‘I Didn’t Want To Die’: Patient Recalls Diagnosis, Recovery From Tuberculosis

Abelino Hernández is originally from Guatemala, but he has worked in neighboring Chiapas, Mexico, for several years to make a living and support his loved ones. He used to work on coffee plantations during Chiapas’ harvest season, from about October to March, and it was common for him to develop a cold due to the frigid weather in the mountains. But during the past year, he began to have a strong cough that felt more severe than a cold.

"It hurt a lot to cough," Hernández says. "My throat bothered me a lot. I couldn't even eat anymore because it burned when I passed saliva."

His employer at the coffee farm suggested that he go to the nearest hospital, about a three-hour trip from the community where Hernández worked. But he was hesitant to go, due to rumors he had heard—during the pandemic, misinformation about health services has run rampant in Chiapas’ rural communities.

"They said that in the hospital they killed people, and I didn't want to die," Hernández says.

But each day, Hernández became weaker. Within weeks, he could no longer stand up, eat alone or go to the bathroom. It all came crashing down one day in a hotel room, when Hernández, feeling faint, asked the hotel owner for a glass of water. Before they could hand him the glass, his vision blurred and he lost consciousness. He woke up in a hospital room at Ángel Albino Corzo Community Basic Hospital, in the Chiapas city of Jaltenango de la Paz.

Looking for answers

For many people in Latin America, it is difficult to find jobs to support their families—a challenge that has only worsened with the COVID-19 pandemic. This prompts them to try their luck in other countries and take a leap of faith in an unfamiliar place, often putting their own lives at risk through heightened exposure to violence, high-risk jobs, and lack of social support.

Partners In Health has worked in Mexico since 2011 and is known locally as Compañeros En Salud. Its programs include mentorship of first-year clinicians; training and support for community health workers; and support for a birthing center, rural primary care clinics, and the Ángel Albino Corzo hospital in Jaltenango—where Hernández was rushed for emergency care.

"I opened my eyes and I didn't know where I was," Hernández says. "I asked a doctor and she told me we were in the hospital. Then I started crying."

The diagnosis wasn’t clear, at first.

Hernández had a cough and fever, so doctors thought it could be COVID-19, since there had been a surge of infections in Chiapas that month. But when they asked more questions, they discovered that he had been suffering from his symptoms for six months. Compañeros En Salud’s clinical team took a chest X-ray, which revealed the diagnosis: Hernández had tuberculosis.

Tuberculosis is the world’s most deadly infectious disease, killing 1.4 million people in 2019 alone, according to the World Health Organization. In Mexico, new cases of tuberculosis arise every year in more than half of all municipalities in the country. Although the mortality rate in Mexico has decreased in recent years, many people continue to die from TB because of a lack of access to medicine.

Treatment for tuberculosis can last between six and nine months, and is intense. For Hernández, it was going to be difficult to take the drugs and cope with their side effects for so long without family, money or belongings in Mexico—his employer had burned all of  Hernández’s clothes and possessions, out of fear that he was infected with COVID-19. And Hernández had nowhere to go—the Mexico-Guatamala border was closed due to the pandemic, and staying in the hospital would be impractical and damaging to his mental health.

Fortunately, Compañeros En Salud was aware of these challenges—and ready to respond.

Compañeros En Salud offered Hernández free housing in a guest house normally used by volunteers. CES also formed a support team of doctors, interns, and volunteers who mobilized to take care of Hernández. Members of this team took turns bringing him food, giving him his medications, and staying to talk with him.

Specialized care and attention are vital to successful TB treatment. To help patients maintain the grueling treatment regimen and manage side effects, PIH teams from Lesotho to Kazakhstan utilize treatment supporters and health care workers—often assigned to a single patient at a time—to make daily checkups and help ensure healthy recovery.

With the support of Compañeros En Salud’s Right to Health program, Hernández was able to visit specialist doctors and carry out lab tests at a specialized hospital in Tuxtla Guitérrez, complementing the treatment he received in Jaltenango thanks to the Health Jurisdiction of Villaflores.

The Right to Health program supports patients with transportation, food, accommodation and accompaniment when they have to travel for several hours to the state or country capital for medical consultations with specialists. This support relieves the burden on patients as they navigate Mexico’s health care system.

And Compañeros En Salud’s care for Hernández was more than just medical.

"Doctor visits became social visits," says Dr. Martha Arrieta, coordinator of primary care at CES, who followed Hernández’s treatment closely. “It was incredible to get to know him and to be able to know his life experience, where he came from and what had happened in his life. Visiting him was one of the most beautiful parts of my day.”

As he recovered in the guest house, Hernández and Compañeros En Salud staff shared stories, discussed their worries and frustrations, and learned from each other. He learned to cook, read, and paint with the rest of the team. They also sang, watched movies, and listened to music. Little by little, he was recovering—not only learning to manage his symptoms, but learning to enjoy life again.

A path to wellness

Recovering from an illness is never a linear process. On different occasions, Hernández got sick again, had a fever or developed gastrointestinal problems. His case was challenging and complex for the Compañeros En Salud team to manage, as they mobilized not only in response to tuberculosis, but also COVID-19.

TB will continue to be a vital issue in Mexico, and around the world, long after the COVID-19 pandemic subsides. With proper treatment, the disease is perfectly curable; but many people struggle to access lifesaving medicines and medical services. It is vital to focus on awareness, prevention and treatment to eliminate stigma and prevent deaths.

Accompaniment is also vital, giving patients the support they need to recover.

Hernández always believed in his ability to heal. Day by day, he became more self-sufficient and regained his strength. In December 2020, he finished his treatment regimen—and a few weeks later, returned to Guatamala to be with his family.

“Now that I return to Guatemala, I am happy to see my cousins,” he says. “But I'm also sad to go. Nothing will be the same. They have taken good care of me here. "