環(huán)球英語 — 521：DOTS and TB
Voice 1
Hello. I’m Marina Santee.
Voice 2
And I’m Ruby Jones. Welcome to Spotlight. This programme uses a special English method of broadcasting. It is easier for people to understand, no matter where in the world they live.
Voice 3
‘I am a community health worker. I am so happy that I could prevent the spread of disease in the community.’
Voice 4
‘Now I know the signs of the disease. So I have sent other villagers to the health centre. I had treatment there. And I am cured.’
Voice 5
‘I followed the plan exactly. Three months later I am cured! It can work for you too.’
Voice 1
These people are talking about a cure for tuberculosis, or TB. You may remember Kheair’s story from an earlier Spotlight programme. TB spread through his family. TB is a very infectious disease. It spreads easily through the air. TB killed Kheair’s children. This situation is common in many places across the world. In fact, throughout the world, three people die from TB every minute. But this does not need to happen.
Today’s Spotlight looks at a successful way to fight and cure TB.
Voice 4
‘Now I know the signs of the disease. So I have sent other villagers to the health centre...I had treatment there.’
Voice 5
‘I followed the plan exactly. Three months later I am cured! It can work for you too.’
Voice 2
These people are talking about DOTS. DOTS is a health plan. The World Health Organisation invented the plan. Each letter in the word ‘DOTS’ has a particular meaning. The letters mean ‘Directly Observed Treatment.’ It is a simple, yet effective method. People must follow DOTS exactly for it to work. If they do, they have a ninety five percent [95%] chance of being cured. The DOTS plan has five main points. The WHO has developed these as a guide for different countries to follow.
Voice 1
First, the DOTS plan needs political support from national governments. Governments need to support action plans. They should create laws to enforce plans, where needed. And they should also provide financial support. The DOTS plan will only succeed with this support.
Voice 2
The second part is good TB testing. Countries need laboratories with all the right equipment. For many countries, this means more investments.
Voice 1
Third, all TB patients should receive the same, correct, treatment and support. The WHO has developed a guide to managing patients and drugs.
Voice 2
The fourth part is an effective drug supply and management system. All health centres should receive enough anti TB drugs. These should be free for all people.
Voice 1
And finally, there needs to be a system that records everything. Experts can use this information to make sure DOTS is working. They can use it over large areas to ensure high quality TB control.
Voice 2
But all this is of no use without the work of two people. These two people have the power to cure TB or let it develop and kill. They are the TB patient and an observer.
Voice 1
The DOTS plan says that every TB patient must have an observer. The observer’s job is to make sure the patient takes the correct medicine at the correct time. The observer does not need to be a health worker. But he or she must be trustworthy. Some observers are store owners. Some are tribal leaders. An observer can be any respected member of the community.
Voice 2
Observers ‘observe’ TB patients swallow their medicines. They make sure that the patients take them in the right order, at the right time. And, they also make sure that the patients complete the treatment. The DOTS plan suggests that observers do this for the whole period of treatment. But, it recognises that this is not always possible. In these cases, observers should watch for the first two months.
Voice 1
The aim of DOTS is to make TB disappear completely from countries. But there is another reason for DOTS. It is to prevent more dangerous forms of TB developing. This is a big concern for health experts. You may recognise the name MDR- TB, multi drug resistant TB. This is a very strong form of TB. It is so strong that current drugs are not effective against it. The TB resists the drugs’ power. Currently, there are four main drugs that treat TB. Some forms of TB can resist more than two of these drugs. This TB is called ‘multi’ drug resistant tuberculosis - MDR-TB.
Voice 2
MDR-TB is very hard for doctors to treat. Patients need more treatment - for longer. The recovery rate for MDR-TB is 50% or less. The WHO estimates that there are around four hundred and sixty thousand [460,000] new cases every year. Meanwhile, there is new evidence of other drug resistant forms of TB. This is a great cause for concern.
Voice 1
So how do people develop MDR-TB? Suppose a person has normal TB. The patient takes his medicine for a few weeks. And then, he starts to feel better. So he stops taking the medicine. This is very dangerous. Improved health is not a sign that all the TB bacteria are dead. Most likely some bacteria remain. Inside the body, these bacteria develop. They become stronger. They can now fight the drugs. Eventually, they make the patient sick again. The old drugs will not work. So, the patient tries different drugs. But these do not work either. The TB has developed into the dangerous MDR-TB.
Voice 2
A person can also develop MDR-TB if they forget to take their medicine. This is why ‘DOTS’ is so important. The observer and the TB patient must work together. It can be the difference between life and death.
Voice 1
Mr Ram Khadka, from Nepal, knows about the dangers of TB. The disease killed some of his family. And it could have killed him also. But, he learned about DOTS in time:
Voice 6
‘When TB attacked my father we had not heard of ‘DOTS.’ And treatment was very costly. My father did not live to see his 32nd birthday. TB killed him.
My mother developed TB also. She went to the hospital but she died. In the hospital I learned more about TB and treatment. It was here that doctors told me I also had TB. I remember all of the patients in the hospital felt hopeless. They did not have the knowledge of DOTS. I knew about DOTS. And I was sure it would work. I tried to make other patients believe in DOTS too.’
Voice 1
Ram Khadka carefully followed the DOTS plan. And today, he is cured. He said,
Voice 6
‘DOTS cured me. It can cure you too.’
Voice 1
Ram is now working to fight the spread of TB. He wants to spread knowledge of the disease. He said,
Voice 6
‘I hate the disease TB. I work to stop it forever. I need several hands to help in my courageous and brave fight against TB.’
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