poverty and TB

These photos make me think about a patient from my few weeks in south africa... he was a quiet, subdued kind of guy... although maybe it was just he was fed up with hospital. He had TB which had affected his spine, so couldn’t move/feel his trunk or legs at all and found it impossible to change positions or sit up on his own. He was in a side room, isolated from everyone else in the ward for obvious reasons, staring at the ceiling all day. He always asked to be covered with about 4 blue hospital blankets because of the cold. I ventured in daily, complete with my mask, gloves and apron to do some passive stretching and repositioning – wearing the mask made me feel like I couldn’t communicate properly with him, couldn’t have a proper chat face to face, couldn’t smile at him...

The one thing I remember him saying was he couldn’t wait to leave the hospital and get back to the smaller community TB facility (where he had been before) - the main reason was he had people he could talk to there... there he didn’t have to be in an isolation room...

To me, the prevalence of TB is one clear example of the impact of poverty - when it is essentially treatable/curable. I know multi drug resistant TB is a different story, but the reasons behind its emergence also can be linked to poverty and the lack of adequate / consistent health care. And this is only one disease. I just wonder what the impact of the current global economic crisis will now have on things like the MDGs and the fight against poverty...