Community volunteers help to ensure the effectiveness of TB treatment in India

Publié: 21 mars 2014 14:17 CET

By Maude Froberg, IFRC
Photos by Gopal Mukherjee

The stairs leading up to the apartment of the Singh family in the center of Jalandhar are steep and worn. Breathless, one arrives at the first floor only to discover another winding flight to climb.

A challenge for anyone, healthy or sick. Yet, 14-year-old Suchi Singh does it with determination.

She climbs though it makes her breathing heavier. She climbs although she can longer hear the echo of her heels. She climbs although her young body is over-run by a disease forcing her into a difficult treatment.

As she comes to greet me, her playful dark eyes sparkle behind the handkerchief covering her nose and mouth. Except for the beige piece of cloth, nothing speaks of her suffering from multidrug-resistant tuberculosis (MDR TB), a strain which takes two years to cure and is 200 times more expensive than the treatment for category I patients.

Along with painful injections, and the unwelcome side effect of losing part of her hearing, she takes seven pills every day.

“It’s a lot of bitter pills to swallow, but I wish to get well,” she says, now halfway through the treatment.

One of the reasons to the successful adherence to her treatment stands next to her; Indian Red Cross volunteers Charanjit and Hardeep. Since Suchi was diagnosed with MDR TB, they have made many house calls, provided advice, supported her with transport to the hospital and with adding supplementary protein to her diet, as weight loss is frequent among patients.

“To submit the toxic side effects of the MDR treatment is a challenge to anyone. The human touch in the TB intervention is the key to success,” says Dr. Kailash Raizada, Senior Advisor to the International Federation of Red Cross and Red Crescent Societies (IFRC).

With nearly two million new cases in India each year, the task to combat TB in India is monumental. According to India’s Revised National TB Control Programme, about 800,000 cases are infectious and causing 1,000 deaths every day.

Staying the course

Since 2009, the IFRC is assisting the Indian Red Cross Society in an intervention, which includes 1,180 patients among the most vulnerable people living with TB, in particular category II patients. The term category II implies someone who has failed previous TB treatment, relapsed after treatment, or defaulted during previous treatment.

The scope is of the intervention, which covers seven states, is aimed at these patients, as they run the risk of developing MDR TB. Nonetheless, it takes persistence and perseverance to ensure the 100 per cent adherence to treatment.

Navdeep Kaur, District Coordinator of the TB Programme in Jalandhar, knows. One of her patients was Gurprett Singh. One day, he simply disappeared. “His parents were quiet about his whereabouts. We returned for several days, but not a sight of him. Asking around in the community, we finally found him in jail,” Kaur recalls.

Alerting the prison authorities about his medical condition, Gurprett Singh was diagnosed and put under treatment again. With further support from the Red Cross, assisting with nutrition in jail, he then followed through with the treatment and is now cured.

The commitment of the Red Cross volunteers also inspire  others. In the outskirts of Jalandhar, a wooden barrack in a long line of shops and offices is home to a DOTS (directly observed treatment short-course)  center, where healthcare workers observe TB patients under treatment. The dust scatters in the air as heavy trucks pass by, and Red Cross volunteer Sunita Devi closes the door behind the patients.

Community champions

Recently 61-year-old Omparkash, a TB patient himself, joined her and being a community leader in this industrial neighborhood with a huge migrant population, he is considered as a role model among TB patients.

“People live in very cramped condition with inadequate ventilation. If one person is ill, the other will be infected. I take every chance I get to raise awareness and reduce stigma,” says Omparkash.

The Indian Red Cross Society is now looking into ways of expanding the TB programme for category II patients.

“Extending our humanitarian services to reach more category II patients will be a contribution to making India a TB free country. Every patient we cure means less human suffering and less money spent on treatment. Also, an infected person risks spreading the infection to 15 people on average, which we hinder through our intervention,” says Dr. SP Agarwal, Secretary General of Indian Red Cross Society.

Community volunteers are at the heart of achieving Universal Health Coverage. Volunteers are improving access to health in even the most difficult contexts. However, effective volunteerism does not happen by itself. It needs recognition, planning and support not only to grow, but to sustain within the communities we serve.

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