One doctor’s misfortune boosts TB treatment activism

Abstract

It’s Christmas; you’re in a hospital isolation ward, sleep-deprived and depressed, bilious and sometimes swallowing your own vomit to keep the pills down, with a painful 3 cm hole in your lung and slowly going deaf – that’s how it was for one unfortunate Somerset West doctor two years ago.

Now remove aspiring paediatrician Dr Dalene von Delft’s medical aid, her cutting edge collegial advice, a steadfast and supportive doctor-husband and an ability to persuade a major drug company to allow compassionate use of an as-yet unproven drug for multi-drug resistant TB – and you have the distilled experience of most MDR TB and XDR TB-infected South Africans. Von Delft counts her blessings because she knows that her struggle pales in comparison with most of her compatriots’. Today she is alive and well, joining the privileged and/or lucky minority (estimates are 42%) of South Africans cured of MDR TB. The worst three months of her treatment left her a changed person, and an activist clinician with strong ideas on the value of basic TB prevention methods that educationalists, peers and health system designers could implement so easily, thus saving hundreds of lives as the local epidemic burgeons.