TB: Return of the Plague

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0:00:11 > 0:00:15Mum died, Dad died, my sister died.

0:00:15 > 0:00:19I'm next so, to me, I feel like I'm alone in this world.

0:00:23 > 0:00:29We've got to effectively control TB if we want to make ourselves safe

0:00:29 > 0:00:34because the truth is anyone can get TB.

0:00:34 > 0:00:38Anyone can die from TB and it's a killer.

0:01:26 > 0:01:29In the southern African nation of Swaziland,

0:01:29 > 0:01:32around a quarter of all adults are HIV positive.

0:01:33 > 0:01:36With so many living with compromised immune systems,

0:01:36 > 0:01:40tuberculosis, which had been in decline for decades,

0:01:40 > 0:01:41has made a dramatic comeback.

0:01:43 > 0:01:45The threat for the rest of the world

0:01:45 > 0:01:49is that with over 8 million new infections every year worldwide,

0:01:49 > 0:01:54new variants of this deadly disease are evolving faster than ever.

0:01:54 > 0:01:58Swaziland currently has the highest rate of TB infection in the world

0:01:58 > 0:02:02but, with the disease spreading with a cough or a sneeze,

0:02:02 > 0:02:06international travel means these lethal new mutations

0:02:06 > 0:02:08are already starting to appear in Europe.

0:02:12 > 0:02:17In Swaziland's capital, Mbabane, 12-year-old Nokubegha

0:02:17 > 0:02:19lives with her 17-year-old brother, Melusi.

0:02:19 > 0:02:23Two weeks ago their mother died from TB, leaving them orphans.

0:02:24 > 0:02:28Since then, they have learnt that Nokubhega is also infected

0:02:28 > 0:02:30with the disease that killed their mother.

0:05:59 > 0:06:04One day a man was sitting on the tallest tree in the forest...

0:06:04 > 0:06:07SHE COUGHS

0:06:07 > 0:06:09..forgetting he is the...

0:06:09 > 0:06:14Nokubegha's mother died from one of the new aggressive mutations

0:06:14 > 0:06:17of multidrug resistant, or MDR, TB.

0:06:17 > 0:06:19This disease is far harder to treat

0:06:19 > 0:06:23and, with no new TB drugs introduced for almost 40 years,

0:06:23 > 0:06:26the bacteria are increasingly difficult to kill.

0:06:28 > 0:06:34Melusi's greatest fear is Nokubegha may also have the multidrug resistant strain of TB.

0:06:36 > 0:06:40The treatment for MDR-TB lasts two years

0:06:40 > 0:06:44and depends on a range of drugs that can have dreadful side effects.

0:06:44 > 0:06:47Nokubhega has been tested for the disease

0:06:47 > 0:06:49and today a nurse is bringing her results.

0:07:49 > 0:07:51Brother and sister share one room

0:07:51 > 0:07:55so, to protect Melusi from catching the potentially lethal infection,

0:07:55 > 0:07:59Nokubhega now has to go and live in an isolation hospital

0:07:59 > 0:08:00two hours away.

0:09:32 > 0:09:37MDR-TB is increasing at an alarming rate in Swaziland.

0:09:37 > 0:09:41The government has now declared the epidemic to be a national emergency.

0:09:41 > 0:09:45The disease is far more lethal than ordinary TB.

0:09:45 > 0:09:47Outbreaks in North America and Europe

0:09:47 > 0:09:50have killed four out of five of those infected.

0:09:50 > 0:09:55Worldwide, around half a million new cases of MDR-TB are diagnosed every year.

0:10:03 > 0:10:0860 miles south of the capital, near the border with South Africa,

0:10:08 > 0:10:11lives Bheki, a builder who is fanatical about football.

0:10:13 > 0:10:16Bheki recently learned that both he and his sister have MDR-TB.

0:13:02 > 0:13:07Bheki and Zandile are unusual in being so open about their disease.

0:13:07 > 0:13:10There is as great a stigma with TB as there is with AIDS

0:13:10 > 0:13:14in Southern Africa, so most victims keep their diagnosis secret

0:13:14 > 0:13:18and, as a result, continue to infect those around them.

