Case Study 1, TB
Bedawal is a small village situated about 18 kms from Salumber block head quarters in Udaipur district of south Rajasthan. The region is remote with scarce public facilities. The main modes of transportation for the villagers are pickup jeeps and odd trucks that pass by the village. Hardly any buses ply on these roads. Bedawal boasts of 5–6 shops and a small bus stand. Dhai Kheda is a small hamlet in Bedawal, with about 60-odd houses, made of mud and stones and scattered across the terrain.
On a small hillock situated in Dhai Kheda, A Meena lives with his five brothers and his parents.
A, a short, lean, young man, aged about 26 years, comes from an agrarian family with 10 bighas (approximately 2 acres) of agricultural land holdings. With time, however, it has been difficult to sustain the family on farm income. During our conversation A’s father recounts, “As the boys grew up and got married, we divided the land among them; now each one cultivates for themselves. But produce is hardly sufficient for the family. The boys have to go out looking for menial jobs to support their families.”
A first migrated for work when he was only 14 years old. He went to Nagpur to work with a wholesale kirana (grocery) shop. He smiles and says, “I was given sixty rupees every month for watching movies and having fun. We were four boys and used to go to the city centre and spend time. It was a nice feeling.” The working hours were usually long and hectic, from 8 in the morning till 11 in the night, with very little or almost no rest. After two years of hard labour, he left his job and came home with a saving of twenty thousand rupees.
A few months later, after recuperating from the toil, he left for Mumbai to work in a bhangar (scrap) shop. He travelled door to door on his bicycle to collect scrap. Initially, he was paid one thousand one hundred rupees per month, which increased to three thousand rupees after the completion of two years. He was paid his entire wages together when he travelled home. In between, in 2008, A got married and he decided to come back to Dhai Kheda in 2011 as he was expecting his first child.
While at home, A started developing intermittent fever with congestion in his chest. He took it lightly thinking that it would be because of cold, but as days passed by it started affecting his health and his work. He then decided to meet the doctor at the Community Health Centre in Salumber who told him that he had an infection in his chest which seemed to have started a few months back, and prescribed him with medication for eight days. His condition did not change even after taking the prescribed medicines. He then decided to go to the Primary Health Centre in Lasadia, where he was asked to do a sputum test. He gave his sputum sample, but the test results were negative. He was again given medication for cough and fever for 15 days. He started feeling better but then the income from agriculture was so low that even basic household expenses like buying food, clothes, and medicine became difficult. Unable to provide for his family, he had to step out again in search of work.
A got a job in a restaurant in Ahmedabad, which offered a payment of three thousand five hundred rupees a month, but unfortunately, within a month of starting work, he fell sick. Initially he had fever for four to five days, followed by cough with severe chest pain. He went to a nearby local clinic where he was prescribed some medicine without a proper examination. He refused to take the medicine and insisted on being examined. The doctor then recommended a sonography test, which cost him about five hundred rupees. He showed the test report to the doctor who regularly visited the restaurant staff to carry out health check-ups.
A reminisces with a frightened look in his eyes, “The doctor told me that there is some disease in my lungs which has caused a hole and water has entered my lungs, and it will take about six months to drain and dry my lungs. I started thinking about my future and my family. I was worried that at such a young age if such a serious disease affects me what will happen to my wife and small kid? The doctor also told me that the treatment would cost about four thousand and five hundred rupees, which I didn’t have. I was tense and decided to come home to seek treatment from the government hospital, and leave the rest in the hands of god.”
“One day I was on my way to the Community Health Centre in Salumber, when I met an old friend and told him about my condition. He informed me about AMRIT Clinic that had newly come up in the village. My friend shared that he had already taken his father to Amrit Clinic, and that he felt much better now with the treatment. The Clinic charged only fifty rupees for eight days and provided medicines for free, he further informed. I became very curious and eager to visit the Clinic. I thought that if it was true then it was certainly a godsend for me,” he said with a sparkle of joy on his face.
“I decided to go to AMRIT Clinic. The very look of the Clinic was comforting for me. I had a positive feeling that I will get cured here, maybe it was because my friend had shared his good experience with me. When I reached the Clinic, I met Keshav bhai (a Male Health worker) and Nita madam (a Primary Care Nurse). They enquired about my problem but I was not even in a position to talk to them due to severe cough and congestion. Eventually, I described to them my ordeal. Nita madam gave me some medicine for cough and fever and advised me to come back on Friday, when the doctor visits the clinic. I returned on the said date to meet the doctor sahib. He asked me to get my sputum tested and to get an X-ray of my chest. I was given a referral letter from AMRIT Clinic for the sputum examination, but for X-ray I had to go to a private laboratory which cost me two hundred and fifty rupees. I had to wait for over 4 hours to get the report, but when I look back at it, it was worth taking all that effort,” said A gladly.
The doctor at AMRIT Clinic examined the reports and X-ray to confirm that A had Tuberculosis (TB). He was informed about the disease and about the strict treatment regime: he would have to take the medication continuously for six months and eat a nutritious, balanced diet during the treatment period. “I was advised to visit the clinic thrice a week for medication, which continued for about two months, and then I was given weekly medication which I took regularly from home. The last set of medicines finished in November 2013. I am totally cured and I feel perfectly healthy now,” said A, content with the medical advice and treatment.
Later on, as part of our community outreach visits, we identified A’s mother also exhibiting symptoms of TB. She was quickly referred to AMRIT Clinic and her tests confirmed our doubts. Currently, she is under treatment and is showing considerable improvement.
“We at AMRIT Clinic do not attend only to patients who visit our clinic; we also do home visits to ensure that everybody in the vicinity is covered. Modi (a Senior Health worker) made three visits to Meena’s house recently to take care of his newly born baby and wife as well,” says Keshav.
A has now gone back to work in the same restaurant in Ahmedabad and is being offered four thousand and five hundred rupees a month. He came back home recently for delivery of his second child and harvesting of crops. He plans to return after the festival of Holi, but before going back he intends to visit AMRIT Clinic for a check-up.
A gave his final remarks by saying, “I visited many doctors, but none of them could diagnose my problem. It was only at AMRIT Clinic that I was correctly diagnosed and within 15 days of treatment I could feel the change in my health. My chest congestion reduced considerably and I was advised to eat medicines for six months continuously to get completely cured. Today I have started earning again and it is only because of AMRIT Clinic, or else only god knows what would have been my fate! For us this AMRIT Clinic is in real sense of its name ‘Amrit — a real elixir’ to save our lives.