You can’t begin to fathom the heartache of not being able to support your loved ones, watching them struggle while you feel utterly powerless. It was terrifying when I thought I had a life-threatening illness that made me fear for my life. But things took a different turn. With the medication, I’m feeling hale and hearty. – Abdi Mohamed, MSF patient.
Introducing this innovative treatment regimen is particularly crucial in conflict-ridden countries like Somalia, where inadequate access to healthcare makes effective treatment even harder to come by.
“During those initial four months, I was confined to bed, feeling like a mere shell of myself,” shares Ahmed Elmi Mohamud, a 65-year-old former teacher from Garowe in northeast Somalia. “But now, I feel much better.”
He recounts his battle with tuberculosis post-treatment at Mudug Tuberculosis Hospital:
“I religiously took every prescribed pill without missing a single dose. I knew each was a step closer to reclaiming my life. After six months, the battle with tuberculosis was finally behind me,” expressed Ahmed.
While he experienced some side effects, “more importantly,” he adds, “it helped me conquer a disease that once made me fear for my life.”
Abdi Mohamed Ali waits in the MSF-supported TB hospital in Galkayo North, in Somalia. Somalia 2024 © Mohamed Ali Adan/MSF
Shorter Treatment Regimen—A Boost for Somalia
Frequent conflicts and climatic hazards like drought have led to mass displacement in Somalia’s northeast. Thousands are forced into cramped living conditions. Combine this with a fragile healthcare system and rampant food insecurity, and the risk of infections like TB or DR-TB skyrockets within households and communities.
“When I tested positive for tuberculosis, I had to stop working,” says Abdi Mohamed, currently undergoing treatment at the TB hospital. “You can’t grasp the agony of being unable to provide for [your] family, witnessing their struggles as you feel helpless. I was engulfed by worry, fearing I had a fatal illness. But, the outcome was different. After medication, I feel alive and well.”
Somalia TB Medications
Medicines for drug-resistant tuberculosis (DR-TB) at the MSF-supported Mudug Regional Hospital in Galkayo South, Somalia. Somalia 2024 © Mohamed Ali Adan/MSF
Economic Barriers to Access
The bulk of patients at the TB hospital come from villages around Galkayo. Unable to work due to their illness, many struggle to afford travel to and from Galkayo. Some lack family members for accommodation, making it even harder to stick to their prescribed medications. Limited income forces many tough decisions, hindering consistent treatment access.
“Most of these patients don’t reside in this town,” explains Dr. Hassan. “They travel from far-off areas, requiring treatment for months. They lack access to shelter and food. This facility operates as an outpatient center.”
“We provide daily or weekly services to those in town,” he adds. “For those from distant areas, we supply a month’s worth of medication.”
Liban Noor, hailing from Hilmo village on Galkayo’s outskirts, tested positive again after a previous six-month treatment. Now under BPaLM treatment for 40 days, Liban holds onto hope while continuing his battle.
“My biggest hurdle is that I’m not from this town and don’t have a place of my own,” says Liban. “I feel like a stranger with nowhere to call home.”
MSF’s Role in Galkayo
In collaboration with the Ministry of Health and the national tuberculosis program, MSF teams manage DR-TB treatment at Mudug Tuberculosis Hospital. Of the ten patients on the BPaLM regimen this year, two have completed it successfully, showcasing its effectiveness.
With fewer side effects and a shorter treatment duration, the BPaLM regimen is promising a transformative change in TB care in Somalia. In conflict and drought-stricken regions with limited healthcare access, scaling up this regimen could significantly improve patient outcomes.
MSF’s effort to implement the BPaLM regimen underscores our dedication to combatting DR-TB, especially in areas where maintaining consistent treatment is challenging. To widen access, it’s vital to decentralize TB care in Somalia. By bringing treatment closer to remote and underserved communities, we can enhance patients’ adherence to treatment and ease the burden of prolonged hospital journeys. Decentralizing care and scaling up the BPaLM regimen are pivotal for reaching more patients and advancing the battle against DR-TB.
Edited by: Ali Musa
Axadle international–Monitoring