0:14:57 > 0:15:02Around 1 in 25 cases of TB are multidrug resistant

0:15:02 > 0:15:05but if someone's already been treated for TB

0:15:05 > 0:15:06then catches it again,

0:15:06 > 0:15:09the chances of developing MDR rise to one in five.

0:15:10 > 0:15:15As with AIDS, the only effective way of tackling the disease is to use

0:15:15 > 0:15:18a combination of multiple drugs to attack the infection.

0:15:18 > 0:15:22Therapy is so complex and the side effects so toxic

0:15:22 > 0:15:26that fewer than 3% of the world's MDR patients receive proper treatment.

0:15:28 > 0:15:32Bheki and Zandile are treated by the charity Medecins Sans Frontieres,

0:15:32 > 0:15:36which works closely with the Swazi government on TB management.

0:15:51 > 0:15:55How often are you vomiting? Like, once a month or one a week?

0:15:55 > 0:15:57One... Maybe once a week.

0:15:57 > 0:15:59- Once a week?- Yes.

0:15:59 > 0:16:01What else? Diarrhoea?

0:16:03 > 0:16:06And you were complaining of cramps, pain in your leg.

0:16:12 > 0:16:15Do you feel you've started gaining weight or not?

0:16:23 > 0:16:24But she's gaining.

0:16:24 > 0:16:26OK, do you still have cough?

0:16:30 > 0:16:35Almost all our patients experience some side effects,

0:16:35 > 0:16:39adverse reaction of the treatment.

0:16:39 > 0:16:44In case of Zandile, she has been experiencing

0:16:44 > 0:16:50the most common side effect like vomiting for quite a long time

0:16:50 > 0:16:54but she is eating now well and she has got a good appetite.

0:16:54 > 0:16:56She's slowly gaining weight.

0:17:32 > 0:17:35The side effects of the treatment make many patients

0:17:35 > 0:17:38so ill that they stop taking their pills

0:17:38 > 0:17:42but without treatment the disease is always fatal.

0:17:42 > 0:17:45The clinic has support groups to encourage patients to stick

0:17:45 > 0:17:48with their meds, no matter how grim the side effects.

0:18:49 > 0:18:54Multidrug resistant TB first emerged because patients with ordinary TB

0:18:54 > 0:18:56were not taking all their antibiotics.

0:18:56 > 0:18:58While that's still a problem,

0:18:58 > 0:19:02more and more people are now being directly infected by MDR patients.

0:19:06 > 0:19:09Living in one room with her sick mother,

0:19:09 > 0:19:11this is what happened to Nokubhega,

0:19:11 > 0:19:13so she's being sent to an isolation hospital

0:19:13 > 0:19:17to protect her brother, Melusi, from being infected as well.

0:22:38 > 0:22:41Nokubhega will have to stay in the TB Hospital for at least

0:22:41 > 0:22:45the first six months of her treatment. She will only go home

0:22:45 > 0:22:49if sputum tests show she is no longer infectious.

0:23:45 > 0:23:50Three months have passed, and Bheki is missing his sister, Zandile -

0:23:50 > 0:23:53she's been taken to the local hospital.

0:23:53 > 0:23:55The side effects of her drugs have got worse

0:23:55 > 0:23:58and she's losing weight fast. Their mother is looking after her.

0:24:27 > 0:24:32In case of Zandile she has been experiencing vomiting,

0:24:32 > 0:24:35but at the beginning it was manageable.

0:24:35 > 0:24:41But recently she vomiting worse, and dramatically,

0:24:41 > 0:24:46and it became intractable, not responding to treatment.

0:24:46 > 0:24:50So, that's why she end up in the hospital

0:24:50 > 0:24:55with dehydration, significant weight loss.

0:24:55 > 0:24:58She is vomiting out drugs as well,

0:24:58 > 0:25:01and the drug concentration in her body

0:25:01 > 0:25:05is much less than it supposed to be.

0:25:05 > 0:25:08So, there are so many things you have to consider

0:25:08 > 0:25:15to take a decision to suspend TB treatment temporarily

0:25:15 > 0:25:19in order to stabilise her condition

0:25:19 > 0:25:23and to improve her nutritional status.

