CNS: Articles of Hara Mihalea

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How important is nutritional support to TB patients and their families?

Hara Mihalea, CNS Correspondent, Thailand
There is a debate whether providing food packages to TB patients motivates them to stay and successfully complete their treatment and so far there is no evidence to fully support this theory. However, people like me who for years have worked at the patient level, can say with confidence that when families do not know when their next meal will come from, they will not seek care when they are sick because they neither want to lose their daily income nor spend the little money they have at the health centre or hospital.

Voices from the ground: Stories of people affected by tuberculosis

Hara Mihalea, CNS Correspondent, Thailand

42 years old Khun Mouk (name changed) comes from a small village of Chiang Rai in North Thailand and does odd construction jobs for a living. When I met him he looked very ill. His wife said that he had been like this for some time now--not eating and losing weight, coughing, feeling very hot, and feeling very tired. Initially he took several herbal medicines to get better. But when they did not relieve his symptoms he went to a pharmacy as well as two private clinics for help. He was given different kinds of cough syrups, antipyretic medicines for the fever and mucolytic tablets to release his cough.

Hara Mihalea - CNS
In response to the numerous unmet needs of women, girls, and transgender people-- especially those affected by HIV, TB or malaria—the Women4GF (women for Global Fund) initiative was launched earlier this year (2013) as part of The Global Fund Gender Equality Strategy. Preceding the 11th ICAAP held recently in November 2013 in Bangkok, a two day workshop on Gender Equality for advocates and activists of Key Affected Populations (KAPs) was organized by the AIDS, Strategy Advocacy and Policy (ASAP) and funded by the Global Fund for TB, AIDS and Malaria (GFTAM or simply GF).

Photo credit: Vinai Dithajohn/UNAIDS

Hara Mihalea and Bobby Ramakant
Signalling an essential shift away from tokenistic participation of young people in HIV programming to encouraging genuine leadership by them was given strong emphasis at the first ICAAP media briefing ahead of the opening ceremony. “We should put the responsibility of fighting AIDS in the hands of people who have a future, rather than in hands of people who had a history,” declared Mechai Veravaidya, Chairperson of the ICAAP local host organization, The Population and Community Development Association.

Following my return from the 43rd Union World Conference on Lung Health (13-17 November 2012, Kuala Lumpur) one evening I happened to be watching CNN, when suddenly, hooray, TB was the topic of a roundtable discussion. Few tips were given on how TB spreads, few tips were given about the long duration of the treatment and the ‘graduation of TB to MDR-TB’ and yes, a long discussion of how TB enters the US and, yes of course, it was blamed all on the immigrants-- the Mexicans crossing the border, the Eastern Europeans, the Africans, and many other underprivileged and marginalized groups. Isn’t it always the case of someone being blamed for something that someone else is not doing right?

Hara Mihalea, PATH

(Written by Hara Mihalea, PATH)

I like to start by sharing a real story which I experienced in one of my visits in the field last year. I'm sure many of you working in the field have similar stories to tell. During a monitoring visit for our PPM program I came across a referral slip made out by a pharmacy staff referring a 36 year old woman to the DOTS health center. Looking at the symptoms circled on the slip one could tell that this was certainly a pulmonary TB case; weight loss, fatigue, chest pain, fever, and cough with blood. We traced the referral to one of the district health centers where we found out that the woman had indeed gone for further evaluation, she was checked, diagnosed, given medication and sent home.