India: Improving TB care and treating victims of violence

MSF wants to improve the level of TB diagnosis and treatment and to document cases of multidrug-resistant TB and co-infection with HIV. Since January 2003, MSF has assisted internally displaced people (IDP) in the Kokrajhar district of Assam state in the wake of violence that displaced more than 300,000 people. MSF provides care to an estimated 45,000 people living in eight camps and to those in surrounding villages. MSF offers primary health care, malaria diagnosis and treatment, prenatal care and water and sanitation services. MSF teams care for patients in existing health centers as well as in the organization's own clinics and they carry out health promotion activities in the region. As malaria is an important concern in India, MSF has conducted drug-efficacy studies as part of its efforts to change India's malaria treatment protocols from recommending chloroquine to artemisinin-based combination therapy (ACT). As of April 2004, MSF has been permitted to use ACT as a first-line treatment. In the state of Jammu and Kashmir, MSF gives medical and psychosocial care to a population caught in the ongoing violence over Kashmir valley. Both sides of this 14-year conflict have targeted the local civilian population: disappearances, arrests, torture and rape are common. As a result, the people of Kashmir suffer from high levels of trauma and stress-related illnesses. MSF teams work in the districts of Srinagar and Kupwara to raise awareness of psychosocial problems and to improve the level of mental health care available. MSF-trained counselors work with patients in an MSF-supported clinic and directly in communities through mobile "on-the-spot" counseling in Srinagar. MSF counsels about 200 patients daily at the outpatient department of the Srinagar psychiatric hospital. MSF has worked in India since 1999. INTERNATIONAL STAFF: 21 NATIONAL STAFF: 90