Feb. 2015— In October 2014, Serhiy* was released from prison in Ukraine, but the long-awaited moment concealed an insidious threat that hangs over him and other ex-convicts who are recovering from multi-drug-resistant tuberculosis (MDR-TB): In working to restart their lives, many newly released former convicts neglect their health needs.

The incidence of TB among inmates in Ukraine’s penitentiaries is approximately four times higher than among Ukraine’s general population. Statistics show that under half of TB-infected prisoners continue timely TB treatment in outside health care facilities after their release. As a consequence, relapses are harder to treat than the original infection.

“I am from Donetsk,” explains Serhiy. “I spent 14 years in prison. Before imprisonment, I lived a normal life: home, family, work. The years of imprisonment deprived me of family and health. And as a result of Russia’s military aggression in Donbas, I remained homeless after I left prison when a shell destroyed my house.”

Serhiy had tuberculosis as a child and was reinfected while serving a prison sentence in a Kharkiv specialized penal colony in 2014. When the TB turned out to be resistant to first-line drugs, health care workers at the penal colony helped him to start on MDR-TB treatment and made sure that he consistently took his medication during his imprisonment.

Helping individuals newly released from prison, and convincing them that even in a difficult situation they should take care of their health, is one of the objectives of USAID’s Strengthening Tuberculosis Control in Ukraine Project, which works with the Kharkiv oblast charity fund, Parus. With USAID support, social workers deliver lectures and provide individual counseling to patients diagnosed with TB, explain the specifics of the disease, and jointly develop action plans for medical, social and psychological support after release.

Psychologists work with former convicts to stem destructive behaviors, while volunteers provide post-release support, including meeting released prisoners at the railway station, linking them with TB facilities, helping to establish relationships with doctors, and monitoring their treatment progress.

“People who are released from correctional facilities are especially vulnerable since they are usually socially maladjusted, often malnourished, do not have the support of family and friends, abuse alcohol and drugs, and have problems keeping a job,” says Olena Ovchynnykova of Parus.

Given Serhiy’s circumstances, the risk was very high that he would lapse in continuing his lifesaving treatment, particularly since he felt very healthy from several months of treatment immediately prior to his release.

It took some individual counseling to convince Serhiy that he would never return to a normal life without successfully completing a full TB treatment course. Upon his release, he enrolled in a hospital treatment program at a local oblast TB dispensary and vows to stay on treatment until cured.

“Today I feel completely healthy, but realize—thanks to the information that I received---that until the whole course of treatment is completed, this feeling can be deceptive,” says Serhiy. “MDR-TB treatment is very difficult, but in my situation, there is no other way out. This is my only hope if I want to conquer the disease.”

*Full name withheld for privacy reasons.

LINKS

Follow @USAIDUkraine, on Facebook