TB care in the Russian Federation

TB is one of the major unmet needs of healthcare in Chechnya. TB mortality and morbidity skyrocketed in the war decades since the whole medical and administrative infrastructure of the TB care was ruined. Moreover, people had to live in overcrowded, cold, damp and badly ventilated shacks or basements in Chechnya or in IDP camps outside the republic. It was often difficult to follow-up on the treatment of TB patients since they became displaced. Since 2004, MSF has rehabilitated four of the five TB hospitals in the republic; in Nadterechnaya, Gudermez, Karagalinskaya and Shali, which cover the population of around 300,000 in five districts of Chechnya. MSF supports the local Ministry of Health doctors in the implementation of a DOTS programme there. MSF health educators ensure that the patients adhere to the treatment and MSF mental health counsellors work with the patients and their families. The treatment success rate for TB bacilli sputum positive patients is over 80 percent. In total, 1,500 patients - and in 2007 alone, 455 patients - were enrolled into the programme. This year MSF also hopes to include the Republican TB hospital in Grozny, the main referral TB hospital in Chechnya. This will enable MSF to access TB patients in remote mountainous regions of the east and the south of the republic, which were excluded before. This effectively means that the MSF programme will be expanded throughout Chechnya.