Kigali, Rwanda - Marie Jeanne Mukamurenzi (40), chuckles in disbelief as she flips through an old photo album. Her eyes pause one glaring picture of herself, unable to recognise the shadow she had become when Tuberculosis (TB) had taken hold.

"Look at those bones. I had become so skinny that you could pour water into the dips of my collarbone, and it would remain," she reflects, pointing towards her neck. Marie Jeanne is a fighter.

The mother of five from Gisozi area in Rwanda’s capital, Kigali, is not the only one fighting this deadly disease.

TB has been affecting Rwanda's communities for years, with the latest incidence reported as 56 cases per 100,000 people in 2021. This represents a significant reduction from 96 cases per 100,000 in 2000 - a decrease of 42 per cent over 21 years.

Still, the fight against TB is far from over, as Marie Jeanne knows all too well. 

Her battle with the illness began in 2013, marked by a fever and painful cough. Within a short period, the disease had decimated her into a feeble frame.

As a farmer selling vegetables to support her family, she could not afford to be sick.

Unfortunately, the illness took hold, leaving her unable to work and forcing her husband to give up his job so he could take care of her.

With no knowledge of the cause of her sickness, Marie Jeanne's family turned to a traditional healer, hoping for a cure. But the herbs she took for weeks only made things worse.

She drank it all, two jerricans full, and felt no change - only more pain and misery. 

She was not alone in her decision to turn to a traditional healer. 55 per cent of women and 41 per cent of men do not seek medical care when showing signs and symptoms suggestive of TB, according to the Rwanda Demographic Health Survey (RDHS) 2019/2020.

Seeing Marie Jeanne in critical condition, a neighbour convinced her husband to take her to the hospital.

Struggling with respiratory distress, she was taken to the University Teaching Hospital of Kigali (CHUK) and put on oxygen. Following X-rays and other tests, she was told that she had TB and began treatment. 

Once she was on the road to recovery, she was transferred back to Kagugu Health Centre to continue anti-TB therapy from home. Since the Government of Rwanda provides free TB medicine, she was not required to pay for any treatment.

Through the World Health Organization (WHO) global advocacy and effective partnership with Rwanda, enormous progress has been made in TB prevention, treatment and care over the past decades. 

In addition, WHO has supported the government in decentralising services to the community level, which includes through Community Health Workers (CHWs). 

Marie Jeanne benefited from the CHW programme as she received the rest of her treatment at home. The CHWs would visit her for check-ups and medication administration through the WHO-recommended Directly Observed Therapy (DOT), enabling her to avoid repeated costly trips to the health centre. 

"Those dark days are behind me thanks to the free TB treatment. I am now back to work, farming, and selling. My children are thriving, and my husband even surprises me with gifts because he can work again," Marie Jeanne shares with a contented smile. 

Through its implementing wing the Rwanda Biomedical Centre (RBC), the Ministry of Health uses sensitive diagnostic machines to identify TB cases quickly.

Speaking at the 2023 World Tuberculosis Day commemorations held in March, RBC Tuberculosis Division Manager, Dr Patrick Migambi said, all citizens deserve quality healthcare.

 "Treatment success rates for multidrug-resistant and susceptible TB cases are 97.5 per cent and 88.7 per cent, respectively. Also, 94 per cent of people with HIV who started TB preventive therapy completed their treatment. With such records, we remain hopeful that we can end TB," Dr Migambi said.

For his part, the WHO Representative to Rwanda, Dr Brian Chirombo, commended the government of Rwanda for the significant progress in TB prevention, treatment, and care. 

"Rwanda's success in fighting TB is due to its rapid implementation of WHO guidance," he said speaking at the same event.

He concludes, "This is in addition to advanced diagnostic tools, alongside a decentralised approach to TB services that utilise well-trained Community Health Workers and a robust primary healthcare system. WHO is proud to partner with Rwanda in its goal to end TB by 2030."  

Thanks to the collaboration between the government, WHO, and development partners, Marie Jeanne has transitioned from severe sickness and depths of despair to a thriving mother, farmer, and business owner.

As Marie Jeanne's struggle with TB fades into the distant past, we can look to her as a beacon of hope, a reminder that Rwanda is making positive strides daily in the fight against tuberculosis.