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TB in Belarus: Facts and figures show us the way

Impressions can be deceiving. For Christian, a German psychotherapist working in Minsk, facts and figures show what really works.

Nurse dispensing medication in a TB dispensary

It’s necessary not only to do good, but also to talk about it, of course. However, it is not enough just to find fine words, but you also have to be able to prove your good work with figures.

Often, the current impression of our day-to-day business is deceptive, while the objective, long-term development may be different.

In Minsk, figures are particularly important because we are in a culture of scientists and researchers. Even in the days of the Soviet Union, the wise minds were trained here at the universities.

No one is content with vague assumptions or promises, and that is a good thing. Most MSF projects are in so-called developing countries, where it is usually a matter of alleviating short-term distress and then strengthening the health system.

Why are we doing this in Minsk? Excellently trained doctors with an interest in science work here. They are open to discussion, innovation and change. There is curiosity and a desire to learn.

Here in Belarus we work very long- term. Although we are a comparatively small project, we try out new approaches and try to back them up with facts and results.

We consider our work very important for the development of new approaches to the fight against drug-resistant tuberculosis, and now that we are trying to provide reliable data and concrete results about the psychosocial work with our patients, other countries are starting to take an interest in our project.

Why are we doing this in Minsk?

Excellently trained doctors with an interest in science work here. They are open to discussion, innovation and change. There is curiosity and a desire to learn.

The latter is very important, because in Belarus, as well as in the post-Soviet culture as a whole, there is a clear understanding of taboo diseases (tuberculosis, alcohol dependence) and what kind of attitude people face in the outskirts of society.

Nevertheless, as a psychotherapist from Germany, I try not to look down on it.

We, of course, have a very developed rehabilitation system, but I suppose that we have not made much progress in how society solves the problem of taboo diseases. I said in the first part of this blog, until the summer of 2018, I thought that tuberculosis had long been defeated.

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MSF counsellor with a patient

Many countries in Eastern Europe and Asia still do not recognise the scale of the problem of alcohol dependence and the threat posed by tuberculosis – after all, it is one of the deadliest infections in the world.

The situation with the Belarusian Ministry of Health is different. Problems are recognized and support is sought.

In 2014, it was the Ministry of Health that invited MSF to work in Belarus. Therefore, here we have the opportunity to share experiences, develop concepts and prove their effectiveness using facts and figures to encourage decision-makers in other countries.

Tuberculosis knows no boundaries. Just remember the terrible noise in the press a few weeks ago, when news appeared about a hundred new cases of infection with tuberculosis in southwest Germany.

As they say, in negotiations it is always good to have an ace up your sleeve. Or, in our case, data on the hard drive.

Returning to the topic, we need facts.

This is not very interesting and not typical for me, but it seems to me that I spent about a third of my working time improving the documentation system of our work – bringing patient documentation up to the standard and systematically collecting, recording and analysing data.

This is difficult because for the first time we began to collect not only medical data, but also data on psychosocial support and its effectiveness. Which we are of course trying to prove.

This means that we combine relatively “soft” data with hard facts, namely, success factors such as adherence to treatment and the result of anti-TB treatment.

It may sound simple and logical, but it means that we need access to the medical data of patients, which in many countries is not so easy or even possible to obtain due to the lack of qualified personnel. Again, our colleagues from the Republican Scientific Practical Center for Pulmonology and Phthisiology (RSPC) in Minsk are a pleasant exception.

Next, we had to develop a procedure for collecting and analysing data because there was nothing suitable for our needs. Whatever we do, we are the first.

In July, the time came. Finally, we were able to provide statistics on our joint work with the RSPC.

We are still far from the goal, but finally there is a feeling that we are moving in the right direction. Our hypotheses are confirmed, we are beginning to observe the effect and note signs that indicate what further steps are necessary. Now, we have arguments not only for continuing work in Belarus, but also for expanding its scope with the support of other organisations.

As they say, in negotiations it is always good to have an ace up your sleeve. Or, in our case, data on the hard drive.

This is a pleasant feeling.