In 2018, there were over 484,000 cases of MultiDrug Resistant Tuberculosis recorded around the world, which contributed to 44.21% of deaths caused by tuberculosis. Women diagnosed with MDR-TB are more vulnerable to low mental and social well-being than men, it is imperative that immediate action be taken to address the difficulties experienced by female patients as well as their support networks. This can be accomplished by putting emphasis on ’patient-centered care’, and a strong Primary Health Care system that is adequately facilitated would go a long way in ensuring efficient prevention and response to MDR-TB especially among women. 

By Christopher Ogwang

Christopher Ogwang

Multi-drug-resistant tuberculosis (MDR-TB) is a major public health hazard on a global scale. It is a kind of tuberculosis (TB) infection caused by bacteria that are resistant to treatment with at least two of the most powerful first-line anti-tuberculosis (anti-TB) medications. This is caused by non-adherence to the treatment regimen or poor prescription. In 2018, there were over 484,000 cases of MDR-TB recorded around the world, which contributed to 44.21% of deaths caused by tuberculosis. Over 62% of these instances were not treated, which is more than half. Noteworthy, the treatment of MDR-TB is much more expensive than the treatment of susceptible TB. In Uganda, various health challenges impede the scale-up of Drug-Resistant Tuberculosis treatment and care, treatment is either inadequate or lacking and in some cases, diagnosed patients delay on the treatment waiting list. Having one or more drug stock outs in health facilities treating susceptible TB was significantly associated with the risk of developing MDR-TB which has been noted as one of the factors contributing to poor outcomes and risk of developing drug-resistant TB, especially in rural communities. 

Women diagnosed with MDR-TB are more vulnerable to low mental and social well-being than men. Married women and women of childbearing age are most vulnerable to MDR-TB’s socio-economic, and mental health consequences, such as isolation, financial difficulties, and despair. Besides the intricacies and length of treatment, psychosocial difficulties frequently aggravate MDR-TB. It is essential to broaden patients’ access to psychotherapy and other forms of mental healthcare while they are undergoing treatment for MDR-TB.

The reproductive and parental roles of women and mothers compound the difficulties they already face in coping with, remaining adherent to, and ultimately benefiting from MDR-TB treatment. In most cases, a female patient is also a wife or mother who provides essential care for other members of her family, including those who also suffer from MDR-TB. Women have the social obligation to care for their sick children and spouses, but they may be denied even the most fundamental needs when they are ill themselves.

It is imperative that immediate action be taken to address the difficulties experienced by female patients as well as their support networks. This can be accomplished by putting emphasis on the requirement for ’patient-centered care’” and enhancing the services offered at local health facilities that are closer to the patients. This would cut indirect related costs associated with treatment that female patients may not be able to afford. This is critical because most women are incapable of maintaining adherence to the treatment regimen, yet worse when it comes to women in rural areas that mainly engage in unpaid care work and have no room to create and focus on income streams.

Along the therapy continuum, we need to emphasise  the significance of psychosocial stresses and social support as intermediary predictors for successful treatment results. To be able to ensure that female patients have a supportive environment to sustain adherence, families, patients and their family members should each receive the appropriate health information relevant to the condition and treatment plan in order to establish a support system that is both enabling and supportive. This is critical in sustaining adherence to treatment and care for Tuberculosis.

In addition, in order to improve the overall level of care provided, the screening for and treatment of mental health disorders should be incorporated in the national recommendations for the management of MDR-TB cases.

There is need to develop and implement a comprehensive mechanism for contact tracing of new tuberculosis cases and defaulters, implement an all-inclusive surveillance system such as the community awareness, screening, testing, prevention and treatment to combat TB. As evidenced from the work by the Center for Health, Human Rights and Development (CEHURD) contact tracing in northern Uganda, continuous tracing and reintegration into treatment saves lives not just of those who had dropped out of treatment but also the ones in their communities. A strong Primary Health Care system that is adequately facilitated would go a long way in ensuring efficient prevention and response to MDR-TB especially among women. 

The writer is a Senior Programme Officer at the Center for Health, Human Rights and Development (CEHURD).

