The TB Express

Our tuberculosis caseload has increased notably in the last few months. I don’t know why. A lot of the new patients have had TB before, which means that this time they have to get 56 doses of a drug called streptomycin. The only way to give it is as an intramuscular injection. Since this is something I learned to do when I was an EMT, for the last several months it seems I have spent a good portion of my day jabbing patients - mainly older, smelly - men - in the butt with needles. (They are pretty funny about making sure I alternate cheeks.) Poor guys. Fifty-six is a lot of doses. But it works, for the most part. They get dramatically stronger and healthier over the course of the treatment.

A few patients aren’t strong enough to make it to the clinic on their own so I load up my syringes and make my rounds. I call it the TB express.

Mandla is first.He lives in one of the tiniest and most tumble-down shacks I’ve ever seen - and that’s saying a lot.
Mavis was always next.
She lived in this small shack.
But I learned yesterday that she died on Friday, shortly after I took that picture of her. Is it exploitative to post it here? Is it wrong to mention I was one of the last people to speak with her?

She was close to the end of her regimen of injections and just had not been improving at all. In retrospect, I imagine she had multi-drug resistant TB but she was never tested for that and, like many others, has slipped through the cracks of the health system despite our best efforts to prevent it.