0:25:25 > 0:25:28Zandile's doctor faced an impossible choice -

0:25:28 > 0:25:31if she maintained TB treatment,

0:25:31 > 0:25:35Zandile would continue to lose weight and fluids, and could die.

0:25:35 > 0:25:39But suspending treatment means the infection might mutate into

0:25:39 > 0:25:43an even more drug resistant form that would certainly kill Zandile.

0:26:05 > 0:26:11'To suspend the TB medication was a very difficult decision for me.

0:26:11 > 0:26:13'We should not stop TB treatment.'

0:26:15 > 0:26:20But also if it keep continue giving the drugs

0:26:20 > 0:26:24then we, anyway, we put you

0:26:24 > 0:26:27at risk to die.

0:26:49 > 0:26:52Are you dizzy? No?

0:27:46 > 0:27:50Bheki is also struggling with the side effects of the drugs.

0:27:50 > 0:27:53The treatment is so gruelling that fewer than half of all MDR patients

0:27:53 > 0:27:55successfully complete the course.

0:28:50 > 0:28:54Bheki is not unusual.

0:28:54 > 0:28:57He's not able any more to...

0:28:57 > 0:29:03to do all the usual activities he used to do.

0:29:03 > 0:29:08And that's, I think, make him frustrated.

0:29:08 > 0:29:14He has a potential to get even depressed because of the treatment.

0:29:14 > 0:29:18I think those who used to work and be active

0:29:18 > 0:29:24and suddenly they become inactive,

0:29:24 > 0:29:27I'd say a huge difference in their lifestyle

0:29:27 > 0:29:33and, of course, it affects their mental and psychological condition.

0:30:35 > 0:30:38Nokubhega has been in isolation in the TB hospital for three months.

0:31:33 > 0:31:35THEY LAUGH

0:32:19 > 0:32:21Very good girl, huh?

0:32:39 > 0:32:41Good girl.

0:34:43 > 0:34:45Sometimes it reminds us at home.

0:34:53 > 0:34:56There are no other children Nokubhega's age in the TB Hospital,

0:34:56 > 0:35:00but 27-year-old Gcebile has befriended her.

0:35:00 > 0:35:03Gcebile was herself orphaned at the same age as Nokubhega.

0:35:03 > 0:35:06She's been fighting TB for over two years,

0:35:06 > 0:35:09but when the side effects of the drugs became too much for her,

0:35:09 > 0:35:10she stopped taking the tablets,

0:35:10 > 0:35:13and what was initially ordinary TB

0:35:13 > 0:35:17mutated into the multidrug resistant strain.

0:35:17 > 0:35:19With none of her family willing to risk looking after her,

0:35:19 > 0:35:22Gcebile had no choice but to come to the TB Hospital.

0:35:24 > 0:35:28It sounds like a prison, sometimes.

0:35:28 > 0:35:33Because you don't get what you want any time, you don't get...

0:35:33 > 0:35:36Sometimes you don't want the food that they have given you,

0:35:36 > 0:35:39but you have to eat it.

0:35:39 > 0:35:41Because there's no way you can get another food.

0:35:43 > 0:35:46Sometimes we need fruits from outside

0:35:46 > 0:35:49They don't always give us fruit. Who will give us the fruit?

0:35:49 > 0:35:52They take us away from our homes to be here

0:35:52 > 0:35:55so that we cannot be dangerous to the people outside.

0:35:55 > 0:35:58So, we are here now, they don't want the people to come here

0:35:58 > 0:36:00to give us any. Why?

0:36:00 > 0:36:04As long as a TB patient's sputum tests positive for the bacteria,

0:36:04 > 0:36:06they remain infectious.

0:36:06 > 0:36:10Out in the community, they will unwittingly spread the disease

0:36:10 > 0:36:12to an average of one new victim every month.

0:36:12 > 0:36:16Despite masks, beds spaced four meters apart,

0:36:16 > 0:36:19and numerous other precautions, two nurses at the TB Hospital

0:36:19 > 0:36:23have already been infected, and persuading anyone to work here

0:36:23 > 0:36:27and care for these patients is an ongoing challenge.

