular TB. Patients under this protocol are strictly observed by the health workers to make sure that they do not miss on their medication, which is provided for free by the Department of Health.
Quelapio also noted that another challenge in the country’s fight against TB is private doctors who handle TB patients although they are not really experts on the illness.
“Private doctors would prescribe medicine but they are not able to monitor if the patients are taking them religiously. In the public health sector, the health workers make sure that the patients are complying with their medication,” she added.
TDFI president Thelma Tupasi has cautioned that non-compliance with the treatment could lead to MDR-TB.
“Many patients would not complete their treatment course primarily because of side effects like dizziness, vomiting and weakness. They feel like their quality of life is affected, so they choose not to continue with their medication which is wrong,” she added.
Amy Sarmiento, executive director of the Philippine Coalition Against TB, has underscored the need for patients to be diagnosed and treated correctly to prevent them from developing resistance to anti-TB drugs.
Sarmiento said that a person who was exposed to an MDR-TB patient, for instance, could also acquire the drug-resistant type of TB.
“There are many MDR-TB cases now because of past practices, like they do not complete their treatment and they do not undergo screening regularly to monitor their condition,” she added.