Our Staff Reporter exposes how a group village head expelled her daughter-in-law, a glimpse of discrimination and exclusion of people with multidrug-resistant tuberculosis (MDR-TB).
She wanted a happy marriage, but Esther Loleya’s dream was shattered when her mother-in-law sent her packing.
The 33-year-old was forced to separate from her husband of three years after being diagnosed with MDR-TB on April 23 this year.
“His mother forced me to go for testing,” says Loleya on how she tested positive to the bacterial disease which does not respond to isoniazid and rifampicin, the first-line drugs given to TB patients.
On April 26, she started taking second-line medicine, an expensive dosage which requires extensive chemotherapy for up to two years.
“Every day, I take 11 drugs plus an injection,” she says.
She had taken the dosage for just a week when her mother-in-law— group village head Chibweya in Traditional Authority Chigaru, Blantyre—evicted her on May 4.
“She called my relatives and told them that I had to leave the place because she was tired of taking care of me. This happened when I was in a critical condition. I could not walk, eat nor speak.”
But Loleya had no option.
“Since there was no ambulance, my husband carried me away on a bicycle…” she narrated between sobs. “My own husband took me and dumped me at my relative’s house. I saw him cycle back to his mother’s place.”
The news shocked a clinician Chipiriro Ngwali who was offering her treatment at Mdeka Health Centre.
“I reasoned with the village head, but it never worked. I asked family members to intervene, but nothing worked. Today, I am walking a long distance to give her medication,” she says.
Presently, Loleya is staying in a one-room hut without windows. It houses 13 people, including her two daughters.
“The house is too small and congested. The one she shared with her husband was bigger. My fear is that she might infect other family members. With poor ventilation, the germs spread easily,” says the clinician.
According to Centre for Disease Control and Prevention (CDC), MDR-TB is contagious.
It spreads from person to person through the air when a person with TB of the lungs or throat coughs, sneezes, speaks or sings.
“These bacteria can float in the air for several hours, depending on the environment. Persons who breathe in the air containing these TB bacteria can become infected,” reads the fact sheet.
In an interview, Loleya’s mother-in-law confirmed evicting her.
She reckons she was tired of providing care and support “without any assistance from her relatives”.
“She married my son and her relatives were taking advantage of this. They never supported her since she was diagnosed with the disease. However, this is not the end of the marriage with my son. She will come back once she is healed,” said the group village head.
Loleya is disappointed and angry.
When asked about the future of her bond with the man she married when she was 30 and healthy, she asserts: “It is better to remain on separation than to go back to a man who does not care when I am sick.”
But Loleya’s story personifies how people with drug-resistant TB in the country keep facing discriminatory abuses.
Some of them are shunned, abandoned and evicted from homes by people who are supposed to support them and provide the care they need throughout the lengthy dosage.
This story of exclusion dumbfounded National TB Control Programme director Dr. James Mpunga.
“This is very unfortunate, why doing this to a patient?” he asks. “This should not be coming from a village head who we trust when implementing projects to ensure people with TB live without stigma and discrimination.”
He promised to link up with health workers at Mdeka to offer her decent housing.
According to the 2012 MDR-TB survey, almost five percent of patients who suffered from TB previously are likely to be diagnosed with the condition.
“These figures mean that the MDR-TB prevalence for Malawi is low, says Mpunga.
The country will roll out another MDR-TB survey later this year.
“As a country, we report not more than 60 MDR-TB patients every year. The treatment duration for MDR-TB is 24 months, but the country will within two weeks start offering treatment which will take just nine months,” says Mpunga.
According to World Health Organisation (WHO), TB kills 5 000 people a day.
In 2016, the United Nations’ health organisation reported that about 10.4 million people were diagnosed with TB and 1.7 million died.
But over 95 percent of TB deaths occur in low and middle-income countries like Malawi.
The heaviest burden is carried by communities which already face socio-economic challenges, including people living with HIV, migrants, refugees, prisoners, ethnic minorities, miners, marginalised women, children and older people.
WHO, in its new ethics guidelines, discourage isolation of contagious patients and discriminatory policies against affected people.