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At 24-years-old, Meryem has always been an active and energetic woman. She loved to travel and moved abroad from Turkmenistan to pursue management studies. Despite intense first-year exams, she passed successfully and was excelling academically.
During the summer break, however, she began to feel unwell: constant fatigue, swollen throat, persistent cough and severe headaches. She initially blamed academic stress, but when the symptoms persisted for over a month, Meryem visited the university hospital.
While doctors first diagnosed her with a common cold, over the next three months, Meryem was treated for everything from the flu to tonsillitis. Medications, physiotherapy and recommendations kept changing. Online searches for her symptoms yielded a range of possibilities—from depression to cancer.
When classes resumed mid-September, Meryem was completely exhausted. She woke up at night drenched in sweat, had lost significant weight and was tormented by a cough. One night, she woke up unable to feel her legs below the knees. She pinched her calves, but sensation only returned after an hour.
"When I suddenly started feeling nauseous from my favorite oranges, I suddenly thought—it’s tuberculosis,” she remembers. “A distant relative had TB, and I compared the symptoms. He also suffered from constant nausea and extreme weight loss. I wasn’t afraid of the diagnosis; I just wanted to know the truth and finally start treatment."
She insisted on an x-ray at the campus hospital, which revealed a dark spot, but laboratory tests did not confirm tuberculosis. Meryem was hospitalized several times the next months, but the treatments provided little relief, and her condition worsened.
A clear diagnosis remained elusive, so Meryem decided to take a leave of absence from her studies and return home.
Upon arrival, she immediately repeated tests and another X-ray, which instead of a spot, now showed a clearly visible open cavity. The next day, they confirmed she had tuberculosis. The diagnosis - drug-resistant tuberculosis - was confirmed by a sputum test using the GeneXpert machine (procured by UNDP Turkmenistan through a Global Fund grant).
"The doctors explained to me how important it was to detect the disease early," Meryem said. "If I had waited a bit longer, my condition could have been much worse".
The diagnosis brought mixed emotions for Meryem. She was shocked that it was indeed tuberculosis, but also relieved that treatment was available and accessible.
After the diagnosis, Meryem began a nine-month treatment regimen, which was far from easy – physically or emotionally. Doctors explained that she had a smear-positive form of tuberculosis – a more contagious form when bacteria actively released from her lungs into the environment. This was terrifying, and despite the doctors' support, Meryem worried about how this might affect her loved ones. She strictly followed the recommendations — self-isolating at home, regularly wet-cleaning her room, wearing a mask and avoiding prolonged contact with family members.
Meryem was incredibly fortunate with her family. They supported her at every stage of the treatment and actively involved her in family life, ensuring she never felt alone. Her parents underwent preventive treatment, while her siblings and their children had follow-up X-rays so they could visit. Even her neighbors supported her on her path to recovery.
Meryem was open about her diagnosis. She knew that tuberculosis carries social stigma and people with it are often misunderstood and. Some young women may even be rejected by the community as future wives and mothers. Her honesty was a bold choice. When chatting with people online, she would bluntly say: “I have tuberculosis!”. This quickly revealed who held stereotypes about the disease. But one special person wasn’t discouraged - an old university friend didn't care what her diagnosis was.
After nearly a intensive month of treatment, Meryem’s condition started improving. Despite the side effects of the medication, Meryem felt uplifted by this news. She was relieved that her family were no longer at risk.
During this time, her family grew even closer. For timely recovery, it is crucial that TB patients adhere to treatment and not miss a dose, so her family picked up her medicines at the medical center and reminded her to take her medications. Many patients in Turkmenistan participate in a “directly observed treatment” process, where they are observed by a healthcare provider to help adhere to TB treatment. Patients receive this treatment in healthcare facilities based on their place of residence, but a new video observation platform piloted by UNDP within the Global Fund’s TB grant, allows for remote monitoring.
During this time, there were periods when she felt particularly weak, both physically and emotionally, and Meryem had to also focus on self-care habits. The medicines caused her skin to darken and dry out, so she found new skincare routines. Her appetite increased and food preferences changed, so she made time for walks in the fresh air to control weight. When the medicines caused apathy, she took up new hobbies. She did whatever it took to emerge from the experience stronger.
Once her tuberculosis was no longer infectious, Meryem was able to start thinking again about her future. Her studies and career were still unresolved, but she planned to continue her education. She was used to being self-sufficient, but her health made even remote work difficult. The young man who wasn’t scared off by her diagnosis became a great support. He took on more responsibilities, caring for her and planning their future wedding so Meryem could focus on her recovery. Their chats became a daily routine — they discussed the importance of following medical advice, shared concerns about the treatment process and explored ways to regain her health faster.
The physical and emotional support of her family and partner made her recovery journey easier and quicker.
After several months of consistent treatment, Meryem noticed significant improvements. Her symptoms gradually disappeared, and doctors confirmed that her immune system had recovered, allowing her to return to an active life. However, despite the positive changes, she faced a new challenge: that stigma. As she began to go out, she noticed some acquaintances and relatives avoided her, fearing infection. This hurt, especially since she was doing everything possible to treat TB and recover.
Today, nearly a year into her treatment, Meryem feels much better. The cavity in her lung has closed and her TB tests are negative.
"I’m eagerly the doctor's clearance. It will be a new beginning for me. Once I get the certificate of recovery, I’ll finally believe that all the plans I’ve been making for almost a year - resuming my studies, preparing for my wedding and setting up our future home - are real."
Meryem’s path to recovery was not easy. She advises anyone experiencing similar symptoms to get diagnosed as soon as possible. If the diagnosis is confirmed, focus not on the disease but on the treatment.
“Most importantly, don’t face it alone,” she emphasizes. “The support of loved ones can be the key to successful recovery.”
Now she knows that life, not illness, awaits her.
Since 2010, Turkmenistan's National Tuberculosis Program has been supported by grants from the Global Fund to Fight AIDS, Tuberculosis, and Malaria. Implemented in partnership with the Ministry of Health and Medical Industry of Turkmenistan and UNDP, these grants have helped reduce the burden of tuberculosis and strengthen the healthcare system.
Starting in 2018, the Government of Turkmenistan gradually assumed financial responsibility for many program activities, including procuring medicines and reagents for the treatment of drug-sensitive tuberculosis. By 2021, this was extended to cover multidrug-resistant tuberculosis (MDR-TB) as well.
In 2025, the Global Fund project will focus on the most complex cases of tuberculosis, as well as supporting diagnosis, treatment and patient care, with a gradual transition to full domestic funding of the program by 2027.
Tuberculosis diagnosis and treatment have become more accessible in the country. However, the path to recovery for patients can still be challenging, especially if the disease is not diagnosed promptly.
