Why pay when TB treatment is free?

People need not be afraid of tuberculosis (TB) as it is completely curable. People should be encouraged to go to the government-run free anti-TB treatment centres (providing the WHO recommended Directly Observed Treatment Short course - DOTS), rather than opt for visiting private practitioners as paying for treatment places an additional burden on the TB patient, said Dr Ashok Kumar, Deputy Director General, Central TB Division, Ministry of Health and Family Welfare, Government of India. Dr Ashok Kumar was speaking at the inaugural session of a unique art exhibition, "Chehera - The Human Face of TB", on the eve of World TB Day 2011 in New Delhi.

Dr Ashok Kumar further added that the message for World TB Day was that TB is a disease that the community must fight together. Also present at the inauguration was Sudha Pillai, Member - Secretary, Planning commission, Government of India.

TB is one of the leading causes of mortality in India, killing 2 persons every three minutes, nearly a 1000 people a day. In the time it takes to read this page, people would have died of TB, a curable and preventable disease that has been with mankind since ancient time. Even though India accounts for the largest portion of TB globally, one-fifth of the world's TB burden, many of us would be hard pressed to put a face to this disease. Perhaps we think it won't happen to us, but over a third of India's 1.2 billion carries the TB bacilli. The TB pandemic causes market failures – severely challenging the prospects for business and investments, raising costs and lowering productivity for companies.

Against this backdrop, Global Health Advocates India (GHA) and Art for Change, had organized a distinctive art exhibition, Chehera-The Human Face of TB, on the eve of World TB Day 2011.

John Mathai, Country Director, Global Health Advocates India said that, "We have planned 'Chehera-The Human Face of TB", in partnership with the Confederation of Indian Industries (CII) as it allows the corporate world and art connoisseurs to get a hard look at the disease. In doing so, awareness about TB reaches communities that are not normally engaged with the disease. This is keeping with the Stop TB Partnership's theme for World TB day 2011: On the move against tuberculosis, Transforming the fight towards elimination. This event, too, focuses on individuals around the world who can contribute to creating awareness about TB and serve as an inspiration to others."

The Global Health Advocates feels that the aim of this exhibition is to bring more people, new resources and fresh approaches harnessed in the fight against tuberculosis. There were 5.8 million notified cases of TB in 2009, which means that there is a case detection rate (CDR, defined as the proportion of incident cases that were notified) of 63% (range, 60–67%). This is up from 61% in 2008. Of the 2.6 million patients with sputum smear-positive pulmonary TB in the 2008 cohort, 86% were successfully treated. (WHO Report 2010: Global Tuberculosis control) While there is improvement in the detection and treatment rates, it still means that with continuing high figures of TB prevalence, TB will not be eliminated in our lifetime.

The exhibits were created by a diverse group of 22 artists. The artists are mostly young Indians from places as diverse as Bihar, Jharkhand, Delhi, Mumbai and Orissa and also include one artist from Japan. The intention was to empower artists to open a visual window into the world of TB and, more importantly, into the life of a patient suffering from the disease; a tangible expression of emotions, trauma and aspiration - to understand what it means to be behind a mask.

Commenting on their decision to support the exhibition Harpal Singh,Member, CII National Council and Mentor, and Chairman Emeritus Fortis Healthcare Ltd, said that "CII works closely with the Government of India Revised National TB Control Programme (RNTCP) and that there are many opportunities already available to implement TB Programs at the workplace which must be harnessed. There are Industries who are involved in TB Control but are focusing only on awareness activities, now the emphasis should also be treatment and control. In several enterprises, an infrastructure already exists to provide medical care to the employees. TB programs at the workplace and beyond provide employers with a unique opportunity to demonstrate its leadership role in partnering with the government to control tuberculosis."

TB is an important issue that needs more attention and focus. TB is more a problem in certain sectors, hence requires a sectoral approach in the business community. Certain corporate industry like coal, mines, iron and steel manufacturing units have TB as a workplace issue both at the shop floor level and also at the community level. A concerted TB program by industry meets both humanitarian and business compulsions.

This effort to create awareness for TB leading to action at the corporate led to this art exhibition. The 22 artists, under the banner of the Art for Change Foundation, underwent an orientation program. After a briefing on the technical, medical aspects from experts in the field, the artists visited patients at the RBTB Hospital, the largest TB hospital in Asia, for a personal introduction to the human face of TB.

Stefan Prakash Eicher, Executive Director, Art for Change Foundation said that "As we engaged with patients from all walks of life - students, homeless, mothers, taxi-drivers, government employees, even a convict in a ward with bars and a policeman on duty - the breadth of the disease's reach struck us, along with the humanness of each tragedy: an old man lying in a bed abandoned by his family, a woman turned out of her home and planning her divorce on getting better, a boy asking us to photograph the man in the next bed, rather than himself, as he feared being recognized locally."

Yet in all the darkness, they also found light shining through - sparks of dignity, hope and aspiration; the young girl, hair immaculately combed, who walked into the hospital garden to pluck a rose for each visitor, her hand shaking as she handed each one out; the optimistic young man seated on his bed with a pile of books, studying for exams to become a doctor and others who just wanted to go back to a normal life.

The body of art (38 artworks) includes an evocatively draped installation figure of a lady, The Empty Chair, by artist Megha Joshi (NCR) to inspire curiosity and questions about TB and Gopal Sharma's (New Delhi) painting, Untitled II, of a man in late stages of TB, whom he compares to a physically weakened Buddha just before a wondrous enlightenment. Two paintings have been inspired by a hospitalised young girl who brought roses for all the artists. One, entitled Rose, is by Shivani Bharadwaj (New Delhi) and the other, Spirit of Life, by Soni Singh (New Delhi).

Lal Bahadur Singh (Ghazipur, UP) through his painting Yearning, showing how badly constrained his wife, who suffered from TB, was during her illness. A painting by Joshua John (Dharbhanga, Bihar), titled 'Rakesh and the Cosmic Coalition' tries to answer the eternal question, 'Why me?' and answers it with hope and optimism rather than a defeatist acceptance of fate. Another artwork titled Mirror-Stage by Japanese artist Sayake Arase records the voiceless streams of consciousness of patients at the RBTB hospital.

Bobby Ramakant - CNS 


Published in:
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1 comment:

  1. Dr Lt Col VP Gopinathan28 March, 2011

    Nice to go through the CNS article (online at: http://www.citizen-news.org/2011/03/why-pay-when-tb-treatment-is-free.html ).

    While DOTS regime has caused reduction in the cases, instances of MDR/XDR cases need early attention, much before they complete therapy. Cases due to drug resistance develop significant morbidity. Patients remaining sputum positive even after two months therapy should be monitored for drug resistance.

    Another problem that poses to clinicians is that TB continues to be under-diagnosed or over-diagnosed. In doubtful cases a second opinion is recommended.

    This subject was highlighted at the World TB day meeting held at Jubilee Mission Medical College, Trichur, India.

    Dr Lt Col VP Gopinathan
    Head, Pulmonary Medicine, Trichur, India
    Email: vpgopinathan@gmail.com

    ReplyDelete