Meet Our Patients (32): Toto’s Story – Tuberculosis Case (Together with SMRU)

Today (World TB day, 24 March 2018) we share the hope for a better life of Toto, a young adult in his 30s. Recently, he visited Mae Tao Clinic because he had Tuberculosis (TB) symptoms. He recognized the symptoms because he had TB one time before.

 

A few years ago, when working in Bangkok, Toto was tested positive for HIV. Later this was confirmed in Myawaddy hospital. Only in 2016, when he was diagnosed with TB at MTC, he started anti-retroviral treatment (ART). He was admitted at Shoklo Malaria Research Unit (SMRU) clinic for TB treatment, and SMRU helped him to enrol for HIV treatment at Myawaddy hospital.

His journey to Mae Tao Clinic is a long one. After being sick for months, going from one clinic in Bangkok to another, he got several diagnoses including cancer, TB, and HIV. He could not afford any of the treatments and decided to go back to his home country Burma. He stayed in one hospital for days waiting for his diagnosis, but when the nurse scowled at him and shout aloud about his HIV status in the patient ward, he decided that he could not stay and left the hospital. This was a matter of dignity.

And then he heard about Mae Tao Clinic, about how we support the idea that patients need a friendly environment to feel secure, and to understand and adhere to their diagnosis and treatment.

Before becoming ill, Toto has had a difficult life. He was born in Yangon around 1985 in a poor family with a Chinese mother and Burmese father. He was raised by his grandmother and only attended school until grade 4, when he was forced to leave the house and look for income because his grandmother died. Toto told us that he was trafficked and was sold to a fishery company close to Bangkok. He worked for several years without being paid. Then he left this company to work in a shop in the Ranong area.

When he arrived at Mae Tao Clinic in 2016, he was quickly diagnosed with TB. He accepted to be treated for the required 6 months and was admitted at the SMRU TB clinic where he completed his treatment.

Toto was eager to go back to work after finishing his TB treatment, feeling healthy again. He found a job as a translator on the Myanmar- China border and therefore was no longer attending the HIV clinic in Myawaddy hospital. After several months, his immunity levels went down and he got infected with TB again. He travelled back to Mae Sot to meet the SMRU TB doctor at Mae Tao Clinic, because he knows that they will listen to him, not judge him and organize his treatment.

After a thorough discussion with the doctor and the counselling team in the TB clinic, he agrees to start treatment for TB and for HIV again. He wants to share his story to help other patients to understand how important it is to adhere to treatment. Toto now understands that he may have to change his life and stay close to a place where he can get ART on a regular basis.

Toto’s story shows how poverty and lack of access to health care may lead to deteriorating health. In addition, many patients do not feel comfortable at government hospitals because of the attitude of the staff. Some leave the health facility without appropriate diagnosis and treatment, or have erratic health care seeking behavior. This is an important concern, especially when we are talking about contagious TB patient. A patient-friendly environment with patient education and building trust is a significant factor contributing to better treatment results.

We want leaders who support the idea that access to health care is a human right, regardless of their origin, religion, or diagnosis.

(This case story is provided by the SMRU)


Consultations

2013 2017 Variation
(2013-2017)
Thai Bur Thai Bur Thai Bur

HIV testing (VCT)

289 252 467 370 +62% +47%

TB screening

216 1 009

+367%

Malaria total caseload

306 410 14 16 -95% -96%
Malaria admission 73 118 5 6 -93%

-95%

The cross-border referral network among the Myanmar Ministry of Health and Sports (MoHS), International Organization for Migration (IOM), Shoklo Malaria Research Unit (SMRU) and MTC has been strengthened. Together with partners, MTC has been tackling the pervasive diseases along the border: Malaria, Tuberculosis and HIV. Through the effort, total malaria caseload has significantly dropped while the number of TB screening and HIV testing show the considerable increase. This evidently illustrates the positive impact of cross-border collaboration.