Friday, November 19, 2010

Ineffective or Inaccessible Treatments are the same as No Treatment – Or Worse

Presently in Haiti there are cases of Tuberculosis (TB) that do not respond to the most powerful medications.  The new more deadly TB that has appeared is called Multidrug Resistant Tuberculosis (MDRTB). While TB is usually easy to treat and has low mortality rates (about 5%), this new line of infection is very difficult to treat, takes longer to cure and has about an 80% mortality rate.  It has been stated that due to the patient’s “non-compliance” with the current TB treatment, which could last as long as a year, the TB bacteria have evolved into a more powerful infection.

The typical treatment for TB is to take medications for two months, followed by a different set of meds for four more months. If the patient follows this treatment plan for the specified six months, he is considered cured.  It is very important during the treatment period that the patient drink clean water and live and sleep in an open-air house. The patient is expected to see the doctor every few weeks. (Remember, those folks who follow these treatment recommendations usually are cured of TB.) 

In places like Haiti, where TB is very prevalent, the more serious MDRTB is increasing. Why, you might ask?  Well…many reasons.  Haitian patients who have TB are being treated just like any other patient regardless of cultural and social conditions.  For instance, Haitians were told to drink clean water.   Most, however, choose to continue drinking from the only water source in their village, which is contaminated.  The next nearest clean water source is several miles away.  Most Haitians have no transportation, other than walking.  It has also been recommended that patients sleep in an open-air room away from others.  Regrettably, most could not build an additional room, with a nice open-air cathedral ceiling to their one-room hut! Moreover they were instructed to come back to the hospital for a regular checkup.  That hospital is several miles away from their village.  Instead of using their limited funds to rent a donkey, most decided to use their money to feed their family.  Does this dilemma of having to choose for one’s family over one’s ‘health’ sound familiar?

The treatment of TB has a proven ‘plan’ for its cure – take the meds, drink clean water, and don’t pass on the dis-ease.  The ‘plan’ does not consider the social and cultural barriers that prevent Haitians from following every single rule.  When Haitians are not cured of the simple TB and acquire the more potent and deadly MDRTB, doctors often blame the patient and label him as being “non compliant” and/or “difficult to treat.”

There are many illnesses (physical, mental, spiritual and social) that if not treated correctly at the onset, can also make the patient feel sicker and pass the dis-ease on to others!  Alcoholism and drug addiction seem to fall into this category.  Addiction is often passed on through generations unobstructed, appearing to get worse with each passing year. 

While there are alcohol and drug treatment facilities around Buffalo, NY, the closest program specifically for Native Americans is several hours away from their homes.  As Haitians suffer from the more virulent form of TB because of limited resources within their communities, Native Americans seem to suffer needlessly for lack of accessible resources.

It would be ideal if Native Americans living around Buffalo did not have to travel several hours outside of their own communities to access the most appropriate and effective alcohol and drug treatments.  However, until there are treatment facilities specifically for Native Americans located within their own communities, alcoholism and drug addiction is likely to continue to evolve into a more difficult problem to solve, continuing to harm future generations.

If you know of alcohol and drug treatment programs around Buffalo specifically targeted to treat Native Americans and are willing to recommend them, please share with us. Peace, DAP

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