The lives of laborers begin from mines and end with tuberculosis in the Chambal region of Madhya Pradesh. Forced to work in illegal stone quarries because they get no other jobs, constant exposure to silica dust puts the laborers at high risk of getting TB.
Saharia tribals and backward classes, most of whom suffer from tuberculosis, dominate the Pahargarh, Chhaina, Likhiganj and Sihonia villages of Madhya Pradesh's Morena district.
The benefits of the Revised National Tuberculosis Control Programme (RNTCP) continue to evade these poverty stricken villagers and even when they manage to get medicines, they are not cured because of high levels of malnutrition.
As most of the people who work at the stone quarries have not been included in the below poverty line (BPL) list, they are not provided with BPL ration cards.
Arun Sharma, a local medical practitioner said, "The main reason behind the spread of TB is the type of houses in which they live. The second reason is malnutrition among these people, due to which they easily get affected by TB or any other disease."
Twenty five-year-old Gita of Pahargarh village is one of the hundreds of tuberculosis patients in the area who are unable to get the Directly Observed Treatment Short Course (DOTS) medicines as the gulf between availability of medical services and access to them is impossible to bridge.
A resident of Pahargarh village, 39 year-old Siayaram, said he is a TB patient but is not getting medicines from the government hospital. "I've to go to Morena where I'm getting treatment at a private hospital," he said. Mamta, 20, also gets her tuberculosis medicines worth about Rs 500 every ten days from a private hospital in Morena.
"It is true that many people are unable to get the treatment in government hospitals as government hospitals are only doing the formality of DOTS programme. They want to do minimum work. These problems will increase with the increase in number of patients. Therefore they want to keep the number of patients at a minimum", said Sharma.
The situation is similar in the Sihona block, which has about 1300 TB patients. Although there is a community health centre in the village, the facilites are inadequate to cater to all the TB patients.
However, block medical officer Padmesh Upadhyay claims that TB is now fully under control. "Earlier there was little hope of a TB patient getting cured. Now it is my endeavor to start the treatment as soon as possible once the disease is detected," he said.
Another problem with the treatment of TB is that if the medicines are skipped even once then the patient has to do the entire course again. If the medicine is not taken properly at the right time then it can do more harm than good. In such a situation there is a risk of drug resistance and treatment becomes difficult, says health officials.