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Pakistan: A new way of treating Hepatitis C
In Machar Colony, a slum area of Karachi, Pakistan, a Médecins Sans Frontières / Doctors Without Borders (MSF) team have been treating patients for Hepatitis C using a new line of drugs to combat the virus.
My name is Khurshid Ahmed. I’m a nurse at the MSF hepatitis C treatment facility in Machar Colony.
I came to Karachi in 2008 from Khyber Pakhtunkhwa (KPK), an area in the north of the country. I did my nursing degree in Karachi, before joining MSF.
New drugs, known as Direct Acting Antivirals (DAAs) are now widely available in Pakistan, making it easy for primary healthcare workers like me and my colleagues – all nurses and general practitioners – to manage the majority of patients.
Since 2015, the team in Machar Colony have screened more than 16,000 people, and started more than 2,400 chronic hepatitis C sufferers on treatment.
The treatment programme is short at only three months long, and it is taken orally, which means no more painful interferon injections.
Patients also experience limited side effects: on the first-line treatment, the worst people suffer are tiredness and body aches. These kinds of issues are easily dealt with, with the willpower of the patient and some over-the-counter medications.
Any patients suffering from severe complications or co-infection are referred to a specialist facility that is better equipped to help them.
Difficulties of the job
The most difficult part of my job is managing patients who have more advanced liver disease.
They must take a regimen of drugs that lasts six months, along with medications to prevent complications that come with their condition. They also tend to experience more unpleasant side effects.
Late last year, we treated one man with advanced liver disease. He was very keen to start his course of drugs. But, he took it only for three weeks, then stopped.
One of the man’s relatives called me, worried, asking me to try to convince him to continue his treatment.
So, one day, after duty hours, I went to their home and counseled the man about the importance of staying on meds. I told him that we could start him on a different regimen, but he still refused to continue.
About five months ago, I found out that he had been hospitalised for complications related to his condition. I haven’t heard anything from him since.
A part of the community
I think it is a real advantage to be a part of the community in which I work. People feel like they can approach me, like I am trustworthy.
When I walk in the street, patients come out of their shops and homes to say hello, give me updates on how their treatment is going, and tell me how they are feeling.
I’m sure my family would love to see me move home. I will return to KPK to live one day; but when I do, I will sure miss Machar Colony.