Tuberculosis (TB) is curable, but
unfortunately in India this disease carries a stigma so much so that in some
instances women suffering from tuberculosis are abandoned by their husbands and
sent away from home because their husbands are ignorant of this fact.
Tuberculosis for many years has been the leading infectious cause of death in
women not only in India but also worldwide. The disease poses a major threat to
women's health security. It is
estimated that almost one-third of the world's population is infected with TB,
and in developing countries it affects most women in their reproductive years.
Many cases are in the passive stage and hence diagnosis can be difficult unless
some triggering factor like HIV or diabetes brings about a flare up of the
disease. A WHO report says that 'The fear and stigma associated with
tuberculosis have a greater impact on women than on men, often leaving them in
a more precarious social and economic position. Tuberculosis in women creates
orphans, impoverished families and reduces the economic development of
society'. Another report from WHO mentions- `The stigma associated with TB
causes women to be divorced or to be unlikely to become married. A study in
India found that male patients with TB expected their wives to care for them
but infected wives rarely received care. Thus, married women may try to hide
their symptoms instead of seeking help'
Medindia's visit to the TB ward at the Kasturiba Gandhi
Government Hospital for Women
in Chennai, South India, confirmed the sad
truth about this social stigma that still hampers all genuine efforts made
by private and public medicare systems in India to get rid of tuberculosis.
Of the ten women currently in the TB ward,
eight women have been abandoned by their husbands as soon as they were
diagnosed with TB and have not seen their children in years. The other two women don't come into this
category only because one is not yet married and the other is a widow.
Ganga, 35, was happily married and
living with her husband and two kids until tuberculosis hit her hard in 2007.
Initially she dismissed her continuous cough as a 'dry' cough brought on by the
humid weather and went about her household chores of cooking, cleaning, washing
and doing everything to make her family comfortable. When the coughing
were severe and fever and chills
raked her body along with excruciating
pain in both her legs
, her husband took her to a government doctor who told
them Ganga's TB was at an advanced stage and said it could be cured if Ganga
took medicine continuously for six months. Ganga's ordeal began soon
She was admitted to hospital and
the government provided nutritious food and medicines all free of cost, but
Ganga's husband never came to visit her at the hospital. After two months of
not seeing her husband and children, Ganga took the doctor's permission to
visit her family promising to take her medicines regularly. She was sent away
by her husband saying she would infect the family and she stayed with her aged
parents making frequent attempts to see her children. Ganga slowly started
neglecting herself (maybe out of depression) and became irregular in taking her
medicines and during a visit to the hospital, the doctor observed that Ganga's
neglect had triggered a virulent form of Multidrug-resistant TB (MDR-TB), that
would further challenge treatment. Her husband filed for divorce stating Ganga
was mentally unstable. Now a frail Ganga is in and out of hospital, working as
a cook to pay for her lawyer's fees to seek her minor children's custody and
the doctors are at their wits end trying to treat her against the odds she
faces both socially and medically.
So it is with Razia Sultan aged
31, sent away by her husband and in-laws even though she was cured of TB and
carried a doctor's certificate to prove it.
She was subsequently given Talaq (Muslim divorce), and landed in the TB
hospital ward within a couple of years after she suffered a relapse while caring
for her poor and aged parents. Annapurna, Gowri and all the other women in the
ward are young women left destitute by their husbands fearing infection. They
have similar sad life stories to share and they couldn't care less that their
real names are mentioned in this report.
An aged nurse Kausalya, who
strictly monitors their drug intake and encourages these inmates to read and chat as a group so that they do
not sink into depression, is their only
family now. Says Kausalya, "I have seen many women come and go in this ward and
often the same women come after suffering a relapse. Mere medicines and rich
protein diet will not do the trick to cure these unfortunate victims. People
with TB have to be loved and given the emotional support to live and get over
their illness, barring which their body automatically loses resistance and they
fall sick repeatedly."
Dr. G. Usha MD, Thoracic
Medicine, Kasturiba Gandhi Government Hospital for Women says, "TB is curable,
provided people take their prescribed medicine regularly along with protein
rich diet. Government hospitals provide inpatients with 2-4 eggs, half liter
milk, rice, bread, vegetables and 100 grams meat for non vegetarians per
person, per day along with medicines. Door to door supply of medicines and
reminders through primary health centers are promptly done. In spite of it the
stigma attached to TB is still a challenge that doctors confront in TB
treatment in these parts of the world."
Said Dr. Usha, "Directly
Observed Therapy Short-course (DOTS)
is found to be successful in curing
male TB patients because their womenfolk ensure that the men take medicine
regularly and get cured. DOTS efforts are negated at the patient end in the
case of female patients, especially in the lower income group because no one is
so keen on monitoring their daily medicine intake and women who are set aside
by their spouses just don't have the will to go on - with their treatment, or
with their lives. The situation is worse in rural areas and tertiary and
peripheral centers where education and awareness of the disease is lower and a
lot of superstition drives people away from seeking medical treatment for TB."
Women don't have a problem saying they have malaria or
chikungunya, asthma or high blood pressure and diabetes for that matter—it is
even fashionable to say so. But the infectious nature of TB and the social
stigma attached to it frighten women from approaching a doctor in the initial
stages when it is easier to cure the disease. They rarely seek medical help
until TB is in a very advanced stage and it takes longer and more intensive
medical treatment for a cure. Women power takes a nosedive in the case of women
TB patients seeking cure from tuberculosis and a trip to the TB ward at the
Kasturiba Women's Government Hospital proves that more than medicine and nutritious
food, tons of love and a caring family is what takes to completely cure
women of tuberculosis.