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    Law firms can sometimes be endlessly chaotic. Lawyers, paralegals, and staff members must organize, analyze, and manage every aspect of multiple cases. They must track and monitor:

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    Table of Contents
    What Should You Look for When Choosing Case Management Software?
    There are many options for case management software. You need to choose software that meets your specific needs.

    Each law firm is unique, and lawyers may have different preferences.

    Fortunately, there are options that allow you to customize a case management program to fit your needs.

    Things you may want to consider include:

    The ease of transferring, storing, and retrieving information
    The ability of the software to work with other programs to gather information and data
    Make minor adjustments and modifications to the system without going through the provider
    The provider offers ongoing, quality support
    Ability to configure the system to adapt it to your needs and current systems
    Ease of retrieving data and create reports, forms, and other documents
    The ability to track time, expenses, and generate invoices and billing documents
    Accept online and credit card payments
    Prepare documents for trial and monitor litigation deadlines
    Many software companies offer free demos or free trial periods. You might need to try several case management software systems before finding the best system for you.

    What Are Some Popular Case Management Software Systems for Law Firms?
    Some of the popular case management software systems available today include:

    CASEpeer,
    FileVine,
    SmartAdvocate,
    Litify,
    MyCase,
    Clio,
    Thomson Reuter’s Legal Tracker,
    Trialworks, and
    LawRuler.
    Here’s a brief overview of each of these top-rated attorney case management systems:

    CASEPeer Logo
    CASEPeer is designed specifically for personal injury law firms. This cloud-based system offers time-saving and organizational features such as:

    Settlement tools to track demands, offers, liens, fees, and costs
    Dedicated tracking of discovery requests and responses
    Integrated calendar
    Automated notifications for statute of limitations
    From the company: “CASEpeer’s powerful built-in tools allow you to constantly evaluate your organization’s workflow, identify opportunities to further develop employees, more effectively communicate on client’s cases, and maximize productivity and results.” -Lucero Smith, COO, CASEPeer

    Demo: Interested in seeing how CASEPeer can help to transform your law firm into a well-oiled machine? Contact CASEPeer today to get started with a free demo.

    Filevine Logo
    FileVine is highly customizable and allows you to keep notes, documents, client communication, and calendar in one place.

    Additional features include:

    Allows multiple users
    Ability to text and email clients
    Task and deadline management
    Integrates with more than 2,000 programs
    Good choice for document management
    Demo: Want to see how FileVine can help you transform your law firm operations? Book a free demo that’s customized to your firm’s particular needs.

    Smart Advocate Logo
    SmartAdvocate is a fully integrated legal case management system. Initially designed for personal injury and mass tort litigation practices, it is now used by a large range of litigation firms.

    Features include:

    Specific tool for tracking insurance information
    Automated workflows
    Medical records tracker
    Fee calculator lets you enter the settlement amount and break out your firm’s fee, any referral fees or other costs for each client
    From the company: “We take pride with each annual release,” Igor Selizhuk, CTO at SmartAdvocate states, “because with each release, we fulfill our promise to our clients to continually provide them with a system that matches their evolving needs.”

    Demo: Interested in learning more about Smart Advocate? Check out their story and discover how this top-rated case management system can be a catalyst for success.

    Litify Logo
    Litify is an integrated solution designed for mid-size and large law firms. It is built on the popular Salesforce platform used by many businesses for automation and analytics.

    It features:

    Robust security
    Automated tasks
    Customizable dashboard to track key performance indicators
    Testimonial: “Working with Litify is like having the best developers in the world as my software guys,” said Johnson. “They understand the legal industry, know what works for the big firms, and bake the best practices right into the platform.

    As the owner of a younger firm, I don’t have to reinvent the wheel.” Anthony Johnson Owner, Attorney at Law Johnson Firm

    Visit www litify com to learn more about how you, your team, and your clients could all benefit from a partnership with Litify.

    Mycase Logo
    MyCase offers an all-in-one case management software solution to document management, time tracking, invoicing, payment collection, and calendaring.

    Some of its key features are:

    Simple user-friendly interface
    Simple pricing structure includes all features instead of having to add options
    Unlimited e-signatures included
    MyCase offers a free 10-day trial, so you can test the software and see if it’s a good fit for your practice.

