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Nurturing vulnerable children back to good health


Vanlalsiam, a teenage boy, recovers from a complex HIV and TB infection. Fiona Fisher, MSF’s doctor in Manipur where the boy was treated, tells about the fight put up by the boy and her medical team for his health.

Vanlalsiam’s grandmother takes care of him as his parents and two siblings have all died

The boy had started antiretroviral and antituberculosis treatment with the Ministry of Health’s medical programme. When he did not improve he was brought to MSF’s clinic in Singngat in 2008. MSF changed his treatment slightly, but he still did not get better.

His health deteriorated and we then admitted him to Shalom, a community care center in Churachandpur. MSF supports this health centre by providing drugs and medical material. Our doctors help the centre’s staff in patient care.

The first photo of Vanlalsiam in this story was taken in November 2009 in Shalom. I thought he would not survive. He was very unwell with chronic diarrhea, poor appetite and severe pulmonary tuberculosis. His chest X-ray revealed an appalling condition.

It was hard for MSF’s doctors to decide whether his health was worsening due to multidrug-resistant TB or drug-resistant HIV. He was so weak that it was difficult to get a sputum sample to test for multi-drug resistant TB. When his HIV viral load was found to be extremely high we went ahead with treatment for drug-resistant HIV. This involved changing his medicines to an unusual second line treatment. He was given more medicines to overcome effects of taking both HIV and TB drugs.


The second photo was taken at a follow-up appointment at MSF’s clinic in Churachandpur in April 2010. I could hardly believe it was the same child. His grandmother is so grateful for his improved health, and now she spoils him rotten. He was eating a big bag of potato chips when we met. She walks with him for several kilometres to school every day and waits there until his classes finish to walk back home with him. When I saw him last, he was happily playing with his classmates like any healthy teenage boy.

In the north-eastern state of Manipur, MSF provides  HIV, TB and Drug Resistant – TB (DR-TB) treatment at its clinics in Chakpikarong, Churanchandpur and Moreh. In 2012, 922 HIV patients, and 119 sensitive TB patients and 21 Drug Resistant TB patients were under treatment at these clinicsatment at these clinics.

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