TB treatment and cure: Can faith help?

Dr Richa Sharma, CNS Correspondent, India
“We have tried to do everything but there has been no improvement. My husband had to take so many medicines for so many months, and yet there was no relief. We finally gave up and went to a faith healer in our village who did some animal sacrifices and put some ash on his forehead. We also went to this famous temple and got pooja done. But even that did not work, says Saroj, a 55 year old woman whose husband has been sick on and off for several years.

Such narratives are commonplace among patients suffering from chronic illness and their care takers. Long standing disorders like TB, HIV, mental health disorders usually have a large burden of unmet need for treatment owing to stigma, long duration of treatment, high rates of non-compliance and inaccessibility to proper healthcare. When these patients get tired and exhausted of the doctor consultations, follow up visits, long waiting time and do not see immediate results, they tend to turn to every other avenue available to them. Faith healing, spiritual healing and traditional healing play  a major role, especially  in low resource settings, where people often approach them for their unanswered questions about diagnosis and definite treatments. “People come to the temple looking for immediate relief for diseases such as TB, HIV but we tell them to keep faith in God and let the medicines perform their miracles”, says Manohar Sharma, a 38 year old pandit (Hindu religious leader) from a small village in Western Uttar Pradesh. In such a situation, it becomes imperative to formulate a holistic health programme involving and engaging the different leaders from the community to ensure a better reach. There are 9.6 million TB cases worldwide, out of which nearly 2.2 million cases are present in India, making it the country with the highest burden of TB. The rising prevalence of MDR-TB worsens the situation.

The government of India has been implementing the RNTCP for almost 20 years and it definitely has made strides in the field of TB prevention. However, there still exists a huge section of TB affected people who have either not received the treatment or have dropped out from the programme. In this view, there have been talks of making the programme more comprehensive by engaging with the faith leaders. There are examples of community models wherein the involvement of faith leaders has shown good results. In a  recent webinar conducted by CNS, Jody Boffa, a community-based researcher and epidemiologist at the Desmond Tutu TB Centre, Stellenbosch University, Cape Town, South Africa talked about how faith plays an important role in the community and is often seen as an honouring of ancestral wisdom. She also provided information regarding a small project that was implemented in her study community and involved the faith leaders who were given information about HIV with the aim to normalise the disease. The churches were also used as centres for HIV screening, thus reducing the stigma among patients and providing a safe place. She said that a similar model is now being developed to address TB. She also highlighted how important it is to spread the message among these leaders about TB— its symptoms, testing and treatment, and also to tell them about the barriers to care.

In the same webinar,  Subrat Mohanty, Coordinator, Project Axshya, International Union Against Tuberculosis and Lung Disease (The Union) also informed about the Axshya project which aims to end TB and has been launched by The Union in collaboration with a few grass root organizations. He said that taking a cue from the successful free-polio India programme which also involved faith leaders, Axshya has also involved religious leaders from the Muslim community in 15 districts of Bihar. They are providing information on recognizing symptoms of TB, and accessing free treatment and diagnostic services. He remarked that the role of religious leaders is important as they have a wider reach, strong network and are actually heard by the people. They are encouraged to pass information about TB following prayer sessions, conduct information sessions in the mosques and also provide education material to the community people. It is equally important to involve the faith healers in this process. An example of a programme addressing mental health needs in Tamil Nadu took cognizance of the fact that faith healers cannot be left out of the process. They were sensitized to the issues of mental health disorders and it resulted in higher referrals of the symptomatic patients to the medical facilities. 

The faith leaders and faith healers (supposedly the dangerous ones) should be involved in such programmes and sensitized to facts. Incentivizing them may also be a good option as most of the healers practice faith healing in lieu of monetary benefits. The community outreach can definitely be improved by reaching out to all the possible players relevant in the community set up. Faith and medicine can work wonders for programmes, if used properly and timely.

Dr Richa Sharma, Citizen News  Service - CNS
March 27, 2017