    Clio Manage Logo
    Clio Manage offers a variety of features, including billing, contact management, document management, calendaring, accounting, task management, online payments, and time tracking.

    A few highlights of Clio include:

    Secure client portal for document sharing
    Matter timelines display who made changes and when updates were made
    Separate module available for client intake/client relationship management
    Clio is versatile and has customizable solutions for everything from solo to large firms.

    Thomson Reuters >ogo
    Legal Tracker has features such as eBilling, matter management, reporting, analytics, cloud integrations, data services, and legal operations.

    It offers such features as:

    Legal analytics to track budgets and compare performance of outside legal counsel
    Robust reporting system
    Excellent collaboration tools
    This Thomson Reuters system is geared towards helping corporate in-house legal departments track and organize their legal teams.

    Trialworks Logo
    Trialworks is a cloud-based solution created by trial lawyers with options for mobile case intake, document management, calendaring, and trial management.

    Some distinct features include:

    Litigation-centered tools
    Based on familiar Microsoft Office platform
    Available as software to be used on local network or cloud-based
    Offers database conversion (as a separate service)
    Check out their website to learn more and schedule a free demo.

    Law Ruler Logo
    Law Ruler has customized solutions for litigation firms and is integrated with Office 365 for convenient workflow. Its detailed dashboard analytics help you keep track of case status, leads, and marketing performance.

    Other features include:

    Built-in settlement calculators
    Automated text and email reminders
    Integrated click-to-call dialer powered by artificial intelligence
    Managing your cases effectively improves customer service, as well as your legal services. You have more time to devote to your clients and work on their cases when you do not need to worry about the day-to-day logistics of case management.

    FAQs About Law Firm Case Management Software
    If you are not familiar with case management software, these frequently asked questions may help you understand why your law firm needs to invest in high-quality case management software.

    WHAT IS CASE MANAGEMENT SOFTWARE?
    Managing legal cases requires a system for keeping up with detailed information about each case. Case management begins before your client hires your law firm. You need an effective way to perform conflict checks before your client signs a retainer agreement.

    Throughout the case, there could be hundreds or thousands of documents to organize, deadlines to monitor, statements to process, and other details that must be analyzed and organized into categories that are easy to search.

    You also have billing, client communications, contact information, appointment scheduling, court information, and case notes to organize and manage.

    After closing the case, you need a system for storing and archiving the case that allows for continued conflict checks. You may also need to access information in one case to assist with a matter in a related case or similar case.

    Today, digital files must be stored, organized, and cataloged. The days of managing legal cases by hand are over.

    WHAT CAN CASE MANAGEMENT SOFTWARE DO FOR MY PRACTICE?
    Gathering, analyzing, and organizing large amounts of information, data, and documents is a significant element of case management. Many lawyers, paralegals, and case managers have multiple cases they handle. As a result, the volume of data can be overwhelming.

    Case management software provides an efficient way to collect and organize data.

    Many software programs link to email, telephone, and other systems to create calls and message logs. The information is stored in the client’s file immediately.

    Tracking contacts with clients, including calls and emails, through the software help to ensure that you do not miss anything.

    Having all the information in one place makes it easy to:

    create reports,
    visualize evidence, and
    collaborate with other staff members.
    In addition, everyone within the law firm can access the case files and all information stored in the files from their desktop or tablet.

    WHAT ARE OTHER BENEFITS OF CASE MANAGEMENT SOFTWARE?
    In addition to managing the data, documents, and other information associated with a client’s case, there are other benefits of using case management software.

    REDUCE THE RISK OF MISTAKES
    Case management software can reduce the risk of human error. Mistakes happen when you are handling multiple cases and thousands of documents. Case management software completes many of the tasks automatically, which reduces the risk of errors and mistakes.

    For example, errors in transferring data to forms could be costly and time-consuming.

    When the data is contained in case management software, the software transfers the data ensuring there are no errors.

    ENHANCE SECURITY
    Lawyers have a fiduciary duty to protect confidential information. A data breach could result in the theft or exposure of sensitive information. Case management software can add another layer of security for data.

    The software also automatically backs up entire files to ensure that nothing is lost in case of a data breach or natural disaster.

