Lindo, a little girl living in the Kingdom of Swaziland, has had to endure daily injections of the MDR TB treatment drug for the past four months. She has a smile so sweet, your heart can’t help but reach out to this little six-year-old . From her sparkling disposition, you would never believe that there was a time when Lindokuhle Mamba never smiled because she was in constant pain. Young as she is, Lindo has already faced death at the hands of one of the deadliest diseases.

Photo: © MSF

Lindokuhle suffers from multi-drug resistant tuberculosis (MDR TB), a strain of the TB bacteria that is resistant to a number of treatment drugs.  Treatment is difficult for a young child – daily injections, and four to seven tablets, twice a day, for a long period of time. Lindo, as she is affectionately known to her loving grandmother, mother and fellow MDR TB patients, has had to endure daily injections for the past four months and will probably continue to do so for a further two to four months. Even after that  she will still have to continue taking many second line TB tablets for a total period of roughly 18 months to two years. Lindo had already developed breathing problems and a constant cough by the time she was three years old. She was so tiny and weak that she could not even walk like the other children her age. Lindo’s mother, who worked on a dairy farm just outside Nhlangano town in the Shiselweni Region of Swaziland, took her daughter to several private doctors and pharmacists, but nothing helped – she she would appear to get better for a short while, but then the throwing up and diarrhoea would start all over again. When Lindo visited her grandmother, Thab’sile Macu, at Machobeni, close to the border with South Africa’s KwaZulu Natal province, the grandmother grew very concerned about her health. “I asked my daughter to leave the child with me for a short while because my biggest concern was that maybe she was not being fed well,” explains Thab’sile. Thab’sile soon realised that Lindo’s problem was much more serious than just malnutrition. She decided to take the little girl to Nhlangano Health Centre, an Médecins Sans Frontières (MSF) operated facility. After several tests and scans, Lindo was diagnosed with TB and started on treatment. When her condition did not improve after a few months, further screening revealed her to be suffering for the much harder to treat MDR TB. Lindo was going to need a long and difficult treatment. “I had to pray to God to help me,” recalls Joyce Sibanda, a TB nurse at the Nhlangano Health Centre. “I didn’t know how I was going to bear the task of giving the painful injections to such a little child every single day.” Unlike many patients who develop drug-resistant TB as a result of defaulting on previous TB treatments, little Lindo caught her infection through exposure to an adult with MDR TB. The old man suspected of having infected the child did not practise proper cough hygiene, and infected a child he was actually very fond of. “I believe more needs to be done to educate people about TB infection control in this country, says Lindo’s grandmother. “Many have died or suffered because people do not know what to do to protect others, like covering their mouths and noses when they cough or sneeze.”. Her grandmother’s nurturing love is helping Lindo on her way to recovery, as evidenced by her weight gain and ever sparkling personality. In the meantime, little Lindo has come to appreciate that the injections are being administered to make her feel better. She doesn’t even cry anymore - something that makes nurse Sibanda’s job a little bit easier.