“We are the only lifeline that people have”: How the Red Crescent helps to control HIV and TB co-infection in Kazakhstan
In Kazakhstan, the figures for HIV / TB co-infection illustrate a stark reality: TB is the biggest killer of people living with HIV. There are an estimated 12,000 people living with HIV in the country and more than a third of die of TB, despite it being curable.
Five years ago, the Kazakhstan Ministry of Health (MoH) was providing medical treatment to those living with HIV (many of them from the most vulnerable sector of the population) but was struggling to deal with the social aspect of the work. Their dilemma was how to reach those people in need and ensure they completed the full course of treatment in a culture where there is still huge stigma attached to HIV – and where many of those affected have been ostracised and forgotten.
When the Kazakh Red Crescent Society approached the authorities in the industrial town of Temirtau – which has the highest rate of HIV in the country – with an offer to work in partnership on providing HIV and TB co-infection support, it was exactly what they had been looking for.
Sholpan Baimurzina, Temirtau AIDS centre director from the MoH explains: “To reach these people and ensure treatments are followed, we need the social support that the Red Crescent provides. This is what was missing in our programme, so when the Red Crescent came to us to suggest this partnership, we were very enthusiastic.”
The Red Crescent is one of just a few organisations in Kazakhstan that specialises in HIV and TB co-infection support. Controlling TB and HIV co-infection has been singled-out as vital to making progress in reducing TB incidence and mortality.
The programme, funded by Astra Zeneca via the British Red Cross, is co-ordinated by Red Crescent multi-disciplinary teams, including a psychologist, a social worker and a lawyer. It targets those with co-infection who are considered most likely to default on their treatment. Clients are usually referred by the AIDS Centres and may also come on their own. Nearly three quarters of clients are former prisoners – of which over half are injecting drug users or homeless people.
The project is already seeing impressive results. Sholpan says: “By providing social support to our patients, we have seen the mortality rate in Temirtau start to decrease in 2007 and 2008 by roughly 25 percent since the co-infection project started. This positive trend is so encouraging; we are seeing these people get better and seeing our strong relationships with them grow.”
For those like Alexander (36), an ex-drug addict and ex-convict from Karaganda, the programme was literally a life-saver. Alexander’s life was turned around through the Red Crescent’s support and he now volunteers for the co-infection programme. “Helping others to live with the same diagnosis of co-infection became my mission in life,” Alexander says. “This programme is about survival. Sometimes we are the only lifeline that people have.”
Images © Claudia Janke/British Red Cross