Persistent low grade fever and cough….

Shobha Shukla - CNS
40 years old Rukmini lives close to the Civil Hospital of BJ Medical College in Ahmedabad. She used to sell fruits to supplement her daily wage earner husband’s meager income till tuberculosis struck her in 2010. She has a 17 year old daughter and an elder son who is married. Rukmini is illiterate but has managed to educate her children up to elementary level.

“Three years ago, in 2010, I started having persistent low grade fever and cough. There was never enough money in the house, so I took treatment intermittently in the private sector, as and when I had money. But one and a half years ago my condition worsened. I was breathless all the time and could not even walk properly. So I eventually came to this government hospital (BJ Medical College) where I was admitted for 3 months for TB treatment but was eventually diagnosed with of Multidrug Resistant TB (MDR-TB). My family is very supportive of me despite the infectious nature of the disease. My husband always accompanies me to the hospital.

Unfortunately, Rukmini’s daughter contracted MDR-TB through her mother and has been on MDR-TB treatment in the same hospital since the last 6 months. The attending doctor, Dr Purvi told me that, “Direct MDR-TB transmission through contact is common. So if a family member of such a patient has TB we test for MDR-TB in the beginning itself and if diagnosed put him/her directly on Category 4 treatment.”

When I met Rukmini in February 2013 she had been admitted in the MDR-TB Ward of Civil Hospital of BJ Medical College, Ahmedabad for breathing problems. TB had perhaps caused irreversible damage to her lungs. Although she had already tested negative for MDR-TB, she was still in and out of the hospital because of breathlessness. Yet, she feels that there has been a vast improvement in her condition as compared to when she began her treatment.

“When I came to this hospital one year ago, I was bedridden. I could not walk without help and could not even drink water on my own. I was totally dependent upon others even for small chores. Now I have become mobile once again and the credit for this goes to the doctors and nurses of this hospital, especially Dr Kusum Shah under whom I was admitted initially for 3 months. They have given me a new lease of life. They have really counseled me well and I follow all their instructions regarding infection control methods at home—I spit in a spittoon given by the hospital, I bury my spit in mud, I keep my house very clean. I hope I will soon be able to go back to my work of selling fruits and not remain a financial burden on my loving husband.”

Dr Purvi was all praises for Rukmini as she had been a very good patient and had diligently followed all the instructions given to her by the doctors. Even during her critical phase of treatment, she never lost hope and bore all drug side effects with a smiling face.

Rukmini’s message for other TB patients: We should not take treatment in the private sector. The MDR-TB drugs which are given free at the government centres are very good and all patients must take them. Nobody must stop the treatment in between.

(Note: This story is the second in line of the series Living with drug resistant TB based on interviews with patients enrolled in PMDT and highlight their personal experiences. This series is part of the Report: Best Practices in PMDT in India (CNS and Lilly MDR TB Partnership, July 2013). The names of all patients have been changed to respect their freedom of anonymity, given the huge social and internalized stigma connected with the disease and associated with other factors such as poverty and illiteracy).

Shobha Shukla, Citizen News Service - CNS
September 2013
(The author is the Managing Editor of Citizen News Service - CNS. She is a J2J Fellow of National Press Foundation (NPF) USA and received her editing training in Singapore. She has earlier worked with State Planning Institute, UP and taught physics at India's prestigious Loreto Convent. She also co-authored and edited publications on childhood TB, childhood pneumonia, Hepatitis C Virus and HIV, violence against women and girls, and MDR-TB. Email:, website: