TB Elimination Campaign: How ASHA workers fighting to rid tuberculosis of social stigma

New Delhi: Ranjana Chaudhary, a 28-year-old ASHA worker in Uttar Pradesh’s Siddharthnagar visits six to seven houses in Madhubeniya village every day with the aim to eradicate the stigma behind Tuberculosis and encourage villagers to get screened for the disease.

Social stigma is still a major impediment due to which people do not readily come forward for testing for the deadly contagious air-borne disease.

Displaying the characteristic reluctance, 70-year-old Vimala Devi (name changed) who had come to a health camp for various ailments immediately gets defensive when asked if she had come for a TB check-up. “No no, why should I have TB?” she said irritatingly.

Chaudhary and lakhs of ASHA workers in remote areas of the country face the daunting challenge of convincing people to attend tuberculosis screening camps and are mobilising vulnerable people to such camps under the ongoing pan India 100-Day Intensified Campaign to Eliminate TB.

Aimed at accelerating efforts towards eliminating Tuberculosis from the country, the government has been proactively screening and testing vulnerable populations such as diabetics, smokers, alcoholics, those who are malnourished, people living with HIV, individuals with a history of TB or COVID, the elderly and household contacts of TB patients.

Since the launch of the 100-day campaign in December last year, the TB programme has notified over 6.1 lakh TB patients across the country of which 4.3 lakh patients were diagnosed from the 455 intervention districts.

“Often we don’t tell people that it is a TB screening camp and tell them to attend it saying a free health checkup camp is being held nearby. Even if detected for tuberculosis people generally prefer to keep it under wraps for fear of isolation and social stigma,” Chaudhary said. “By virtue of the fact that TB is a communicable disease, stigma is multifold. Especially if a woman is diagnosed with the disease, the family considers it as a curse and tries to hide it for fear of the girl remaining unmarried. Lots of families also try to keep it confidential thinking they would be ostracised from the community,” said another ASHA worker Sunita.

Dr Shailendra Bhatnagar said TB is a very peculiar disease. If you do not get the right treatment at the right time you may infect other family members of the family and neighbours. “If a TB-positive patient is not treated he or she can create 15 new patients in one year. Similarly further if this new lot of 15 new patients are not treated in the second year the figure becomes 225 and similarly the chain can go on and on,” he explained.

Dr Bhatnagar stressed that as soon as one gets any of the symptoms, he or she should get tested. If found positive, the entire family is examined.

Contact tracing, which became popular during the COVID-19 pandemic, is a terminology that has been used in TB programmes for several years now, Dr Bhatnagar informed. It is being done with the intention that if one index patient gets Tuberculosis, his or her household members and the people they interact with on a routine basis in work areas or elsewhere are examined for signs of TB.