Following independence in 1991, Georgia has suffered from periods of civil war and unrest. Tension has abated, but unemployment and destitution remain very high and Georgia is now one of the poorest former Soviet Republics.
Widespread poverty and an inadequate health system have resulted in alarmingly high levels of tuberculosis (TB). Lack of funding for running health facilities and for staff salaries has been a major problem. Consequently, many health facilities are so run-down that patients fail to use their services, and preventative health care is completely neglected.
MERLIN'S WORK IN GEORGIA FROM 2001 TO 2007:
Controlling TB
Merlin began working in Georgia in 2001, helping the local authorities expand their TB control network to rural clinics in Shida Kartli. Since then, Merlin has helped in the provision of outreach care throughout the region. The programme enables patients living in remote villages to receive daily treatments from local nurses rather than having to spend money and time travelling to specialist TB centres. Merlin has also restored four district TB facilities, re-established laboratories, supported a small TB ward, designed health education materials and trained health workers and family members in TB care. Before Merlin's work began, nearly a third of TB patients in the region dropped out of treatment early. Now, around 90 per cent of patients complete their full course of treatment.
In early 2006, Merlin extended its support for TB control to Kakheti where the regional TB dispensary is being renovated. This project currently benefits a combined population of 750,000 people in the Shida Kartli and Kakheti regions. Merlin's piloted approach to TB control in Georgia has been recognized as so effective that the Government has now adopted our methods as a model for other regions
Restoring rural health services
With funding from the European Union, Merlin has helped to lay the foundations of a modern and effective primary health care system in eastern Georgia. A key aim is to improve services for vulnerable people living in rural districts. By September 2007, our teams renovated and equipped at least 52 health centres in the Kakheti region. Essential equipment and medical supplies were provided to each site so that newly trained family practitioners and nurses could deliver a more comprehensive and higher-quality service. Staff were also supported by Merlin's community health workers and a mobile theatre group to deliver health education messages. As part of this programme, Merlin supported the Ministry of Health in the implementation of a National Health Promotion Strategy in Kakheti, which reaches nearly half a million people.
Key Achievements
• 878 patients diagnosed with TB in 2006 and referred for appropriate treatment
• TB dispensary in Kakheti rehabilitated in 2006
• 245 health staff trained in Kakheti and Shida Kartli in 2006
• 18,500 leaflets and booklets printed and distributed in 2006 to raise awareness of TB
Supporters of Merlin’s work in Georgia included the European Union and Jersey Overseas Aid.
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Obituary: Professor Tim Cullinan
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FIELD DIARY: On the road with the TB team
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