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18 March 2014 @ 09:20 pm
I watched TB: Return of the Plague on BBC4 last night, which despite the melodramatic title was a moving documentary focussed on two families in Swaziland dealing with multi-drug resistant tuberculosis. It was very well made, with due sensitivity to the patients and their families involved, one of them a 12 year old girl who spent 6 months as the only child in an isolation hospital. Swaziland has the world’s highest incidence of TB. Many patients are also HIV positive, although the documentary didn’t focus on this; given that 25% of the population has HIV, numbers-wise there are a lot of TB patients don’t have it.

In addition to the immediate sympathy for the situation in Swaziland, it also ended up giving me a much greater sympathy for the Chalet School and the San; an appreciation of how much Brent-Dyer is depicting a world in which doctors are working with treatments that they know aren’t good enough for the disease they’re dealing with. A lot of the stuff that I’d hitherto regarded as platitudes struck a chord with the experience of the medical staff in the film.

One thing that was clear was that not only do we desperately need new TB drugs, but that the MDR-TB patients badly needed access to psychological treatment as well. Treatment takes a long time and has serious side-effects, and there is major social stigma attached. People stop treatment, preferring to die at home than continue to endure it when it seems as if it is doing nothing for them, but as well as their individual suffering this potentially spreads further drug-resistant mutations of the virus. Obviously, limited funding was going to drugs and other direct physical support, and the doctors were well aware of the psychological dimension, but it was awful to watch people who were might because they couldn’t bear the treatment, though it had a good chance of curing them. The documentary mentioned, but did not play up, the element of this as a global health crisis, as it indeed it is. London has the highest incidence in western Europe, admittedly miniscule compared to other parts of the world. A friend of my sister is currently being treated for the (ordinary) TB that she almost certainly caught while teaching English in Indonesia.