“Better Health for a Better Life” Herat Multidrug-Resistant TB Ward Saves Lives

August 2, 2019

Abdul Majid, a MDR-TB patient, at the main gate of the newly built MDR-TB ward in Herat. Photo © UNDP / S. Omer Sadaat / 2018


Abdul Majid’s mother was sick for ten years. However, because of limited access to health facilities in their remote village, she was not able to get the treatment she needed for her form of tuberculosis (TB). Finally, she died of the illness.

However, for Majid, the problems were just beginning. “Not long after she died, I started to have difficulties in breathing, coughing, as well as back and chest pain,” he remembers.

These are classic symptoms of tuberculosis. He felt weaker by the day, and couldn’t work, and eventually, could not even get up to walk. Nor could he afford the drugs necessary to treat his condition.

“Doctors were prescribing me all kinds of drugs, but because I could not afford to take them regularly, they stopped having an effect.” said Majid.

One day, however, he learned about a newly-built TB hospital in Herat. Majid went to the hospital where he was diagnosed with multidrug-resistant (MDR) TB.

MDR-TB occurs when regular TB is treated with poor quality drugs, or when patients stop treatment prematurely. MDR-TB is also highly contagious and very difficult to cure.

In 2016, of the estimated 1,400 MDR-TB patients in Afghanistan, only 189 (14%) were detected. Majid’s mother was one of the unlucky ones who were left undiagnosed. For many patients, especially those in remote areas, there are no facilities for examination and diagnosis.

To address this gap, the Ministry of Public Health, in collaboration with UNDP and the Global Fund to fight AIDS, Tuberculosis and Malaria, built, equipped and furnished regional MDR-TB wards in four regions - Kabul, Nangarhar, Herat and Balkh. Staff have also been given the training necessary to treat MDR-TB patients.

It is almost 45 days since Majid came to the ward in Herat. “By the grace of God, since I am here I have felt much better,” he said.

Dr. Rahe Faramerz, who heads the Herat ward, commented, “In the past, there was only one hospital in Kabul that could treat this form of TB.  All over the country MDR-TB patients had to travel to Kabul, or even go abroad, to seek medical treatment.”

The Herat MDR-TB facility was inaugurated in September 2017, and now has four trained doctors and four nurses working full time. In just a few months they have treated 14 patients for MDR-TB. The ward provides services to four other provinces: Ghor, Badghis, Farah and Nimroz.

Photo © UNDP / S. Omer Sadaat / 2018

Photo © UNDP / S. Omer Sadaat / 2018

Photo © UNDP / S. Omer Sadaat / 2018

Photo © UNDP / S. Omer Sadaat / 2018


Chaman, 45 years old, from Chughcharan, is another patient in the Herat MDR-TB ward. Due to the unavailability of MDR facilities in her province, she was forced to leave her two children in the care of kind neighbors while she sought life-saving treatment. But it is better than travelling all the way to Kabul.

 “I am so happy I am getting treated in this ward,” she says. “Unlimited happiness, like from the earth to the sky. However, I still miss my children. “

Each week, she goes for her medical tests, and hopes for the best. Her only plan after getting healthy is to be with her children.

According to Dr. Faramerz, much more can be done to provide information to people about the threat of TB.

“We should also have awareness-raising programs through the religious leaders (Mullahs) in the mosques located in remote areas,” he said, “to educate local people about this disease. When someone has a cough for more than two weeks, they should go for a checkup as soon as possible.”

For Majid and Chaman, the journey to full health has begun. With luck, and thanks to these new wards, many others will start on the same journey.

UNDP, with a grant from the Global Fund, has trained 1,328 health workers to improve TB diagnosis/treatment and built 4 Regional isolation wards to improve treatment for multidrug-resistant TB. We are also working to reduce discrimination through training and community awareness programmes.