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Activist Communique: Manitoba woman forced into jail to seek TB treatment

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A Manitoba woman has been in jail since April 2011, as part of her treatment plan to treat her infectious TB, and now has been ordered to spend another three months behind bars. The 30-year-old woman -- who has been described as "belligerent" to staff on the Health Unit of the jail -- was first diagnosed with TB in December of 2010 and put on a treatment plan that health officials claim she has repeatedly refused to follow. Normal TB treatment takes between six and nine months to complete when there are no interruptions in the treatment regime.

The detention was ordered under a rare section of Manitoba's Public Health Act after her case of TB was diagnosed as infectious, and she allegedly repeatedly stopped her treatment, thus allowing the government to secure a court order -- the original 90-day court order was extended last week -- to keep her locked up in a Manitoba jail.

"I am concerned that without proper treatment, (she) may eventually develop drug-resistant tuberculosis that is difficult or impossible to treat," wrote Dr. William Libich of the Winnipeg Regional Health Authority in an affidavit filed with the courts.

While it would be easy to slip into a simplistic blame the patient, treating TB has complex social interaction factors to consider. According to public health literature, "the twin problems of delay in seeking treatment and abandonment of a prescribed regimen derive from complex factors. People's confusion as to the implications of the tuberculosis symptoms, costs of transportation to clinic services, the social stigma that attaches to tuberculosis, the high cost of medication, organizational problems in providing adequate follow up services, and patients' perception of clinic facilities as inhospitable all contribute to the complexity."

Another public health journal notes, "the highly infectious nature of TB also raises important ethical questions regarding the appropriate government responses to prevention and treatment, questions that must be grafted alongside the jurisdictional ambiguities associated with health care and public health interventions in the Canadian context. Should states, for instance, put in place measures to involuntarily detain people with certain forms of TB from mixing with the general population?"

Health officials in this case were concerned about the woman's threat to general society not only because of the infection nature of her TB but also because of her previous involvement in the sex trade industry.

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