You have Tuberculosis? Here’s your ticket home

Tuberculosis(TB) and AIDS are very serious diseases, they have many things in common, they both can be fatal, not easily recognized and sometimes the patient is very healthy, yet they get the shocking news in a routine medical check up. Such traumatic experience is not easy on anyone, especially on those who have to be deported afterwards.

In the Gulf Cooperation Council (GCC) they take these diseases very seriously, maybe a bit too serious. For example a TB diagnosed patient can only stay for 3 months at most before being deported to their home country.

Also a TB-cured person is considered unfit and is not allowed to the GCC countries, ever.

GCC depend mainly on migrant labor, averaging 35.7% of total population for the GCC countries. Most of them come from countries where they have a higher risk getting infected with these diseases.

Y.B is an Eastern European who used to live in Qatar. She worked for a five-star airline as a cabin crew. She was one of the unfortunate people who have been diagnosed with TB.

Like many of us she was doing a medical check up when she found out that she has a tiny scar in her lung, a “dead scar” is what this few millimeters long scar is called. That’s a trace of TB; lucky for her it was latent TB, yet she was quickly deported.
WHO VS GCC

TB is a treatable and curable disease. The vast majority of TB cases can be cured when medicines are provided and taken properly.

According to World Health Organization (WHO), since 1995, over 46 million people have been successfully treated and an estimated 7 million lives saved through use of DOTS and the Stop TB Strategy recommended by WHO.

Here are the DOTS five-points to help monitor and cure TB that WHO recommends in comparison with what happens in GCC.

First, ‘secure political commitment, with adequate and sustained financing.’

Usually the TB patient is fired from their job, and gets deported to his country in a matter of few months, stopping the income, therefore sustaining the treatment becomes more difficult.

Second, ‘ensure early case detection, and diagnosis through quality-assured bacteriology.’

It depends on how early the patient knows; if he or she knows from the GAMCA centers in their country then they are on their own from the start, no consideration from the medical centers and no transferring to a proper hospital to treat them.

This whole process is facing wide criticism from many people calling to stop GAMCA as they describe it as “Immoral attitude and lack of medical examination guidelines for workers at the GAMCA medical centers.”

If they know while they are inside the GCC, that’s a dramatic treatment. Doctors usually don’t give much detail about the disease. Most patients have described the process as “a horrible experience.”

Third,  ‘provide standardized treatment with supervision and patient support.’

According to the National Tuberculosis Program Manager in Qatar, Dr. Abdul Latif al-Khal, said in a report earlier, “usually residents found with TB were not deported except if the sponsors insisted as in the case of domestic workers such as house-helps and drivers.”

In the course of three months, neither house-help nor driver, Y.B. was deported.

She was left with the minimal amount of information about her medical condition, “During every medical test I did, nothing was discussed directly with me. They just told me I had TB and nothing about it, what kind or whatever,” she said.

Fourth and Fifth, ‘ensure effective drug supply and management. Monitor and evaluate performance and impact.’

Dr. Al-Khal explained, “We provide treatment to all TB patients and we have a country-wide treatment program that registers and follows up on all the cases.”

The usual course of treatment of TB takes up to 6 months. In different cases, the patients are deported within 2-3 months with the least amount of information. Not only that, there is no coordination with their home countries and they are not provided with any medical documentation.

“I went home empty handed, facing a fatal disease I know nothing about.” She expressed.

Does GCC care about the patients?

“Anyone who had TB and has been treated properly is considered cured and should not be discriminated against,” said Dr. Mario Raviglione, the director of the Stop TB department at the World Health Organization (WHO) to a local UAE newspaper. “This becomes an issue of human rights.” he added.

Y.B. is now healthy, working and enjoying a normal life in Europe, yet she is separated from her fiancé who lives in Dubai, whom she cannot visit, since she is banned from entering the entire GCC. “They just drove my future family apart, it’s senseless,” She added.

That’s one example out of many, one of them was a nurse who got the disease from a patient and wasn’t allowed back to the country she was working in, because she was doing her job.

“Just to remind you people nurses are the reason why you are well and healthy today and this is how you repay us?” she complained.

HIV

Same process happens with HIV patients. A South African journalist who has been in Qatar for only 2 months faced a cruel experience. He went to get a normal medical check up, without knowing the results he was taken to prison, then had his contract terminated and been given a warning, either to leave the country within 42 hours or face arrest.

Did the deportation contain the disease?

Such direct deportation policy has sabotaged the containment of TB in the UAE. The fear of deportation has made the patients do not come forward which spread the disease. According to a UAE local journal, “Cases of pulmonary TB – the most infectious – more than doubled in the capital from 193 in 2009 to 450 in 2011, and 143 were reported in the first three months of this year alone, according to new figures from the Health Authority Abu Dhabi (HAAD).”

Global Issue

“63 countries have some form of HIV (or TB) specific restriction to entry, stay and residence of immigrants; and 28 countries deport people once HIV+/TB status is known,” According to Dr. Gilles Cesari, Regional Director at the International Union Against Tuberculosis and Lung Disease (The Union)’s office in Singapore.

The need of a global awareness on such diseases is obviously required, the act of throwing the patient from a country to another just because they have a disease –clearly they didn’t ask for it – is just a bit harsh. Forget where he or she is from. They are human beings after all, help them get better.