“It would be better to die than to suffer this way,” Fathia says, wiping her hands together with finality. She sits across from me at the Caritas medical center in Djibouti, crying. I’m trying not to cry. I’m also trying not to back away as she coughs without covering her mouth. She is a single mother, a refugee from Somalia, and all five of her children have tuberculosis, commonly called TB.
According to the World Health Organization, close to 50 people are infected every week in Djibouti—a massive percentage for a small country with a population of less than 1 million. The disease is transmittable by air, a fact that I’m well aware of while we talk. A person of my healthy constitution and plentiful diet is unlikely to develop an active case of tuberculosis. And yet I know American lawyers who have had active TB. Diplomats. Teachers. Students. People just like me. The disease is in New York City, in Minneapolis, in Paris.
Like other infectious diseases that plague the modern world, the cure to TB is complicated. But because of the social stigma and isolation associated with it, medical professionals are increasingly convinced that part of the solution will come from one simple source: trust born of relationships.
“A trusting relationship is critical,” says Annie Mikobi, a Congolese doctor working in Djibouti. “Without it, there is no observance of treatment.”
“Stigma is a huge barrier, and breaking down stigma requires trust,” says Bob Carter, a family practice doctor with SIM (Serving in Mission) who has worked with TB patients in Kenya and Zambia for over 20 years. “TB patients must trust that I care about them, that I won’t disclose their ...1
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