Four months in (July 2011)

We spent two days in each township, escorted into various areas within the township.

In Nyanga we saw and interviewed nine of the thirty-three patients so far enrolled on the programme. In Robertson (Nquebela) we saw seven of the eleven patients enrolled so far.

We think it fair to suggest that, generally, the patients enrolled in South Africa are on average much weaker than those enrolled in Kampala. This was the aim of the programme, because we knew how serious the problem is in the townships of South Africa despite the drugs and diagnostics being available.

Despite these patients being far weaker (several originally bed-ridden), we've seen very similar response to what we saw in Kampala including some very clear recoveries from extreme illness which both patients and carers put down the moxa. No problems were identified, and we were really impressed with how the carers have applied themselves to the programme.

Just over 50% of the patients we saw were also HIV+, and yet again we are seeing no discernable difference in response between these and those who are just infected with TB. Two of the patients are confimed MDR-TB, both having spent eight months in hospital and both on the second year of their drug treatments. One was almost deaf from the side effects of the drugs, and both were chronically weak.

One of the MDR-TB patients is also HIV+, and has given us much food for thought. She is quite easily the slowest responder we have seen so far. It is very early to draw any conclusion, but we wonder whether the combination of drug therapies (second line TB drugs and HIV drugs) which are known to negatively interact creates an additional block to the host immune response. The other MDR-TB patient is at a similar stage of second-line TB treatment, but has responded well to the moxa treatment. The difference may be that she is not also taking HIV drugs.

Survival rates for MDR-TB patients is often estimated to be below 50%, so we know that we must pay particular attention to these patients, since we believe moxa might be of particular benefit for them.