Elmira Karashalova works as a nurse at the outpatient clinic in her small village in rural Kazakhstan where her main duty is to administer the daily medication needed for recovering tuberculosis (TB) patients to become fully healthy. When Elmira took over this duty, she often found it frustrating. “Patients do not always remember that they have to take medicine; do not come regularly and don’t understand the importance of TB treatment. At first I felt very annoyed and nervous; I criticized patients severely for being late and for missing visits.”
Elmira was understandably frustrated by what she saw as her patients’ irresponsibility. Some patients stop their treatment when they feel better because they think that they’ve been cured. However, these patients may still be infectious, and must complete the entire course of treatment to ensure that they don’t get sick again and don’t spread TB to friends and family.
In order to address this issue, the USAID Quality Health Care Project is training health providers to better encourage patients to successfully complete their TB treatment. By communicating more effectively and empathetically, health care providers encourage patients to complete their full course of treatment, and thereby completely rid themselves of TB infection.
Elmira participated in a USAID-sponsored training on interpersonal communication and counseling skills, and it changed her opinion completely about her responsibility to her patients. “After the training, I realized that my patients’ failure to adhere to their treatment regime was directly related to their lack of knowledge about TB, to the absence of family support and to my attitude towards them.” Now that Elmira is practicing her newfound communication skills, her patients come regularly to the clinic, not only to receive their medication, but also to share the ups and downs of their lives. One of Elmira’s patients summed it up, “When I do not see you, my day just isn’t as good.”