0:37:31 > 0:37:34Nokubhega's quarantine is having an impact on her brother,

0:37:34 > 0:37:36Melusi, as well.

0:37:57 > 0:37:58Shut up.

0:37:59 > 0:38:01You remain silent.

0:38:02 > 0:38:05Maybe listen to music.

0:38:05 > 0:38:07Nobody to laugh with.

0:38:11 > 0:38:13Yeah, I miss her a lot.

0:38:14 > 0:38:16Miss my sister.

0:38:18 > 0:38:24It's my sister, it's my sister always liked making things like this.

0:38:24 > 0:38:26Planting trees.

0:38:28 > 0:38:30And things.

0:38:31 > 0:38:33She enjoys it very much.

0:38:41 > 0:38:43Er, she's left her mark.

0:38:45 > 0:38:50When I'm feeling lonely, I play music.

0:38:53 > 0:38:56MUSIC PLAYS THROUGH EARPHONES

0:39:01 > 0:39:04HE SINGS FAINTLY

0:39:11 > 0:39:14DANCE MUSIC PLAYS

0:40:56 > 0:40:59Her friend, Gcebile, also feels the hospital

0:40:59 > 0:41:01is having a bad effect on Nokubhega.

0:41:03 > 0:41:06I don't think it's a good place for her.

0:41:06 > 0:41:09There are old people here.

0:41:09 > 0:41:12People with a lot of problems

0:41:12 > 0:41:15and they talk about boys and husbands, you know?

0:41:17 > 0:41:20I wish she could have a better life.

0:41:20 > 0:41:26I know this place have influenced her so much, she has changed a lot.

0:41:27 > 0:41:31We can even hear from her language.

0:41:32 > 0:41:38Having TB has changed her life so much.

0:41:50 > 0:41:51Hello, Nokubhega.

0:41:52 > 0:41:53- Hi, doctor.- How are you?

0:41:53 > 0:41:57- I'm fine.- How are you feeling? Sit up, Nokubhega.

0:42:13 > 0:42:14Are you eating well?

0:42:14 > 0:42:17'For anyone who had to be on treatment for two years,'

0:42:17 > 0:42:19you'd agree with me, that's a lot of time,

0:42:19 > 0:42:25so a long duration of time to be taking toxic drugs.

0:42:25 > 0:42:30So, we've had so many of those patients that stop treatment

0:42:30 > 0:42:33and we've actually had a patient that committed suicide.

0:42:35 > 0:42:38Because of the diagnosis of the MDR-TB.

0:42:40 > 0:42:41So, that's pretty bad.

0:44:11 > 0:44:15If the patient don't take properly drugs, miss drugs,

0:44:15 > 0:44:20it's one of the very dangerous risks,

0:44:20 > 0:44:24it's amplification of the resistant,

0:44:24 > 0:44:27its resistance is growing.

0:44:28 > 0:44:32Bheki is on a cocktail of ten drugs, eight aimed at the TB,

0:44:32 > 0:44:36and two intended to try to reduce the impact of the side effects.

0:45:25 > 0:45:28What does it mean? You are going to choose now, your drugs?

0:46:02 > 0:46:04We can do for night, more for night than morning.

0:46:12 > 0:46:14It's better to take before going to sleep, eh?

0:53:09 > 0:53:13Nokbegha has been at the TB hospital for almost six months.

0:53:13 > 0:53:17If her sputum tests negative for the tuberculosis bacteria, she'll

0:53:17 > 0:53:21soon be able to leave the hospital, and continue her treatment at home.

0:54:17 > 0:54:21- Hi, Noku, how are you?- I'm fine.

0:54:21 > 0:54:24I'm fine. How have you been doing? Huh.

0:54:24 > 0:54:28I hear you've been vomiting, how's the vomiting now?

0:54:28 > 0:54:30How's the medication going?

0:54:30 > 0:54:32Are you taking your medication, every day?

0:54:32 > 0:54:36At the same time? Correctly? Yes.

0:54:36 > 0:54:38And do you report when you vomit?

0:55:03 > 0:55:06And having that chronic lung disease has its own

0:55:06 > 0:55:09problems in terms of, you know, functioning.

