MSF teams in Georgia and region: concerns about interrupted TB treatment

Following the outbreak of violence in the breakaway region of South Ossetia and subsequent attacks by the Russian army on the Georgian territory, MSF is active with the situation of thousands of people who have fled the conflict, and is also alarmed at the possible interruption of treatment for drug resistant tuberculosis (TB) in programmes in Georgia and Abkhazia. Assessing the refugee situation on north of the Russian border Two MSF assessment teams arrived in the region of North Ossetia on the weekend, where the main flow of people fleeing the violence from South Ossetia was expected. Although numbers are difficult to establish, there are clearly many people escaping from the conflict zone, heading mainly to the Russian province of North Ossetia, but also to other regions within Georgia. MSF teams are assessing the needs of displaced people and are prepared to provide staff support, as well as medical kits and other relief items. Currently, the needs of those who sought refuge in North Ossetia seem to be met by the Russian health authorities and the emergency organisation Emercom. MSF will also try to gain access into South Ossetia, which is currently inaccessible. MSF is also present in Georgia and Abkhazia, providing health care to patients affected by drug-resistant TB. The teams are preparing to provide support to hospitals in Georgia and to evaluate the needs of the people who have been displaced by the conflict. Support to Georgian hospitals and initial evaluations The MSF team in Tbilisi, the capital of Georgia, will support several hospitals in Georgia, providing medicines for patients who have been injured or burned, in collaboration with the Georgia health authorities. The hospitals in various regions of the territory have admitted close to 1,200 injured patients who are being cared for by Georgian doctors. Other evaluations will be conducted on Wednesday, August 12, in the internally displaced-persons camps located around the city of Tbilisi. There are three camps in the city and five camps surrounding the capital, each with a few hundred displaced persons. Teams will also attempt to access South Ossetia to pursue evaluations, but the region remains inaccessible for the time being. Concerns relating to the provision of resistant-TB programs The on-going treatment of patients affected by multi-drug resistant tuberculosis (MDR-TB) is of key concern to MSF. Suspending a TB program for even a few days can have dire consequences on the health of the patient. For the time being, the two MSF MDR-TB programs will continue. In Soukhoumi (Abkhazia), our team is still providing treatment to 80 patients in the hospital and in seven mobile clinics. In Zougdidi (in Georgia), where close to 120 people are under treatment, MSF international staff have evacuated the city, while local teams remain present in the health structures to provide care. Despite their presence, three patients have already left the hospital, which will probably have a negative consequence on their treatment. As TB is a contagious disease, their departure may also pose a serious health risk for those with whom they come into contact. Both MSF teams in Soukhoumi and Zougdidi have two weeks worth of medical supplies for MDR-TB. In two weeks time however, they will have run out of one of the drug molecules (PAS), which will negatively affect the continuity of treatment for the patients.