In her home on the outskirts of Zimbabwe’s capital city, 48-year-old Mary Marizani says that, although she has conquered MDR-TB, she now faces another challenge: “I have my appetite back and now I am eating everything in sight.”
Mary’s ability to joke has finally been restored following two gruelling years of medical treatment for MDR-TB which included daily injections and a cocktail of highly toxic pills that made her vomit, lose her appetite and hallucinate.“I felt like I had bugs crawling on the inside of my head,” she says.
First signs of TB
Mary first showed the symptoms of tuberculosis (TB) in 2006, after caring for four members of her family who had the disease. After eight months of treatment, and without screening her to confirm whether it had been successful, she was taken off TB medication by her doctor who declared she “looked much better”.
Over the following months, Mary was in and out of hospital with fever and a dry cough that would not shift. She grew thinner and thinner, her condition got worse and – having already lost half her body weight – she took the advice of a neighbour and went to a clinic where Médecins Sans Frontières (MSF) was treating patients with TB.
She was diagnosed with a strain of TB resistant to the usual drugs. At that time, no treatment was available for drug-resistant TB in Zimbabwe, but when MSF launched its MDR-TB project in Epworth, near Harare, in December 2010, Mary became its very first patient.
For Mary, the treatment came only just in time. “Just two days before the MSF doctors came to tell us the good news – that she would go on a new course of drugs – my mother had coughed up half a bucket of blood. It was terrible, I thought she was going to die,” says Mary’s 24-year-old daughter, Shorai.
Zimbabwe's TB stigma
In Zimbabwe, there is massive stigma around TB, and many people wrongly believe that the disease is incurable. Mary says, “Most of my family deserted me for two years while I was on MDR-TB treatment. My own relatives didn’t come to visit me when I was on death’s doorstep. The only family I had left was MSF and my two children.”
It was a horribly difficult time: “I had to pass through hell to get to heaven,” says Mary, but she was able to see the treatment through to its end with the support of MSF staff, who also shared their knowledge with government doctors throughout Zimbabwe, most of whom had no previous experience of treating the disease.
"It’s extremely difficult to watch your patients try to cope with the horrendous side effects caused by this arduous two-year treatment. We urgently need treatment for DR-TB that can cure people in less time and with fewer side effects,” says Kodjo Edoh, MSF Health Advisor for Zimbabwe.
Growing number of patients
In those two years since Mary became Epworth’s first MDR-TB patient, the numbers on treatment have grown. Currently, MSF is treating 40 MDR-TB patients at its projects across the country, helped by the introduction of a new test for TB drug-resistance, known as GeneXpert, which has cut the diagnosis time from 42 days to just two hours - more than 500 times faster.
Now Mary is cured, she is energetic and sociable again, and an inspiration for the other patients at Epworth. For them, she is living proof that the treatment works.
“The MDR-TB treatment was a miracle,” says Mary. “MSF lifted me up from my deathbed and gave me back my life.”