Barbara Farashishko (52) from Mabvuku, Harare, will always remember the year 1995 as they year her entire life changed completely following a Tuberculosis (TB) diagnosis at Parirenyatwa Hospital. The events that followed her positive TB diagnosis led to a plethora of misfortunes such as losing her Job, loss of family, massive stigma from family and society and above all, two more TB reinfections in the years that followed.
By Michael Gwarisa
Her TB journey started when she was pregnant in 1995 after she began coughing and experiencing shortness of breath and would have difficulties sleep. Because she was pregnant, she thought it was nothing serious. Even those whom she asked would tell her that the symptoms she was having were common amongst pregnant women.
However, symptoms persisted even after giving birth, a move that prompted her to visit the local clinic where she was later referred to Parirenyatwa Hospital for specialist attention.
At Parirenaytwa Hospital, I was admitted in the C4 ward, i had numerous tests done on me including sputum tests and an x-ray examination but still, no sign of TB was detected in my lungs or phlegm. It took a Lumbar puncture procedure to detect that i actually had TB,” said Barbara.
A Lumbar puncture, also known as a spinal tap, is a medical procedure in which a needle is inserted into the spinal canal, most commonly to collect cerebrospinal fluid for diagnostic testing.
“After the Lumber puncture had been done and a positive TB result came, i was then transferred from Parirenyatwa Hospital to Wilkins Hospital. I was admitted at Wilkins Hospital for three months. Because i had TB and Wilkins Hospital is an Infectious Disease Hospital, i could not stay with my newly born baby, neither could i breastfeed her. My parents took care of her during that period.
“In my fourth month at Wilknins, a Doctor’s strike ensued and all patients were discharged since there was no one to attend to us. I boarded public transport home and disembarked at the bus stop. I was still feeling sick and weak and I couldn’t walk on my own so my father had to carry me on his back. Imagine getting home on your father’s back in the ghetto and having all eyes staring at you in that state.”
She continued taking her medications and after six months, she started breastfeeding her baby after consultation with the doctors at Beatrice Infectious Disease Hospital who prescribed medications for her to ensure she could breastfeed without infecting the baby.
“Where I was married, the family said they were no longer comfortable having me stay with them as they feared I would die. So they told me to stay at my parent’s. I however thank my parents who stood by me during that period when nobody wanted to even get close to me.”
Double TB Reinfection
By end of year 1995, Barbara had completed her TB treatment. However, her joy lasted for a short while as she was hit again by another TB infection in the year 2000 and another one eight years later. Tuberculosis (TB) recurrence can result from either relapse of an original infection or exogenous reinfection with a new strain of Mycobacterium tuberculosis (MTB).
“In the year 2000, the TB was in my lungs unlike the first time. I was initiated on my medications instantly and I received about 60 injections during that same year. My child whom I had given birth to in 1995 unfortunately passed on that same period. I could not mourn her properly as i had to go get my jabs everyday. I continued getting my injections for two months and I was also taking the tablets. Eight years later, in 2008, I was again reinfected with TB and this got the doctors worried. That is when they referred me for HIV testing and the results came out positive. I was initiated on an antiretroviral regimen. So i would take the TB injections and drugs concurrently with the HIV medications,” added Barbara.
According to studies, HIV increases the rate of recurrent TB by increasing the rate of reinfection disease and the catastrophic collision of tuberculosis and HIV has yielded an extraordinary burden of suffering and death at both the individual and population levels. The convergence of these twin epidemics results in millions of deaths globally due to tuberculosis. Tuberculosis is thus the leading cause of death in people with HIV/AIDS, and HIV infection contributes to a substantial proportion of tuberculosis deaths.
However, for Barbra even though she was experiencing drug fatigue as she was taking both HIV and TB medications at the same time, she says that since the day she was initiated on Antiretroviral Therapy (ART) in 2008, she has never had any TB reinfection or relapse.
Stigma and Discrimination
Following her first diagnosis in 1995, Barbara said she experienced massive isolation, neglect, stigma and discrimination from siblings and those in her community.
“I encountered a number of challenges. Stigma and discrimination was one of them. I could see people talk and pointing fingers at me. Some were already seeing the walking dead in me. At one point, I heard a neighbor reprimanding her daughter who had come to see me during that period. Even some of my siblings could have non it. I remember some wouldn’t even touch the utensils I would have used.They would make sure my clothes don’t mix with theirs and even the utensils that I used, they labelled them with initials to my name,they would not make a mistake of using them.
“Even some of our tenants had to leave for fear of being infected. In the community, people did not want to associate with me. In 2008, I lost my job as a cleaner at this other cleaning company because of TB. At work, they started by giving me light duties before they officially told me that I was fired and they could no longer have me on the team. It started off as a sick leave, after some time, a communication came informing me that my services were no longer required even though they did not give a genuine reason for my dismissal.”
Community TB Voluntary Work
Following her TB Journey, Barbara has now dedicated her time and life to volunteering as a TB Champion and advocate in Mabvuku.
“I am now volunteering in the community with my peers where we are trying to reduce the new TB infections and morbidity through peer education in health facilities in our area and also leading support groups in her community educating people around TB and how best they can manage it. I always tell people that having TB is not a death sentence. TB can be treated if one gets access to treatment and a good nutrition. My life is a testimony, I was bedridden at some point and couldn’t even do anything but all that has changed now, I am now fit.”
Through the support groups and peer to peer meetings they have, Barbara offers psycho-social support to TB patients and survivors. She also acts as the bridge between the Clinic and the community and vice versa. She also does defaulter tracking and assists in following up on TB and HIV patients who would have defaulted on their medications and refers them back to treatment.
Those who know Barbara from back in 1995 when she had her first TB diagnosis can attest to the fact that she is a conqueror and has defeated what many had deemed her death sentence. It took resilience, adherence and a positive mind-set for Barbara to emerge victorious from this life-threatening situation. TB is not a death sentence and with early detection and treatment access, it can become a thing of the past.
