Fighting tuberculosis in Peru's village of hope

Peru is home to the highest rates of multi-drug resistant tuberculosis in the Americas, and one in four patients abandon the treatment needed to kill the bacteria, said Dr. Leonid Lecca, the executive director of Boston-based non-profit Partners in Health (PIH) in Peru.

The problem is not a lack of medicines but their harrowing side effects and inadequate health services to help patients follow through with six months to years of treatment.

"Some medicines change the color of your skin. Some cause bouts of psychosis," Lecca said, blaming a lack of investment in medicine for "the disease of the poor."

But in the shantytown Carabayllo on the outskirts of Lima, where clusters of pastel-colored homes cling to dusty hills, tuberculosis patients in a low-budget PIH program have been sticking to their drug regimens.

PIH trains community volunteers to tend to tuberculosis patients in their homes, making sure they take medicine daily and helping them navigate the public health bureaucracy, Lecca said.

The volunteers, nearly all women already active in the community, have proven better at finding and curing people with tuberculosis than white-coated professionals, said Lecca.

Guadalupe Quispe, 61, has treated eight patients as a volunteer in her neighborhood Villa Esperanza, or Village of Hope, where the stigma of tuberculosis can cost jobs and relationships.

The position doesn't pay, but has other rewards, Quispe said as she walked up a slanted street. She pointed to a small house where she once persuaded a woman coughing up blood to see a doctor. The woman would've likely died otherwise, Quispe said.

"After she got better she went to school. And now she's a nurse and has a family. When I think of her I feel happy," Quispe said.

So far, no tuberculosis patient in PIH's year-and-a-half-program has dropped out - a key step to stopping the spread of drug-resistant forms of tuberculosis that result from unfinished treatment, said Lecca.

Now halfway through his treatment for tuberculosis, William Campos, 49, is starting to imagine a healthy life again.

"I want to walk again, to work again. I want to get up in the morning, get on a bus and head to the countryside," Campos said from his bed under a sheet-draped window in his home in Carabayllo.

Quispe has helped bring a wheelchair ramp to Campos' home and visits him every day, badgering him to eat better ahead of his scheduled back surgery. Tuberculosis has eaten away at part of his spine.

"I used to cry constantly, the pain was so unbearable. I even thought about killing myself. But thanks to Mrs. Guadalupe I have hope to push through this," Campos said, beaming at Quispe teary-eyed.