Some people show exemplary bravery in the heat of battle. But it takes true courage to fight a battle where you are alone in your despair, when the enemy is within you, where you do not have your comrades fighting alongside you. You are alone in your pain, fear, despair, darkness, and uncertainty.
Image: Zolelwa Sifumba
Life withers or expands in proportion to one’s courage. At just 22, Dr. Zolelwa Sifumba contracted Tuberculosis in the line of duty from “occupational exposure.” She was a medical student then, just into her initial clinical placements.
While on rotational duty at different hospitals in South Africa, Dr. Sifumba contracted TB from an infected lymph node growth on her neck.
To make matters worse for her, Sifumna had a variant of the disease that was resistant to the two most potent TB medication, rifampin and isoniazid. Being a medical student she was immediately aware of the difficulty in getting through it. While TB is in itself a very difficult disease to fight through, having MDR-TB made it more so. More than the breathing difficulty associated with TB, she had to endure the multiple side effects of MDR that included nausea, diarrhea, kidney failure, psychosis, hearing loss and much more.
Excruciating pain was a constant companion and at times she felt like giving up. At times the treatment for MDR-TB seemed more painful than the disease itself. Worldwide TB kills more people than any other single infectious disease. As per the latest report by the World Health Organisation, Over 10 million people were afflicted globally in 2017 and 558,000 developed TB that was rifampicin-resistant, the most potent frontline drug while 82% of them were multidrug-resistant TB(MDR-TB). 87% of all cases were reported from 30 countries while 3 countries, India (24%), China (13%), and Russia (10%) reported the highest number of MDR/RR-TB cases.
TB is caused by bacteria that spread through the air. It usually affects the lungs, but can also affect the brain, the spine or the kidneys. It is curable but the toll it takes on the mind and body is appalling. And only 40% of the people afflicted ever got through.
Excruciating pain and despair were a constant companion. But she pulled through, one painful day at a time. The stigma attached to TB goes back to the days when it was incurable. So people prefer not to reveal if they are afflicted, or even seek treatment.
TB generally attacks people who have a weak immune system, the main reason it attacks people who are HIV positive, as their immune system are the most compromised. Living close to people with TB puts one at risk as the bacteria spreads through the air. And nobody is immune to the disease.
Dr. Sifumba was under treatment for 18 months, “a constant storm” she says, and in 2014 she finally pulled through.
Since then, Dr. Zolelwa Sifumba is one of the Faces of the Fight, a series by Global Fund that highlights the story of workers at the frontline to tackle global health issues like TB. It is disturbing that TB, outside the medical community, does not get the global attention and urgency that it deserved. The Global Fund to fight AIDS, Malaria, and Tuberculosis is an international organization that financially supports programs in more than 100 countries.
— Trevor Noah (@Trevornoah) August5, 2019
TB is pandemic and only organizations with global outreach can be effective on a large scale; this is where Global Fund can contribute. 60 nations have already committed funds. The non-government organizations and the private sector have also been generous. A notable mention is the Bill & Melinda Gates Foundation. Their contribution has been a great help.
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The overall mortality has dropped since 2000 by 37%. Doctors and other health workers who are at the frontline everyday need all the support that they can get. Funding is also needed to fight the stigma associated with TB. Social issues are as much the reason for patients dropping out of the course of treatment. A patient is left without a job and gets socially isolated when their affliction is revealed.
Dr. Sifumba says that the medicines had definitely helped her but what kept her going were those who guided her through the rough journey and made it more bearable. The compassion that she shows her patients is a legacy of her days as a patient when she was able to overcome the ordeal thanks to the support of the health workers and the doctors.