Partners In Health has helped thousands of poor patients receive treatment for tuberculosis in Tomsk, a region of southwestern Siberia, since 2000. PIH staff members work with the Tomsk Tuberculosis Medical Center, a public health facility, to deliver medicine and food to patients at home every day. This year, another public institution, the Tomsk AIDS Center, joined the collaboration, and now pregnant women who are HIV-positive receive daily treatment.
This fall, our staff members spent a morning with 30-year-old tram driver Katya Smirnova,* who was having trouble keeping up with her treatment. (Photos by Elena Devyashina for Partners In Health)
PIH Nurse Natalya Shtrevenskaya (right) and Driver Vadim Zyuskov, equipped with Smirnova’s medication and food, knock on her door but receive no response. They knock again and check her windows. It’s crucial that patients receive their daily dose of medicine. When staff can’t find patients, they return to try again later.
Smirnova (left) finally hears their knocks and invites the team into her home. PIH Project Manager Alexandra Solovyova (center) and Shtrevenskaya discuss Smirnova’s health, while Smirnova’s daughter listens.
Smirnova is about 20 weeks pregnant and HIV-positive. She and her husband are unemployed. On top of this, recent test results showed that her liver is functioning abnormally and her hemoglobin levels are low, which threaten her and her baby’s health. After three weeks of treatment, PIH staff want her to visit the Tomsk AIDS Center for tests to see how she is responding to medication, but she is reluctant.
Smirnova explains that she struggles to pay for public transportation to reach the center. She is also ashamed of being ill.
The team explains why she needs further tests and that she has nothing to be ashamed of. They offer to drive her there and guide her through the appointment. With encouragement, she agrees to go.
Oksana Kustova (left), a social worker at the center, provides Smirnova’s patient card listing past appointments and examinations.
Solovyova and Kustova arrange an appointment for Smirnova with an infectious disease specialist.
Dr. Loubov Vasilenok and Smirnova discuss her health in detail, including previous test results. Kustova notes what the doctor says, ready to help Smirnova if she has trouble understanding the technicalities of her treatment.
After their meeting, the doctor refers Smirnova for blood tests to see if her liver function and hemoglobin levels have improved.
Kustova and Smirnova head to the pharmacy. Kustova runs through the doctor’s instructions, reminding her of future appointments and encouraging her to keep them.
The two collect Smirnova’s antiretroviral therapy at the pharmacy, which PIH staff members will continue to bring her every day.
Shtrevenskaya registers today’s visit in the patient log before she and the team drive Smirnova home.
Once Smirnova’s test results are available, staff members will ensure she is able to continue treatment for her liver and hemoglobin levels, in addition to her antiretroviral therapy. They plan to pay close attention to her health, supporting her however they can.
*Name has been changed