0:55:11 > 0:55:14But I cannot ignore the fact that the treatment has got severe

0:55:14 > 0:55:16side effects as well,

0:55:16 > 0:55:20which makes it quite difficult for patients to adhere to the treatment.

0:55:23 > 0:55:25IN DIALECT

0:55:30 > 0:55:35Nokubhega's daily injection, Amikacin is a 40-year-old drug that

0:55:35 > 0:55:38has some of the most severe side effects.

0:55:38 > 0:55:41It can cause serious kidney problems,

0:55:41 > 0:55:44as well as the nerve damage that can lead to permanent deafness.

0:55:44 > 0:55:47How are the ears?

0:57:39 > 0:57:42Rules on how far apart beds have to be,

0:57:42 > 0:57:44to reduce the risk of cross infection,

0:57:44 > 0:57:48mean that despite it's size the hospital can only take 70 patients.

0:57:48 > 0:57:50So there is always a pressure for beds.

0:57:50 > 0:57:55A new patient has just been admitted into the bed across from Nokubhega.

0:57:55 > 0:57:59She has scrofula, a complication of TB caused by the bacteria

0:57:59 > 0:58:01infecting the lymph nodes in the neck.

0:58:01 > 0:58:05Nokubhega's mother also had scrofula before she died.

0:58:41 > 0:58:44The same night she arrived at the hospital Nokubhega's new

0:58:44 > 0:58:46neighbour lost her battle with TB.

1:00:01 > 1:00:03Nokubhega's friend Gcebile is also living in fear.

1:00:03 > 1:00:08Her sputum tests have remained obstinately TB positive, and

1:00:08 > 1:00:13she's worried she may be one of the 5 per cent of MDR patients whose TB mutates

1:00:13 > 1:00:18into the even more deadly form known as XDR, or extremely drug resistant.

1:00:58 > 1:01:03We do have a regime for XDR, but I should say it's very difficult

1:01:03 > 1:01:07to cure XDR because we're just giving what we have on the table.

1:01:07 > 1:01:10The reality of XDR is that it's almost incurable.

1:01:12 > 1:01:15A 2006 outbreak of XDR in South Africa,

1:01:15 > 1:01:19killed 52 of 53 patients who caught the disease.

1:01:19 > 1:01:25Even now around 70 per cent of XDR patients die within a month of diagnosis.

1:01:36 > 1:01:39When you start on XDR treatment you go down.

1:01:40 > 1:01:45You go down because it's another treatment that has new side effects.

1:01:45 > 1:01:49It's really bad, yeah.

1:01:49 > 1:01:51So I don't know what is going to happen.

1:01:51 > 1:01:54I don't know.

1:01:55 > 1:01:57'Those patients they have MDR'

1:01:57 > 1:02:03and one mistake, they can easily go in to XDR TB treatment, I mean

1:02:03 > 1:02:11diagnosed with XDR, which is sad to see patients fading away day by day,

1:02:11 > 1:02:16with not much hope that you will cure them.

1:02:24 > 1:02:29'There is a patient, unfortunately she developed XDR TB that she

1:02:29 > 1:02:34'had contracted from her parents within the same household.

1:02:35 > 1:02:38'Currently she is on XDR TB treatment'

1:02:38 > 1:02:41and she's lost her parents, she's lost her hearing,

1:02:41 > 1:02:46and she's actually not doing so well with the treatment.

1:02:50 > 1:02:54Gcinekile discharged herself from hospital wanting to spend

1:02:54 > 1:02:57what may be her last weeks at home.

1:02:57 > 1:03:00She's been asked not to return to her university course,

1:03:00 > 1:03:03so now lives in isolation in her dead parents' house.

1:03:05 > 1:03:09Imagine waking up in the morning, you've totally lost your hearing.

1:03:09 > 1:03:11I wouldn't wish that on anyone.

1:03:11 > 1:03:15I'm a person who loved music a lot,

1:03:15 > 1:03:21especially gospel from my church so I miss listening to that music.

1:03:21 > 1:03:26I had my own favourite songs, and you know I found myself

1:03:26 > 1:03:30taking my phone, trying to listen, there's nothing I can hear.

