Concern about the return of Tuberculosis to Czech Republic

The disease tuberculosis is regarded by most as a thing of the past. But in recent years it has been making something of a comeback, particularly in the countries of the former Soviet Union. Tuberculosis has also been making the news in the Czech Republic, after a 52-year-old man recently died of the disease in north Bohemia. Now Czech authorities have been coming up with novel ways to fight TB.

Since the fall of the iron curtain thousands of Russian and Ukrainian labourers have come to the Czech Republic in search of work. Given the fact tuberculosis has reappeared in their countries, many Czechs are wary of them. However, leading TB expert Dr Ludek Trnka tells me that in the case of legal immigrants at least they have to undergo an x-ray to be allowed to stay in the country.

"Another problem, however, are the illegal immigrants and of course no-one can check them. I would say this is a very big problem. And we have not solved this problem so far because the Ministry of the Interior doesn't know how to reach them. It depends on the responsibility of Czech people who hire them, if they are responsible or not."

Dr Trnka says tuberculosis infection rates in the Czech Republic have not actually increased in recent years. However, he is quick to point out the necessity of detecting the disease in society's risk groups: illegal immigrants, drug addicts, the very poor and, above all, the homeless. For two years now Dr Trnka's team have been running a novel programme to reach potential victims on the streets of Prague.

"We were very lucky because we got a bus equipped with a mass miniature radiograph, or MMR, which is an x-ray device on the bus. And the bus can go near these people."

In the Prague district of Karlin, around 50 people are examined on the refitted military bus in the course of an afternoon. Nurse Zlata Kantorkova explains how the system works in practice.

"Our clients come to the bus and show us their ID. Then we check on our computer if we haven't seen them over the last 12 months, we x-ray them and before they go we give them a food coupon."

The food coupons are an effective incentive to the homeless and the very poor, who are less likely than most to care about their health. This homeless man's name is Libor and he has just been examined.

"When they know you live on the streets they examine you, get your information and that kind of thing. Then they let you know if there's anything wrong with you. I came both for the food coupon and because I care about my health."

Prague's anti-tuberculosis project has been such a success that the World Health Organisation is sending people from Western and Central Europe to the city for training later this year.