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Fighting TB in India's Slums

DW Staff (act) 21.03.08March 21, 2008

Every year about nine million people get tuberculosis. Up to two million die of the disease. And yet, antibiotics can treat tuberculosis. However, the World Health Organisation warns that resistance to the antibiotics can also form. That's why tuberculosis patients need a lot of information about the disease and how to treat it. One street theatre project in the slums of New Delhi is there to provide it.

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Almost two million Indians get tuberculosis every year
Almost two million Indians get tuberculosis every yearImage: AP

It's noisy in Jahangirpuri, a slum in the north of Delhi -- it is also very crowded and dirty. About a hundred thousand people live here -- they are badly fed and cramped together in tiny, dark lodgings.

The slum is an ideal breeding ground for diseases such as tuberculosis.

Contrary to what it sounds like, the man coughing on the street does not have TB but is an amateur actor pretending to be ill

Some local youths are performing a street play about contagious diseases in one of the narrow lanes -- the eight boys are wearing T-shirts from the German Leprosy and Tuberculosis Relief Association (DAHW).

The boys are participating in a DAHW project which not only gives information about tuberculosis in the slums of Delhi but also offers treatment.

Ideal means of communication

Street theatre is an ideal means of reaching the slum dwellers -- most of them are illiterate and have access to neither television nor radio. The DAHW also has health posts where TB patients can get weekly advice and free medicine from local volunteers.

”We chose volunteers from the slums only -- the basic criteria is that he should be a resident of a slum, well-accepted by the community and should be available around the clock,” explained the doctor Rajbir Singh.

The volunteer helpers are trained up in about two weeks and they then get posted in their own district as lay specialists for tuberculosis.

Filling the gap

The DAHW thus fills a gap in the Indian state health system. Although the state offers good treatment for TB the centres are often very far away from the poor districts and they often only open when the slum dwellers are at work.

That's why the local health posts are so important. Health workers there are on hand also to explain to patients that they should not stop their treatment as soon as they feel a better but should continue their course of treatment till the end.

The volunteers get 1,000 rupees a month for their work -- not much but money is not their main motive, Dr Singh says: ”They are more inclined towards social service. They feel satisfied when they reach out to so many TB patients and a number of TB patients they get cured at their centre. This practice brings them recognition in society.”

Effective recipe

It's obviously an effective recipe -- even though the physical conditions in the slums are miserable -- there is damp and overcrowding and poor sanitary conditions, the success of the project is evident.

”In Delhi, the defaulter rate among patients from slums is around 13 to 14 percent, but at our centres all throughout 2007 we never had a defaulter rate of over 4 percent,” Singh said proudly.

The World Health Organisation estimates that 1.7 million Indians fall ill with tuberculosis every year -- more than in any other country. Many die of the disease.