TB Day – Operation ASHA, Delhi

An abridged version of this article was published on Operation ASHA's Facebook page on March 25th.

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“My brother kneels (so saith Kabir) to stone and brass in heathen-wise,

But in my brother’s voice, I hear my own unanswered agonies. His God is as his Fates assign;

His prayer is all the world’s – and mine.”

– Rudyard Kipling, “Kim” (1901)

Negotiating one’s way through the immense flood of humanity and indifferent cattle ceaselessly streaming the claustrophobic narrow meandering streets delineating the oxymoronic urban village of Tehkhand in south-east Delhi, it is explicably easy to fathom why communicable diseases spread with such diabolical intensity in Indian subcontinent.

On a scorching summer morning, the scene is fairly reminiscent of Dante Alighieri’s “Inferno”. Flanked on either side by unbelievably overpopulated, multi-storied residential buildings whose ground-floor facades have been transformed into cramped cubbyhole shops and confectioneries, the obnoxious-smelling streets, deplorably pockmarked or shrouded with thick carpets of dog and cattle excreta with astonishing frequency, overflow along the peripheries with absolute black putrid sewage. Unparalleled in their irritability, an incalculable number of flies violently flicker around, and yet their all-enveloping presence does not in the least hinder the tiny impoverished children, their straw-colored hair and dust and slime-ensconced faces reflecting terrible tales of starvation and poverty, from carelessly running about in the accumulated filth and grime.

Unremarkable among a row of similar inconsequential buildings is an insignificant little clinic crowned by several cardboard information panels, one of these identifying it as an Operation ASHA DOTS center, another vibrant violet one announcing adherence to RNTCP.

Last-mile Delivery to the BoP

Endeavoring to eradicate Tuberculosis (TB) from the world over, Operation ASHA (OpASHA) is a Delhi-based non-profit, non-government organization operational in India and Cambodia, with third-party replication in Uganda, Dominican Republic, Peru and Kenya. Additionally, medications, care and counseling are also provided to underprivileged patients suffering from hemophilia, diabetes and HIV-AIDS.

Why Tuberculosis?

The statistics are horrifying – according to World Health Organization (WHO), of the 9.6 million people globally diseased with TB in the year 2015, a staggering 2.2 million were in India. Of these, over 330,000 died, that is, two deaths every three minutes, which is the approximate time required to read this article!

More people die of TB-related complications in India than in countries like Pakistan, Nigeria, Indonesia and China. What is however most perplexing is that the disease is totally curable, and the medicines are available free of cost from any government hospital/dispensary. More distressing is the absolute failure of medical health workers to get patients to adhere to the RNTCP-DOTS (Directly Observed Treatment Short-course) treatment regime whereby a patient has to consume the specified drugs for 6-8 months in the former’s presence (thus, directly observed).

Default in treatment can have the TB bacterium transform into Multidrug resistant (MDR) which, at its current rate of manifestation, shall prove to be the scourge of the developing world if unchallenged.

By employing Biometric eCompliance and electronic medical recordkeeping (EMR) systems consisting of android phones and fingerprint readers, OpASHA has succeeded in reducing default rate to less than 3% vis-à-vis 60% reported by governmental bodies and other NGOs, and that too by spending less than 19 times the capital invested by the latter.

Fighting Tuberculosis worldwide

Slightly within the physical peripheries of Tehkhand village is located the aforementioned OpASHA’s community DOTS centers, its inconspicuousness an additional advantage for the distressed patients trickling in intermittently throughout the day since they are often forced to maintain secrecy about their medical condition as a consequence of the severe social stigma associated with the disease.

Every 24th March, recognized as TB Day throughout the world, Tehkhand thunders with the slogans of several score OpASHA volunteers who march the constricted and clogged streets armed with starkly functional placards and posters stating “We want zero TB deaths” and mentioning the numerous indicators associated with the deadly disease.

This year, Dr. Sengupta, Delhi District TB Officer (DTO), too joined in and further expounded on the disease’s symptoms as well as the ill-effects of the consumption of alcohol and cigarettes. Patients and counselors from OpASHA’s Tehkhand centers, volunteers from the village, OpASHA office staff and officials from the government TB departments joined in to help make the event a success and disseminate knowledge about the disease and, most importantly, the complete effectiveness of its cure.

#zeroTBdeaths

This article and the ones that’ll follow germinate from the realization that knowledge about this horrendous disease and its catastrophic consequences is still abysmally low, even among many highly educated and remarkably accomplished individuals with whom we, the OpASHA staff, interacted, and we need to rectify this immediately.

Your help too counts! To know more, visit opasha.org.