Addressing gender inequity to eradicate TB in India

Pritha Roy Choudhury, CNS Correspondent, India
Rajni, the 19 year old  girl who helps us with the domestic chores, suffers from some physical disability. She cannot walk properly. Hailing from a financially challenged family, her father drives a rickshaw while her mother contributes to the household income by ironing clothes. She and her two sisters work as domestic helps.

For Rajani, the eldest of the 3 siblings, every day is a struggle, especially those days when pain in her leg aggravates. It was during one such attacks, after giving her a  pain killer, that I decided to discuss the matter with her to find out a possible solution to her problem. I was  told that she had started having this pain four years ago when she had injured herself due to a fall.

I then spoke with her mother to understand her condition better, and also to make her aware of the urgency of medical help as there seemed to be a gap in her hip region. It took me one week to convince the family to let me take her to a hospital in New Delhi for a medical check up. The doctor, upon examining her, suspected a case of semi treated extra pulmonary TB of the bone. He asked me to get certain tests done to confirm the cause, see the extent of the damage and start with the treatment .

Coming out of the hospital, I began to look for a suitable diagnostic centre. Rajani’s family was reluctant to resort to any diagnostic procedure and take the help of medical treatment. Instead, they preferred going to the temple and praying for her recovery. I was ready to pay for the cost of treatment and diagnosis but they seemed to rely more on superstitious beliefs rather than medical science.

There are numerous such cases which are contributing to the failure of bringing in positive outcome in the mission to end TB by 2030. Delivering quality primary care to the population in India is always challenging. While the sheer magnitude of patients coupled with weak primary healthcare systems creates difficulties, some challenges lie outside the purview of logistics. It is also about religious beliefs, superstitions and gender inequity that abounds in our society, wherein spending any money on the healthcare of women and girls is considered a waste of money and resources. And so quacks and faith healers abound, while education and health takes a backseat.

India continues to have the highest number of TB cases in the world, as revealed by WHO’s Global TB Report 2017- an estimated 27.9 lakh patients were suffering from TB in 2016 and up to 4.23 lakh patients were estimated to have died during the year. Multi drug-resistant TB (MDR-TB) also remains another public health crisis and a health security threat for the country.

The Global TB Report 2017 also highlighted that under reporting and under diagnosis of TB cases continue to be a challenge, especially in countries  with large unregulated private sectors and weak health systems, including India.

Though various measures are being taken at government level to eradicate TB from India by the end of 2030, unless and until addressing the existing cultural beliefs and norms, as well as gender inequity, is prioritized, it will remain a tough job.

Pritha Roy Choudhury, Citizen News Service (CNS)
3 April 2018