SOUTH AFRICA: Busisiwe Beko, "I'm pregnant, I've got HIV and also TB"
"Running around like a headless chicken"
DURBAN, 15 June 2012 (IRIN) - In 2005, Busisiwe Beko realized she was pregnant. She also found out she was HIV-positive, and that she had active tuberculosis (TB). Then she developed multidrug-resistant TB (MDR-TB) and for the next year struggled to get proper, timely treatment for her and her baby daughter, who contracted MDR-TB.
At the time, MDR-TB treatment was only initiated if the patient was in a specialized hospital. Unable to secure a bed for Beko and her child at one of the hospitals, her doctor chose to start her on treatment at the local clinic. The South African government has since moved to decentralize drug-resistant TB care and treatment.
Beko is now an MDR-TB counsellor at the international medical humanitarian organization, Médecins Sans Frontières, and has her own local radio show on TB. She spoke to IRIN/PlusNews about her struggle to access care and treatment.
"My long walk to be still alive started in 2005 when, around March, I start suspecting I was pregnant. So I went to the clinic for a pregnancy test. Instead of getting a pregnancy test, I was offered an HIV test. I came [back] positive. I went to the pharmacy for a pregnancy test and that was also positive.
"I started feeling sick. I was tired, losing weight, I started to cough. Just imagine - the stomach is growing bigger but, me, I'm growing thin.
"I went back to the clinic to see the doctor, and even the doctor suggested - because clinically I was not doing fine - [that] I must have an abortion, but it was so late. I was already five months pregnant. I went back home, because there was nothing to be done - not even x-rays - because I was pregnant.
"One day, I went to the clinic and asked the doctor if there was any form I could sign so I could get x-rays. Then one of the nurses suggested I take the sputum jar and… try to produce a sputum sample. I did manage to produce some... When I went back to the clinic [the test showed) I had TB. Now, I'm pregnant, I've got HIV and also TB.
"By December I delivered my baby... I was getting more sick. In February, I am still on normal TB [treatment] but at the clinic they told me I had MDR-TB. I was going to be sent back home, and then I had to wait until they booked a bed for me at the hospital because they couldn't start the treatment at the clinic.
"The doctor made an appointment with a specialist to [screen my baby for TB]. It was February. The nearest appointment I got was May. When the driver came to fetch me at the clinic [to go to hospital to start MDR-TB treatment], he refused to take me because he said there was no place for the baby. I said fine, [I won't go] because there was no one at home to look after the baby.
"After a month, the doctor said that they were going to start me on drug-resistant TB medication at the clinic because they couldn't get me a spot at the hospital... This treatment was not easy. They [the pills] have a terrible smell, you have to swallow them, they make you vomit, and they make you dizzy. Every time you look at them, you think twice about it, but I took my treatment.
"From there, I went for my baby's appointment. Between the specialist appointment, my ARVs and my TB treatment I had to go to three health facilities. I was running around like a headless chicken.
"From the signs and symptoms, the doctor said, 'No, this baby is having TB.' The baby was admitted the same day and...later they started her on the drug-resistant TB treatment. When I brought my baby to the TB hospital, even the nurse was surprised. She said, 'I wonder, where did this 5-month-old baby get drug-resistant TB?'
"I said, 'From her Mum.' She said, 'But where is that lady? Why is she not taking the treatment?' I said, 'I'm here. I'm taking the treatment.' She said, 'But where?' I said, 'At the clinic.' She didn't believe me. I said, 'Check your files for the name 'Busisiwe Beko. Maybe you will find out why I did not get that bed earlier at the hospital.'
"She said I had to go home and leave my baby because they had a bed for the baby, not for me. A week later, a bed was available for me and I stayed there for two weeks because I was almost finished with my injectables. My baby was admitted for seven months in all.”