    FACILITATE REMOTE WORK
    Lawyers and staff members can access client files and data from work, home, and other locations. In addition, case management software that is cloud-based allows employees to access data even when telecommuting.

    TRACK LEADS
    In addition to managing your current cases, case management software can help you track leads. An efficient, easy-to-use system to track and follow up with leads increases retention rates for the law firm.

    A lead can be entered into the system, forwarded to the correct person to respond, and scheduled for a follow-up. All information about the lead is in one location that is accessible to everyone.

    IMPROVE EFFICIENCY
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    Get More Insight Into Case Management For Your Law Firm
    At LawRank, we specialize in SEO for lawyers: getting law firms like yours to rank for competitive, high-volume keywords in competitive markets.

    We know that your business operations have to be set up for success when you begin to see an influx of calls and clients.

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    Updated 2022

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    All throughout time, we can see how we have been carefully conditioned to come to this point where we are on the verge of a cashless society. Did you know that the Bible foretold of this event almost 2,000 years ago?

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    These verses could not be referring to something purely spiritual as scripture references two physical locations (our right hand or forehead) stating the mark will be on one “OR” the other. If this mark was purely spiritual, it would indicate both places, or one–not one OR the other!

    This is where it comes together. It is shocking how accurate the Bible is concerning the implantable RFID microchip. These are notes from a man named Carl Sanders who worked with a team of engineers to help develop this RFID chip:

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    Carl Sanders, with a team of engineers behind him, with U.S. grant monies supplied by tax dollars, took on this project and designed a microchip that is powered by a lithium battery, rechargeable through the temperature changes in our skin. Without the knowledge of the Bible (Brother Sanders was not a Christian at the time), these engineers spent one-and-a-half-million dollars doing research on the best and most convenient place to have the microchip inserted.

    Guess what? These researchers found that the forehead and the back of the hand (the two places the Bible says the mark will go) are not just the most convenient places, but are also the only viable places for rapid, consistent temperature changes in the skin to recharge the lithium battery. The microchip is approximately seven millimeters in length, .75 millimeters in diameter, about the size of a grain of rice. It is capable of storing pages upon pages of information about you. All your general history, work history, criminal record, health history, and financial data can be stored on this chip.

    Brother Sanders believes that this microchip, which he regretfully helped design, is the “mark” spoken about in Revelation 13:16–18. The original Greek word for “mark” is “charagma,” which means a “scratch or etching.” It is also interesting to note that the number 666 is actually a word in the original Greek. The word is “chi xi stigma,” with the last part, “stigma,” also meaning “to stick or prick.” Carl believes this is referring to a hypodermic needle when they poke into the skin to inject the microchip.”

    Mr. Sanders asked a doctor what would happen if the lithium contained within the RFID microchip leaked into the body. The doctor replied by saying a terrible sore would appear in that location. This is what the book of Revelation says:

    “And the first (angel) went, and poured out his vial on the earth; and there fell a noisome and grievous sore on the men which had the mark of the beast, and on them which worshipped his image” (Revelation 16:2).

    You can read more about it here–and to also understand the mystery behind the number 666: https://2RUTH.ORG

    The third angel’s warning in Revelation 14:9-11 states,

    “Then a third angel followed them, saying with a loud voice, ‘If anyone worships the beast and his image, and receives his mark on his forehead or on his hand, he himself shall also drink of the wine of the wrath of God, which is poured out full strength into the cup of His indignation. He shall be tormented with fire and brimstone in the presence of the holy angels and in the presence of the Lamb. And the smoke of their torment ascends forever and ever; and they have no rest day or night, who worship the beast and his image, and whoever receives the mark of his name.'”

    Great hope is in our midst, and is coming in a mighty way–the greatest revival for Jesus in the history of the world where we will see the most souls come to Him of all tribes, tongues, nations, and peoples (Rev. 7:9-10); for we have this promise in God’s Word in the midst of these dark times:

    “Then I saw an angel coming down from heaven, having the key to the bottomless pit and a great chain in his hand. He laid hold of the dragon, that serpent of old, who is the Devil and Satan, and bound him for a thousand years (not literal–rather a spiritual label for time spent in eternity); and he cast him into the bottomless pit, and shut him up, and set a seal on him, so that he should deceive the nations no more till the thousand years were finished. But after these things he must be released for a little while (when the Antichrist and false prophet will rise up and God will test the world).” (Revelation 20:1-3)

    “The coming of the lawless one (the Antichrist) is according to the working of Satan, with all power, signs, and lying wonders, and with all unrighteous deception among those who perish, because they did not receive the love of the truth, that they might be saved. And for this reason God will send them strong delusion, that they should believe the lie, that they all may be condemned who did not believe the truth but had pleasure in unrighteousness.” (2 Thessalonians 2:9-12)”

    Who is Barack Obama, and why is he still involved in politics?

