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Successful treatment MDR-TB, Mankayane, Swaziland

First group of MDR-TB patients celebrate end of treatment

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“I feel like jumping and dancing and shouting,” says Linda Vilakati. “It has been a long and difficult journey, but I’ve reached the end.”

Linda is one of 55 people celebrating with songs, smiles and tears at Swaziland’s Mankayane hospital. Linda is 48, but the youngest at the party is just three years old. They are the first group to have completed two years of gruelling treatment for multidrug-resistant tuberculosis (MDR-TB) at Médecins Sans Frontières’ (MSF) project in Mankayane, run in partnership with Swaziland’s Ministry of Health.

Linda waves a certificate, which reads: “Although treatment was lengthy and came with its hardships, at the end I managed because I value my life and my health comes first.”

Linda began treatment for tuberculosis (TB) in 2010, but two years later he had gotten worse, rather than better, and was diagnosed with MDR-TB, a strain of the disease that is resistant to treatment by the usual drugs. The only medicines currently available for MDR-TB are highly toxic and can have serious side effects.

“After six months of injections I developed ear problems,” says Linda. What began as a buzzing noise in his ears developed into partial deafness in his right ear and total deafness in his left. The deafness caused by the drugs is irreversible, but Linda now accepts that, with the current drugs, there was simply no alternative if he wanted to get better.

I owe my life to the MSF teams. They took good care of me. I even named their cars ‘my car’, because whenever they came to visit I knew they would bring health, hope and help to me. Whenever I saw ‘my car’, all my worries and frustrations vanished Linda, treated for MDR-TB

“Losing my hearing was very difficult for me,” says Linda, “but I tried to be positive about it, telling myself that the doctors knew what they were doing. Eventually I accepted that this was the price I had to pay for my health.”

Linda’s hearing problems were not his only hardship. “I just wish treatment was not so long,” he says. “It is not easy to take 15 tablets that make you sick every day for two years.”  The difficulties were made worse by the fact that Linda was forced to stop work when his health deteriorated. Short of money, he did not have enough to eat, and found it doubly hard to take medication on an empty stomach. During this time, he and his wife relied on handouts from their neighbours and on support from MSF.

As well as medical care, MSF provided him with regular food hampers and bus fares to the hospital. Linda also received psychological support from an MSF counsellor, and visits from a community treatment supporter who helped motivate him to stick to the treatment until its end. MSF’s outreach team also made home visits to help with infection control. Sometimes the team will add extra windows or doors to a patient’s house to increase the flow of air; at other times they may construct an extra bedroom for patients to reduce the risk of infecting family members with the disease.  

“I owe my life to the MSF teams,” says Linda. ”They took good care of me. I even named their cars ‘my car’, because whenever they came to visit I knew they would bring health, hope and help to me. Whenever I saw ‘my car’, all my worries and frustrations vanished.”

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Tuberculosis
Journal article 6 February 2014