Savitha Basavaraj Angadi, 41, sits crossed-legged on her couch in the living room of her one-bedroom house. Her face was pale and stained with dried tears, yet, she smiles to greet the unexpected guests. She hides her sobby face while she shows the picture of Mallawa Chanwasappa Angadi, her mother-in-law who died seven months ago due to tuberculosis on the very same couch.
It all began about a year ago, when Mallawa Angadi, 70, drastically lost weight and had difficulty in breathing. She was then taken to the general hospital, where she was diagnosed with Tuberculosis. She continued her medication for six months as prescribed, yet didn’t recover and succumbed to this deadly disease plaguing Saundatti, a taluk in the Belgavi district of North Karnataka.
Angadi’s was not the lone case in this horrid disease. In the last three years, more than 108 people have lost their lives due to tuberculosis. The rising number of deaths is mainly due to the lack of awareness about the consequences of the discontinuation of medicines, which most often leads to the onset of Multi-drug Resistant (MDR) TB.
While Angadi’s family believe that it was the social stigma and her loneliness that killed her, the doctors argue that her’s was the case of untreated MDR-TB. “Maybe she was being treated for normal TB and clearly, medicines didn’t work as she might have had MDR-TB”, said Dr Navadgi, a private practitioner in Saundatti.
Out of every 35 cases (appx) that are registered in Saundatti general hospital, at least five of them are detected as MDR-TB.
Approximately, India has 79,000 multi-drug resistant TB patients among the registered pulmonary TB cases each year. In the 20th annual edition of the World Health Organization’s global tuberculosis report, India’s high volume of TB deaths is followed closely by Indonesia, China, the Philippines and Pakistan.
In 2017, a study was conducted by the Health Department in 20 districts which revealed that Belagvi has the highest number of new TB cases (414) in Karnataka. As of last year, India has the world’s largest number of TB patients with more than 2.74 million new cases reported every year in the country.
Poverty, malnourishment and HIV are other major factors in the growing number of TB cases along with the aforementioned late or wrong diagnosis of the disease. “It is really difficult to say whether or not the person is suffering from TB as the symptoms differ from person to person. This leads to delay in the process of diagnosis and treatment”, said Dr Manjunath, medical officer. More than 70 per cent of the Saundatti’s population is below the poverty line. Tuberculosis occurs if the immunity of a person is compromised and if he/she comes in contact with an infected person. “First of all, malnourishment in this taluk is very high which makes them even more vulnerable to fall prey to this menace and secondly, more than 7-8 people live together in the same small room. Even if one gets infected, there are chances that everyone will get infected with the TB”, explained Medical officer, Shripad Sabmis.
Even though TB is a curable and preventable disease, Suandatti has not been able to even minimize the TB cases. “We have 850 dots centres across the taluk. We make sure that every patient receives the treatment, yet, many drop the medication in between due to the side-effects of the pills”, said medical supervisor, Doni. The default cases (cases not being followed) stood up to 7 per cent where the default percentage of more than 5 per cent is considered ‘unsatisfactory’ by the Revised National Tuberculosis Control Program (RNTCP).
The RNTCP has set a goal of eliminating TB by 2025. Given the drastically growing cases, rural India seems far from achieving this goal. The previous National Strategic Plans of 2012-2017 allegedly failed due to lack of funds and lack of awareness among the people. The RNTCP team lead by the medical supervisor conducts various awareness campaigns across the taluk yet the lack of sense of urgency remains a challenge in this battle.