1:03:32 > 1:03:37My mind is so suicidal I also hated myself. You know

1:03:37 > 1:03:43when I look at a rooftop I think to myself, "I wish

1:03:43 > 1:03:48"I knew how to tie that knot," and I try remembering...

1:03:48 > 1:03:54I tried remembering how we used to do it as Girl Guides, but it just

1:03:54 > 1:03:59doesn't come back. But I remember all the other knots, so to me

1:03:59 > 1:04:03it sometimes tells me that it's God's work that I can't remember that knot.

1:04:03 > 1:04:08Cos if I would I know myself I would do it.

1:04:10 > 1:04:16My dad, then the older one, me, and my brother.

1:04:17 > 1:04:18It crushes me.

1:04:20 > 1:04:23My friends have boyfriends or husbands.

1:04:23 > 1:04:27What man would want a girl with TB, skinny and bone?

1:04:27 > 1:04:32You see how hard it is. It's very hard.

1:04:32 > 1:04:37Cos even if people just see the face, think like,

1:04:37 > 1:04:39"Wow, she's beautiful,"

1:04:39 > 1:04:46but come see the whole body, scary, no guy would fall for that.

1:04:47 > 1:04:53I've took every single injection they have on the regime

1:04:53 > 1:04:58and every tablet, I'm not going to win this battle.

1:04:58 > 1:05:03That's it. I'm not going to win it.

1:05:03 > 1:05:06I never will.

1:05:08 > 1:05:13Instead it's just killing me slowly. Next thing I'll be crazy out there.

1:05:15 > 1:05:18Cos this thing's slowly eating me up.

1:05:21 > 1:05:26'It will take a while but the disease is progressing.'

1:05:26 > 1:05:33It'll progress to a point where she probably cannot

1:05:33 > 1:05:37use the bit of lungs she's left with.

1:05:43 > 1:05:47I am deaf because of TB.

1:05:47 > 1:05:52I lost my parents and my sister because of TB.

1:05:52 > 1:05:58I've been out of school now because of TB.

1:05:58 > 1:06:03I can't enjoy my youthful days cos of TB.

1:06:03 > 1:06:07I'm not living like every other people

1:06:07 > 1:06:12with their siblings in the same house, cos of TB.

1:06:12 > 1:06:20Like, seriously now, how many things are going bad for me just cos of TB?

1:06:20 > 1:06:23You see I really don't care about the stigma cos I'm now able

1:06:23 > 1:06:25to stay alone.

1:06:25 > 1:06:29But like seriously, all these things just cos of TB.

1:06:32 > 1:06:33It's not fair.

1:06:36 > 1:06:38It's really not fair.

1:06:42 > 1:06:48By the end of 2013, XDR-TB cases had been reported in 92 countries.

1:11:27 > 1:11:31During the funeral, a fire started inside Bheki's house.

1:11:31 > 1:11:32Many of his possessions

1:11:32 > 1:11:36and some of his TB medication have been caught in the flames.

1:12:42 > 1:12:45While Bheki's world grows darker, there is hope for Nokubhega.

1:12:47 > 1:12:52After six months of daily injections her sputum tests are now negative.

1:12:52 > 1:12:54Her brother, Melusi, is still at school,

1:12:54 > 1:12:55being supported by the church.

1:12:55 > 1:12:58He can't afford to look after Nokubhega,

1:12:58 > 1:13:01but their church has found a family willing to take care of her for now.

1:14:37 > 1:14:41Nokubhega still has at least a year of taking numerous drugs every day,

1:14:41 > 1:14:45and if she lapses the disease will come back stronger than ever.

1:14:45 > 1:14:49So a normal life, free from the stigma of TB,

1:14:49 > 1:14:50is still a long way off.

1:16:02 > 1:16:04But things are not going

1:16:04 > 1:16:07so well for Nokubhega's friend from the hospital, Gcebile.

1:16:37 > 1:16:38How are you Gcebile?

1:16:38 > 1:16:43We are following on your results and your clinicals, you have

1:16:43 > 1:16:47been on medication for more than a year now, it's a year almost, yeah?

