Fighting TB
A tuberculosis survivor leads group that helps patients deal with the disease
Ma. Cristina Brigaste was so good at taking care of patients at a government hospital that not once did she think she would one day be a patient herself. So just imagine her nightmare when she found out she had tuberculosis.
Since then, the 27-year-old nurse knew her dream career would no longer come true.
“I had TB when I was volunteering at a government hospital for nine months. Sobrang bumaba ‘yung resistensiya ko dahil sa pagod at hindi pagkain sa loob ng eight hours. (I was always tired and I could not eat for eight hours so my immune system weakened.) Because it was a government hospital, the nurse-patient ratio is so big. Nagrorotate kami sa ER na naka-simpleng mask lang, minsan wala pang suot. At hindi namin alam kung sino doon ang may TB. Nawalan na rin ako ng alaga sa sarili (We were rotating in the ER wearing only a simple mask; sometimes we didn’t even wear one. We didn’t know who had TB there. I failed to take care of myself),” recalled Cristina.
She was cured after the six-month treatment in 2011. But three months later, the signs and symptoms returned; this time the disease has become multidrug-resistant TB (MDR-TB).
“Hiyang-hiya ako noon at nalulungkot kasi nagvovolunteer na nga lang ako, tapos nahawa pa ko. Iniisip ko noon, paano na ‘yung future ko? Paano pa ko tatanggapin bilang nurse kung may tama na ‘yung baga ko? (I was so embarrassed and sad then because I was just volunteering and yet I contracted the disease. I was thinking, what will happen to my future? How can I land a job as a nurse if my lungs are already damaged?),’” Cristina said.
SURVIVING THE ORDEAL
The ordeal of going through the treatment for MDR-TB was physically, emotionally, and financially draining for Cristina who had to deal with adverse reactions to the anti-TB drugs she was taking, the stigma attached to the disease, and the cost involved in availing of the treatment.
“Bukod sa takot akong mahawa ang pamilya ko, sobra pong hirap. Walang araw na hindi ako sumusuka tuwing umiinom ako ng gamot. Ang laki rin ng gastos ko kasi kailangan kong mag-taxi araw-araw mula sa bahay ko sa Marikina papunta at pauwi sa Lung Center of the Philippines (LCP). Hindi ko kaya mag-jeep at magpalipat-lipat ng sakay kasi hilong-hilo ako. Never pa akong nalasing sa alak pero sa mga gamot na iniinom ko, mas lasing pa ko sa lasing (Apart from my fear of passing it on to my family, coping with TB was so hard. There was not a single day that I did not vomit when I took the medicines. My transportation expenses were also costly because I had to take the cab every day to and from my house in Marikina to LCP. I couldn’t take the jeep because I got dizzy. I have never got drunk from alcohol but with the medicines, I felt more wasted than those who got drunk from alcohol),” she shared.
For 18 months, Cristina had to endure the daily intake of 11-14 tablets, which she would pair with juices and snacks and consume within two to three hours. She would also engage in activities with other patients to deal with drug reactions such as vomiting and nausea.
“Ako ‘yung klase ng pasyente na hirap na hirap talaga sa pag-inom ng gamot. Kailangan unti-untiin kong inumin para hindi ko maisuka ‘yong mga gamot kasi sayang. Ma-iincomplete ako at hindi maka-count ‘yong araw na ‘yon kapag kulang ang nainom ko. Kaya hinahalo ko sa juice at kumakain din kami ng snacks na tinatawag naming pulutan pag umiinom para makaya ko (I’m the type of patient who finds it difficult to take medicines. I have to take it one at a time so I do not spew it out. If you fail to drink one medicine, you will be marked incomplete for that day. That’s why I mix it with juice and take it with snacks so I can endure it.),” she said.
Because of the medicines, Cristina developed hypokalemia and suffered from insomnia, difficulty in hearing, and poor memory. People would talk behind her back and stay away from her for fear of getting infected. Through all these, Cristina drew comfort and the dedication to finish the treatment from her supportive family and newfound friends, who were fellow TB patients.
CHAMPIONING THE RIGHTS OF PATIENTS
“Naging mas magaan para sa akin ang lahat noong naging member ako ng patient support group. Na-feel ko na hindi ako nag-iisa, may ibang nakakaramdam din ng nararamdaman ko. Tumatambay kami sa Lung Center office hanggang sa mawala ang tama ng gamot, at sabay-sabay kaming umuuwi pag okay na. ‘Yun at ang libreng gamot na binigay ng The Global Fund through PBSP ang nakatulong nang malaki sa akin (Things started to get easier when I became a member of a patient support group. I felt I was not alone because there were other people who were going through the same thing. We stayed at the Lung Center and left the hospital together when the effect of the medicines had subsided. That and the free medicines given by The Global Fund through PBSP were a big help to me),” said Cristina.
Established in 2001, the Samahan ng Lusog Baga Association, Inc. (SLB) is the first organized group of former TB patients in the country. When Cristina became its president last year, she organized more advocacy and patient-centered activities that included community lectures and TB information dissemination. The SLB also actively participated in national and local TB consultation and planning workshops. SLB initiated livelihood activities for its members and plans to put up chapters nationwide to reach out to more TB patients. SLB seeks to build its capacity to become peer educators of TB patients.
Her group also works closely with the treatment center Patient Support Group of the Lung Center of the Philippines (LCP) National Center for Pulmonary Research.
Cristina is now a training specialist for Programmatic Management of Drug-resistant TB at the LCP. Her group is bent on empowering patients to open up, get treatment, and eliminate the stigma and discrimination that come with the disease.
The Global Fund to Fight AIDS, Tuberculosis, and Malaria funds Philippine Business for Social Progress’ flagship project in health, the Intensifying and Mainstreaming Directly-Observed Treatment Short Course Project, which aims to assist the Department of Health National TB Control Program in reducing TB prevalence and mortality by 50% by 2016 from the 1990 baseline in support of the Millennium Development Goals for poverty alleviation.
Part of the project is the provision of free diagnosis using state-of-the-art TB rapid diagnostic tools, second-line TB drugs, and patient enablers for multidrug-resistant TB patients nationwide.
“Malaki ang pasasalamat namin sa The Global Fund, Lung Center at sa PBSP dahil kung hindi dahil sa libreng gamot at serbisyo, hindi kami gagaling sa TB. Kaya hinihikayat namin ang ibang hindi pa nag-a-out, na magpagamot na sila dahil pagkatapos ng treatment, babalik rin sa normal ang kanilang buhay (We are very grateful to The Global Fund, Lung Center, and PBSP because if not for the free medicines and services, we will not be cured of TB. That’s why we urge those who have not yet sought treatment to avail of the services. I assure them that after the treatment, their lives will return to normal),” Cristina said.