A Disease of Isolationism: Tuberculosis in Romania

Tuberculosis has silently taken its toll on Romania since the collapse of the Soviet Union. When communism fell in Romania in 1989, the country witnessed a breakdown of its public health care system. Today, Romania has thehighest rate of Tuberculosis in the European Union. This disease, thought by many as a “disease of poverty,” has left patients with the unhealthy misconception that they must suffer in isolation for fear of stigmatization from society.

Tuberculosis (TB) is an infectious disease which primarily attacks the lungs and materializes in constant bouts of coughing. The virus is transmitted through the air, which makes TB highly contagious. Diagnosis of active TB, not to be confused with latent TB, relies on X-ray detection. Treatment of TB does exist, but it can be extremely complex, and it carries a host of incapacitating side effects. During a typical 6 month treatment plan, patients often experience headaches, paranoia, dizziness, and joint pain, which render it difficult to accomplish day-to-day tasks. Because of these complications, many patients will opt to stop taking their course of treatment when they begin to feel better, or they will choose not to take their medicine all together. Every day in Romania, individuals will choose to forgo treatment in order to work, needing to provide for their families rather than be taken out of the workforce for half a year.   

High poverty levels, among other factors, may account for the staggering number of MDR-TB cases Romania sees each year. MDR stands for multi-drug resistant, a form of TB that develops when a patient becomes resistant to multiple levels of treatment. MDR-TB will often show up in patients who start and stop taking their medication, and requires a more rigorous string of drugs, which are harder to come by in Romania. On average, MDR-TB carries a survival rate of about 50 percent. In Romania, however, treatment is only successful in 20 percent of all cases. What is contributing to this anomaly in the Tuberculosis crisis, and what can be done to fix it?

In recent years, Romania has consistently had one of the lowest GDP per capita expenditures on healthcare. Because of this, hospitals and physicians are unable to deal with the ramifications of TB. Under normal circumstances, it takes a few days to diagnose TB, but in Romania, the typical diagnosis can take months. Once a patient reaches this point, the proper drugs in the right amount can be extremely hard to obtain, as the market is prone to consistent stock-outs. Romania’s Ministry of Health oversees this health crisis, but it has failed to take serious financial action on the matter.

An even deeper problem may lie in the social side of TB. In Romania, those diagnosed with TB are extremely hesitant to share that they are infected because admitting so is considered shameful. If Tuberculosis is a symbol of poverty, it’s no wonder that one would want to distance themselves from being seen in such a seemingly negative light. This fear of stigmatization can lead to deferred diagnosis, rejection of one’s diagnosis, and inevitably, a higher risk of infection for others. Romania is in need of programing that helps its citizens understand that everyone and any one is at risk of Tuberculosis – it does not chose who it wants to affect based on their income.

For an individual to overcome TB, they require an enormous amount of social and economic support. When both society and government have abandoned individuals, it makes the pursuit of recovery incredibly more difficult. Romania is in need a multi-faceted approach, which its government must commit to in order to protect its citizens. Economic assistance not only needs to be channeled into its health care system, but it needs to be channeled into poverty reduction. One should not have to choose between putting food on the table and recovering from a deadly disease. This is a question of justice, and Romania’s government must recognize that healthcare done well does not increase poverty; it allows citizens to participate as capable economic agents, able to provide for themselves and their families.

For any solution to be effective, it must also address the need for communal welfare. Education needs to be executed in schools and workplaces where Romanians can learn the truth about who TB affects and how they can help their neighbors who are currently recovering. Patients need to be drawn out of isolationism, and need to feel comfortable doing so. Education could not only help to reduce the spread of infection, but it could decrease the consistency with which TB develops into MDR-TB.

By nature, governments ought to serve with the goal of promoting safety and public order for their citizens. Tuberculosis holds the possibility of compromising these ideals, and therefore should be a strong political priority. On another level, promoting the health care needs of ones’ citizens goes beyond policy, and seeks to respect the full dignity of human nature by acknowledging that everyone is born with physical and emotional needs. In Romania, the hurt and suffering felt by those suffering from TB deserves a humane response that restores individuals’ integrity. Within every citizen is a great amount of potential – a government response that is fast and strong will not only help with individuals’ immediate needs, but strengthen its society in the long run.

In the end, Tuberculosis is not a personal matter but a societal problem. Romania’s future should not be clouded with the threat of this disease. We have the tools and the information to act and must  be all the more responsible.

-Jenny Hyde is currently a senior at Gordon College majoring in International Affairs with an International Development concentration. She is an advocate for political engagement and gender equality. Follow @jennyhyde_live.