1:16:48 > 1:16:53But each time we are taking your sputum that is also coming back positive.

1:16:53 > 1:16:55They're not changed.

1:16:55 > 1:16:58So it show that the drugs are not working on you.

1:16:58 > 1:17:00Because it's not possible that the drugs are working

1:17:00 > 1:17:03and you are fine clinical, but each time we are testing it

1:17:03 > 1:17:07we come in positive and positive and positive and not change.

1:17:07 > 1:17:11So it's true that we know you feel bad, no-one can be ready to be

1:17:11 > 1:17:17told that, OK. My results are not bad but that is the reality.

1:17:17 > 1:17:20You are not doing OK.

1:17:20 > 1:17:23The drug we are giving you are not giving us any change,

1:17:23 > 1:17:27as long as when you monitor the bacteria still there always.

1:17:27 > 1:17:30You are going to move from this ward to other ward.

1:17:33 > 1:17:37Cos this side we are keeping those patients who are culture negative,

1:17:37 > 1:17:41smear negative, but you are not among them now.

1:17:41 > 1:17:44Forget about going home now. This now, it's XDR.

1:17:46 > 1:17:49I know you need to cry now, it's a sad - it's a sad news,

1:17:49 > 1:17:53I admit, so yes, have your time and we'll talk later.

1:17:54 > 1:17:59This is now XDR, that's the information we wanted to deliver to you today.

1:19:15 > 1:19:19In the 21st century, we shouldn't have people dying from TB.

1:19:21 > 1:19:27Zandile is not isolated case, it's happening very frequently.

1:19:27 > 1:19:32It's painful, we, we tried our best to, to save her life but, erm...

1:19:34 > 1:19:36..sometimes it happens.

1:19:40 > 1:19:44And she was fighting for a - for life,

1:19:44 > 1:19:46and her family were fighting for, for life.

1:20:05 > 1:20:08The cocktail of drugs Bheki is taking were

1:20:08 > 1:20:11developed between 40 and 70 years ago.

1:20:11 > 1:20:14New TB drugs are slowly coming to market -

1:20:14 > 1:20:17but an effective combination has yet to be tested,

1:20:17 > 1:20:19so better treatment is still years away.

1:21:48 > 1:21:50PERSON SNEEZES

1:24:46 > 1:24:50I feel sorry that in the... in this era of globalisation

1:24:50 > 1:24:56we still use old, old drugs and we cannot, erm, eliminate TB.

1:24:59 > 1:25:01Nokubhega's friend Gcebile couldn't face

1:25:01 > 1:25:05the thought of living in an XDR isolation ward.

1:25:05 > 1:25:09So she's discharged herself and is living alone at home.

1:25:50 > 1:25:55Gcebile is still at home, alone, fighting her battle with XDR-TB.

1:25:59 > 1:26:05Anyone can get TB. We all use public transport.

1:26:05 > 1:26:07And even at the workplace,

1:26:07 > 1:26:11you don't know whose health is in what condition.

1:26:11 > 1:26:14You don't know who's sick, who is not sick.

1:26:14 > 1:26:18Who is faithful to their medication and who's not.

1:26:18 > 1:26:21So TB's just in the air,

1:26:21 > 1:26:24so whether you're poor or rich you can't stop that.

1:26:24 > 1:26:26There's no way you can stop it.

1:26:31 > 1:26:36Six weeks after filming, Gcinekile lost her battle with XDR-TB.

1:26:38 > 1:26:41In developed countries, in western countries,

1:26:41 > 1:26:49they should be threatened how is the spread of TB.

1:26:49 > 1:26:53But there is no global response.

1:26:53 > 1:26:55CHILD COUGHS AND CATCHES BREATH

1:26:55 > 1:27:00The fact is we cannot choose the air you breathe.

1:27:00 > 1:27:04And hence, anyone can get TB, anyone can die from TB.

1:27:09 > 1:27:12We are living in the era of globalisation.

1:27:12 > 1:27:17So infectious airborne diseases like TB,

1:27:17 > 1:27:22is, er, given great opportunity

1:27:22 > 1:27:26to spread worldwide very rapidly

1:27:26 > 1:27:32and have a huge impact on global public health.