    So what’s in the name? The meaning of someone’s name can say a lot about a person. God throughout history has given names to people that have a specific meaning tied to their lives. How about the name Barack Obama? Let us take a look at what may be hiding beneath the surface.

    Jesus says in Luke 10:18, “…I saw Satan fall like lightning from heaven.”

    The Hebrew Strongs word (H1299) for “lightning”: “bârâq” (baw-rawk)

    In Isaiah chapter 14, verse 14, we read about Lucifer (Satan) saying in his heart:

    “I will ascend above the heights of the clouds, I will be like the Most High.”

    In the verses in Isaiah that refer directly to Lucifer, several times it mentions him falling from the heights or the heavens. The Hebrew word for the heights or heavens used here is Hebrew Strongs 1116: “bamah”–Pronounced (bam-maw’)

    In Hebrew, the letter “Waw” or “Vav” is often transliterated as a “U” or “O,” and it is primarily used as a conjunction to join concepts together. So to join in Hebrew poetry the concept of lightning (Baraq) and a high place like heaven or the heights of heaven (Bam-Maw), the letter “U” or “O” would be used. So, Baraq “O” Bam-Maw or Baraq “U” Bam-Maw in Hebrew poetry similar to the style written in Isaiah, would translate literally to “Lightning from the heights.” The word “Satan” in Hebrew is a direct translation, therefore “Satan.”

    So when Jesus said to His disciples in Luke 10:18 that He beheld Satan fall as lightning from heaven, if this were to be spoken by a Jewish Rabbi today influenced by the poetry in the book of Isaiah, he would say these words in Hebrew–the words of Jesus in Luke 10:18 as, and I saw Satan as Baraq O Bam-Maw.

    Malie and Natasha are the names of Obama’s daughters. If we write those names backward (the devil does things backwards) we would get “ailam ahsatan”. Now if we remove the letters that spell “Alah” (the false god of Islam being Allah), we get “I am Satan”. Mere coincidence? I do not believe so!

    Obama’s campaign logo when he ran as President of the US in 2008 was a sun over the horizon in the west, with the landscape as the flag of the United States. In Islam, they have their own messiah that they are awaiting called the 12th Imam, or the Mahdi (the Antichrist of the Bible), and one prophecy concerning this man’s appearance is the sun rising in the west.

    “Then I saw another angel flying in the midst of heaven, having the everlasting gospel to preach to those who dwell on the earth—to every nation, tribe, tongue, and people— saying with a loud voice, ‘Fear God and give glory to Him, for the hour of His judgment has come; and worship Him who made heaven and earth, the sea and springs of water.'” (Revelation 14:6-7)

    Why have the words of Jesus in His Gospel accounts regarding His death, burial, and resurrection, been translated into over 3,000 languages, and nothing comes close (the Quran about 110 languages)? Because the same Spirit of God (YHVH) who created all people likewise transcends all people; therefore the power of His Word is not limited by people; while all other religions are man-made, therefore they tend to primarily stay within their own culture. The same God who speaks to all people through His creation of the heavens and earth that draws all people around the world likewise has sent His Word to the ends of the earth so that we may come to personally know Him to be saved in spirit and in truth through His Son Jesus Christ.

    Jesus stands alone among the other religions that say to rightly weigh the scales of good and evil and to make sure you have done more good than bad in this life. Is this how we conduct ourselves justly in a court of law? Bearing the image of God, is this how we project this image into reality?

    Our good works cannot save us. If we step before a judge, being guilty of a crime, the judge will not judge us by the good we have done, but rather by the crimes we have committed. If we as fallen humanity, created in God’s image, pose this type of justice, how much more a perfect, righteous, and Holy God?

