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TB & Me: "Today I am alive, and I value my life"

Vadim Kravchenko first contracted tuberculosis in prison. He shares his journey and explains why fighting the disease is about more than just medication...

I feel that recovering from TB is not just about medication but also how you feel and how you perceive yourself. So now I exercise and do pull-ups for two hours every day.

I am looking for a job too, but it is proving to be so difficult. A job should bring satisfaction, I aspire to a job that is needed by society but that also pays the bills. But there was a time when my life was beset by negativity and illness. Today I am alive, and I value my life.

Prison

I had a normal childhood. My father worked in the Zhytomyr court and my mother used to work in a bank. I studied history and I used to spend most of my time with friends at the local hangouts. But I got involved with street gangs, and in 1994 I went to prison for the first time.

I felt medical workers in the prison did not think of prisoners as human beings...

Amongst my friends then, it was seen as quite admirable to be jailed and released. Later I was involved in robberies and violent crimes. In 2000, I was sentenced to death for the murder of two people but my sentence was later commuted to nine years. For the first three years of that prison sentence I was completely alone.

"I was ready to die"

It was in the confined spaces of Zhytomyr prison that I contracted TB for the first time. For the first eight months I was limited to a tiny physical space. In that small room, I was fading. I had a high fever, I lost weight and I was sent to the special ward for TB patients. There I found out that I had TB and tested positive for HIV too.

I was ready to die as my sentence was long and I was only 24 or 25 years old. From the window of my cell, I used to see black body bags and the doctors used to tell me that most TB patients in the prison system would eventually die. I felt medical workers did not think of prisoners as human beings.

Using drugs and alchohol

I survived those years due to the support of my parents. I used to get better food. And perhaps better nutrition helped me recover in those years. When the Ukrainian parliament introduced laws to support TB patients in penal institutions, I returned to Zhytomyr and continued to serve the remainder of my sentence there. I was later released but ended up in prison again for a robbery. By that time, I had started using methadone and getting drunk on vodka.

If there are no jobs and no future opportunities, no moral support from friends and family, then you come to the conclusion that no-one cares

While I was in treatment for drug addiction, I found that I had drug-resistant TB and moved to the TB Dispensary in Zhytomyr. I would crave vodka and sometimes I would try and source bootleg alcohol from my contacts in the area. When I entered the MSF programme, I felt vulnerable and had uncontrollable emotions. Subsequently I discovered that I had liver cirrhosis and had contracted hepatitis C.

More than medication

Treatment for drug-resistant TB needs to factor in a lot of things. Sometimes drugs have side-effects that need to be explained to patients like me; otherwise we start to doubt and stop taking our medication.

The authorities need to think of adequate nutrition – four meals a day. Besides food, you need to maintain your spirits. Isn’t that where a psychologist comes in? Prisoners like me get food parcels once we are discharged but if there are no jobs and no future opportunities, no moral support from friends and family, then you come to the conclusion that no-one cares. The food parcels are exchanged for vodka and sometimes the TB returns.

"Together in the fight"

It is not possible to fight TB alone. That’s why we need psychologists and social workers. Patients, doctors and social services all have to cooperate; we are all together in this fight.

The doctors and the psychologists at the TB Dispensary helped me a lot; they stood by me in support and felt that I was listened to. I felt the MSF psychologist was honest and sincere with me. I have decided to not drink alcohol again. I am also receiving hepatitis C treatment, which will be completed in May 2021.

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In collaboration with the regional TB hospital, MSF in Zhytomyr offers free care involving the combination of a shorter treatment, the use of new highly-effective drugs (bedaquiline and delamanid), outpatient care, psychological counselling and social support services.