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"Small steps towards healing": Tackling TB and alcohol addiction in Belarus

When alcohol is your primary coping strategy, giving it up can feel impossible. But when you recieve a diagnosis of another life-threatening disease, the need to do so becomes more urgent, and more challenging. Raman blogs from Belarus...

Earlier this year, I attended the 9th regional TB symposium. Such symposia have been organised annually since 2011 by Médecins Sans Frontières (MSF) and the ministries of health of the countries of the Eastern Europe and Central Asia.

This year, the symposium Overcoming challenges in TB care: from policy to practice took place in Ukraine.

Just imagine...

I was glad to see many like-minded people who take incredible efforts to defeat tuberculosis. Representatives of Ukraine, Belarus, Armenia, Georgia, Tajikistan, MSF, WHO, TB people, STOP TB Partnership, European Coalition Against Tuberculosis, USAID, Harvard Medical School gathered today to talk about achievements and challenges, share best practices and fresh perspectives.

The trend towards the introduction of short-term, all- oral regimens for the treatment of drug-resistant tuberculosis is very encouraging. Just imagine that patients will be spared from daily injections, for which you need to stay in a hospital for a long time or go to an outpatient clinic once or twice a day.

Wonderful news

Every time a team member excitedly shares the smashing news that another patient is completing treatment in a couple of weeks, I can’t believe that together with the patient we finally achieved the goal of being cured, and it seems that these months swept by.

At the symposium, my colleague and I made a presentation about the person-centred approach to helping patients with drug-resistant tuberculosis and alcohol problems. This approach, which we use in our project in Minsk, consists of multidisciplinary psychosocial support and harm reduction.

Tuberculosis and alcohol

Imagine that you are buying a refrigerator, and you are forced to buy a car along with it. You wouldn't be happy, right?

Similarlarly, when a person is treated for tuberculosis, they are expected to drastically change their habits and stop drinking. The person has just been told that they have tuberculosis, which requires a long, uncompromising treatment. For many of our patients, drinking is their primary coping strategy, and the only one available to them.

It is unrealistic to demand and expect that they can immediately stop drinking. You need to work with patients to reduce consumption, search for and teach new ways to respond to stress.

A journey towards recovery

The essence of person-centred care is to help the patient realise that the responsibility for their treatment is theirs more than anyone else’s around them.

All participants of the treatment process are determined to help them recover and utilise all possible life resources during and after treatment. Our goal is to help patients reduce their alcohol consumption to a safe level.

Alcohol addiction is a disease, and those who live with it cannot change overnight. They will have to deal with it their whole life.

Together, we take small steps to help them move towards healing.

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Read more: Stories from the tuberculosis and alcohol project

TB in Belarus: Saturdays at the tuberculosis clinic

I still have a suitcase in Minsk...