Success Story: Abdul Ghaffar

Abdul Ghaffar, 20, lost his father as a young boy and is the sole provider for his family, running a pan shop in Lasi Muhalla, Kalakot, Lyari. In January 2007, he began coughing constantly with sputum, experiencing regular bouts of fever during the nights with rigors and losing weight at an alarming rate.

Ghaffar visited multiple doctors to find the source of his illness, but only received treatment for his symptoms. After two months, his conditioned had deteriorated to the point that he was unable to walk or eat. His family became increasingly worried that his health would not improve.

Then one day his family received a pamphlet on the signs and symptoms of tuberculosis (TB) produced as a component of Greenstar’s TB Good Life Project. As a result of the information provided in the pamphlet, Ghaffar’s family was able to link his symptoms to those associated with TB. They immediately contacted Greenstar’s community health officer (CHO), Amir Balouch.

The TB Good Life Project’s slogans, “TB treatment at your doorstep” and “TB treatment only a phone call away,” held true to its claim. CHO Amir Balouch made a house visit to Ghaffar to assess his condition. After recognizing the signs and symptoms of TB in Ghaffar, Amir called Dr. Abid Jalaluddin Shaikh of Greenstar, for his professional opinion and recommendations on the next steps to take.

Abdul Ghaffar, left, with Greenstar community health officer, Amir Balouch, right.

 

Since Ghaffar was bedridden and thus unable to make the trip to the nearby provider, Amir took a sample of his sputum and sent it immediately for microscopy at a nearby laboratory. Two days later, Amir collected the results from the laboratory and delivered the results to Ghaffar. Ghaffar had tested positive for TB.

“I was shocked to learn that I had TB and couldn’t imagine returning to a normal life again,” said Ghaffar. After undergoing counseling, Ghaffar was registered for TB treatment with Greenstar-trained provider, Dr. Daulat Lohano. He began his treatment in April 2007.

Ghaffar’s treatment was monitored by CHO Amir to ensure compliance. His condition began to improve dramatically. The coughing and fevers had been controlled and he started gaining weight. After five months of treatment, Ghaffar returned back to his regular routine, opening his shop again to earn money for his family.

After eight months of treatment, in December 2007 Ghaffar was declared cured of tuberculosis, owing to his commitment to follow his treatment and the commitment of his family and the Greenstar team.

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Success Story: Shahida and her family celebrate healthy life.
Access to Tuberculosis Treatment and Quality Care Saves Family Lives in Korangi, Pakistan

At the age of 54, Shahida is taking care of her grandchildren with more energy and zeal after the successful treatment of TB DOTS.

She describes her story very proudly when she was being treated for pneumonia by her G.P two years back. She visited a GoodLife trained provider, Dr. Hafeez to seek a second opinion where she was diagnosed as a smear positive T.B patient.

“The news of being found Smear positive was a shock for me, I could hardly imagine that I would be a healthy person again”, says Shahida, who is now enjoying a healthy family life with her extended family.

Shahida and her family share happy moments with the GoodLife team. Korangi, Sindh, Paksitan

At the third DOT Visit, GoodLife Community Health Officer, Nadeem found her daughter, Bushra, 34 and grand daughter, Rukhsna, 16 with the same symptoms and suggested to send her daughter and grand daughter for the lab test. “ My daughter was not willing to go for the test, having passed through the same phase, I tried and succeeded in convincing her” describes Shahida with a pride.

Shahida and her family is one of the 5000 TB patients cured by GoodLife Cure TB program in Pakistan. Financially supported by The Global Fund, the GoodLife TB DOTS program is part of the government’s initiative to control TB.The Ministry of Health began implementing Directly Observed Therapy, Short-Course (DOTS) in 1995, with Balochistan as a pilot province. Between 2000 and 2004, DOTS coverage through the public sector has increased in Pakistan from 9 to 79 percent.

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TB DOTS -- New Hope in Reducing Tuberculosis
Fighting TB with TB DOTS in Pakistan

Pakistan ranks seventh among the 22 high-burden tuberculosis countries worldwide, according to the World Health Organization (WHO) Global TB Report 2006. Every year, approximately 280,000 people in Pakistan (primarily adults in their productive years) develop TB.

Population (thousands)	154 794
TB burden (2004 estimates)
Incidence (all cases/100 000 pop/yr)	181
Incidence (ss+/100 000 pop/yr)	81
Prevalence (all cases/100 000 pop)c	329
Mortality (deaths/100 000 pop/yr)c	40
Case detection rate (all cases, %)	36
Case detection rate (new ss+, %)	27
DOTS coverage	79%
DOTS treatment success (2003 cohort, %)	75
Source: WHO Report 2006

60-year-old Khuda Bakhsh is the sole bread earner for his wife and six children. He lost hopes to recover from TB as he believed TB was not curable. He was under treatment for Pulmonary Tuberculosis for eleven months and there was no relief. Then, someone advised him to go to a far TB Sanatorium, where he was again screened and was found smear-positive. Hopeless Khuda Buksh heard of a camp organized by GoodLife TB DOTS Program in Rawalpindi. He went to Adil Diagnostics lab in March 2006 to give his sputum sample. He started shedding tears the moment a doctor asked him how he was feeling; all he could say was “Dr Sb Khuda ke wastay mera ilaaj karain” (Please Doctor treat me for God sake!).

The doctor found that Khuda Bukhsh was initially diagnosed by a general practitioner as having Pulmonary Koch’s and was put on Anti Tuberculosis treatment (unfortunately under-dosed), and not as per DOTS protocol. The brief summary suggested that Khuda Buksh was found smear-positive at the end of the second month, and he was put on continuation phase medication. Khuda Buksh was also not educated about right dosage and he never stopped smoking while being under treatment.

Having seen his history, the GoodLife doctor decided to take Khuda Buksh’s case as a challenge. She educated him about DOTS strategy, and requested for his cooperation to quit smoking. As a category II patient, Khuda Buksh was registered as a relapse type. Initial Intensive phase continued for three months with Injection Streptomycin as per DOTS protocol. At the end of the third month, his sputum was found out to be negative for the first time.

The GoodLife TB DOTS program is part of the government’s initiative to control TB. The Ministry of Health began implementing Directly Observed Therapy, Short-Course (DOTS) in 1995, with Balochistan as a pilot province. Between 2000 and 2004, DOTS coverage through the public sector has increased in Pakistan from 9 to 79 percent. Now, the government is also trying to increase DOTS coverage through private sector partners such as Greenstar/GoodLife.

	“This is a new day, filled with hope for a better tomorrow”
Khuda Buksh at GoodLife Camp, Rawalpindi. Pakistan, March 2006. Photograph courtesy: Mirza Mohammad

 

In 2001, the government declared TB a national emergency, which led to a 15-fold increase in the budget, including contributions from a wide range of donors. Incidence of active Tuberculosis is estimated as 246/100,000.

After seven months on treatment, Khuda Buksh is putting on weight and is feeling much better than before. Khuda Buksh is now hopeful and runs a grocery store. He has committed to create awareness in the community about TB DOTS, and everyone can see the signboard on his shop saying “TB is a curable disease”.