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Even patients who can get medications may face a terrible choice. Sometimes the side effects are so intense, patients give up the treatment.
Josue Gamarra is completing two years of treatment for drug resistant tuberculosis in Lima, Peru.
“Sometimes when I take the medications, I have problems seeing and my ears buzz. And sometimes my stomach gets upset and it gets ugly,” says Josue. “Sometimes when I go to take my pills, it takes me two hours just to swallow them. I’d look at the pills and just seeing them would give me nausea.”
Josue got involved with other TB patients through a local clinic. “I’ve seen a lot of cases where people abandon treatment, and it makes it even worse. They have to go to the hospital. Sometimes it’s too late to cure them and they die,” he says. “The doctors told me, two years on this treatment. I had to do it to get better, and to protect my family by not infecting them. That’s why I had to continue. I don’t want any one to get this disease. I wouldn’t wish it on anyone, not one single person.”
The treatment and side effects kept Josue from a regular work schedule for two years. Now that he’s recovered, he’s eager to get back to work.
“I started working in my neighbor’s bakery and later on I worked in cleaning, and as a gardener and as a waiter,” Josue says. “I’ve always liked to work.”
But finding employment after TB can be as daunting as the treatment.
Viviana Pauca works with “Socios en Salud,” a local healthcare group. “It’s true that health is the most important point, but after we treat these patients and they get better, how are we going to reintegrate them into society?” she asks. “Often the jobs they are applying for ask for medical checkups. Many patients have lost a lung, or have lung damage. It would be impossible for them to find work.”
“Socios en Salud” teaches recovered patients how to start a small business of their own.
Working with the international non-profit, “Partners in Health,” they help launch micro- enterprises.
“Patients can generate some sort of income, without having to ask others who might reject them,” Pauca says. “We teach people how to recognize a good idea, how to start a business, how to seek growth in a business and how to manage the business carefully so it doesn’t fail.”
Josue plans to buy clothes at central markets that are hard to reach from outlying areas. He’ll re-sell the clothes in local markets, saving his neighbors the cost and trouble of transportation.
His mentors have high hopes for Josue. “He’s a very enterprising person. He can help other people believe they can get better, move forward and come out ahead,” Pauca says. “He knows that TB can’t stop him and that there’s a lot to be done after recovering from TB.”
Supervisors say they’ve seen other patients earn enough money to move from make-shift homes into places with more space, more ventilation and light.
This lessens their chances of tuberculosis re-infection, and sets up their whole families for better physical and economic health.