    God has brought down His moral laws through the 10 commandments given to Moses at Mt. Siani. These laws were not given so we may be justified, but rather that we may see the need for a savior. They are the mirror of God’s character of what He has written in our hearts, with our conscious bearing witness that we know that it is wrong to steal, lie, dishonor our parents, murder, and so forth.

    We can try and follow the moral laws of the 10 commandments, but we will never catch up to them to be justified before a Holy God. That same word of the law given to Moses became flesh about 2,000 years ago in the body of Jesus Christ. He came to be our justification by fulfilling the law, living a sinless perfect life that only God could fulfill.

    The gap between us and the law can never be reconciled by our own merit, but the arm of Jesus is stretched out by the grace and mercy of God. And if we are to grab on, through faith in Him, He will pull us up being the one to justify us. As in the court of law, if someone steps in and pays our fine, even though we are guilty, the judge can do what is legal and just and let us go free. That is what Jesus did almost 2,000 years ago on the cross. It was a legal transaction being fulfilled in the spiritual realm by the shedding of His blood with His last word’s on the cross crying out, “It is finished!” (John 19:30).

    For God takes no pleasure in the death of the wicked (Ezekiel 18:23). This is why in Isaiah chapter 53, where it speaks of the coming Messiah and His soul being a sacrifice for our sins, why it says it pleased God to crush His only begotten Son.

    This is because the wrath that we deserve was justified by being poured out upon His Son. If that wrath was poured out on us, we would all perish to hell forever. God created a way of escape by pouring it out on His Son whose soul could not be left in Hades but was raised and seated at the right hand of God in power.

    So now when we put on the Lord Jesus Christ (Romans 13:14), where God no longer sees the person who deserves His wrath, but rather the glorious image of His perfect Son dwelling in us, justifying us as if we received the wrath we deserve, making a way of escape from the curse of death; now being conformed into the image of the heavenly man walking in a new nature, and no longer in the image of the fallen man Adam.

    Now what we must do is repent and put our trust and faith in the savior, confessing and forsaking our sins, and to receive His Holy Spirit that we may be born again (for Jesus says we must be born again to see and enter the Kingdom of God in John chapter 3). This is not just head knowledge of believing in Jesus, but rather receiving His words, taking them to heart, so that we may truly be transformed into the image of God. Where we no longer live to practice sin, but rather turn from our sins and practice righteousness through faith in Him in obedience to His Word by reading the Bible.

    Our works cannot save us, but they can condemn us; it is not that we earn our way into everlasting life, but that we obey our Lord Jesus Christ:

    Jesus says,

    “Not everyone who says to Me, ‘Lord, Lord,’ shall enter the kingdom of heaven, but he who does the will of My Father in heaven. Many will say to Me in that day, ‘Lord, Lord, have we not prophesied in Your name, cast out demons in Your name, and done many wonders in Your name?’ And then I will declare to them, ‘I never knew you; depart from Me, you who practice lawlessness!’ (Matthew 7:21-23)

    “And having been perfected, He became the author of eternal salvation to all who obey Him.” (Hebrews 5:9)

    “Now I saw a new heaven and a new earth, for the first heaven and the first earth had passed away. Also there was no more sea. Then I, John, saw the holy city, New Jerusalem, coming down out of heaven from God, prepared as a bride adorned for her husband. And I heard a loud voice from heaven saying, ‘Behold, the tabernacle of God is with men, and He will dwell with them, and they shall be His people. God Himself will be with them and be their God. And God will wipe away every tear from their eyes; there shall be no more death, nor sorrow, nor crying. There shall be no more pain, for the former things have passed away.’

    Then He who sat on the throne said, ‘Behold, I make all things new.’ And He said to me, ‘Write, for these words are true and faithful.’

    And He said to me, ‘It is done! I am the Alpha and the Omega, the Beginning and the End. I will give of the fountain of the water of life freely to him who thirsts. He who overcomes shall inherit all things, and I will be his God and he shall be My son. But the cowardly, unbelieving, abominable, murderers, sexually immoral, sorcerers, idolaters, and all liars shall have their part in the lake which burns with fire and brimstone, which is the second death.'” (Revelation 21:1-8)

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