Har subah sirf utho mat Jaago Re TATA TEA

Think back to middle school - its toils and troubles, homework and hormones. Few people remember those as the golden years. Now, imagine coming down with a cough, perhaps just a minor cold? But the cough lingers, worsens, and a low fever develops throughout the days. Losing your appetite, you try to eat regularly but vomit after eating anything. At night, the fever spikes and symptoms become painful. When the cough gets deeper, even more painful, mom sends you to school with medicine. Other students notice the medicine, and, having also noticed your cough getting progressively worse, suggest that you get tested for Tuberculosis (TB) - Tuberculosis, an infectious disease which, people tell you, cannot be cured.
Nine months ago, Rekha, an eighteen year old girl from Tughlabad in Delhi, found herself in this situation. While approximately 300,000 children per year are forced to drop out of school to contribute to the family income, there are also the many children who contract TB themselves, interrupting their lives at a critical point in their education, learning and development.
Fortunately, Rekha followed her classmates’ advice and was tested at the AIIMS Hospital in Delhi for TB. Her three sputum tests confirmed TB diagnosis, and the hospital staff informed Rekha that she would have to undergo six months of treatment, returning every two months for a follow-up sputum test.
Unlike many other TB patients, Rekha began TB treatment with the full support of her family. Asha, an Operation ASHA counselor, visited Rekha’s home to speak with Rekha and her family. As Asha explained the details of TB treatment, transmission, and prevention, she left Rekha with the understanding that TB was not fatal but rather treatable. Despite wide-spread belief of TB’s fatality, Rekha believed with confidence that she would be cured.
Rekha was directed to the “Mepha Beauty Parlor DOTS-Center” in Tughlabad, an Operation ASHA DOTS-Center very close to the family’s home. Given the social stigma against TB, Rekha was afraid of how neighbors and friends might react. She didn’t tell anyone about her diagnosis. Despite her anxiety, she went to the center herself, continued to follow the treatment schedule, and successfully began the Intensive Phase of her treatment.
For the next two months, Rekha was unable to attend school. Her teacher had advised her to “stay at home and get rest”. Following Asha’s instructions to prevent TB transmission to her family and friends, Rekha routinely separated her bedding and utensils from others’ and spit only into a tin cup, which, after boiling for twenty minutes, she would throw into running water. She continued to follow the treatment schedule.
After two months, Rekha reported sputum negative. No longer in danger of infecting those around her and feeling much better, she was able to return to school. Still, she was experiencing side-effects of giddiness and itching with the medication. Entering the Continuation Phase of treatment, at which point the highest default rate occurs statistically, Rekha was at the most decisive point of her treatment. Areas like Rekha’s experience some of the highest default rates up to 60%.
At this critical point of treatment, Asha played a crucial role as counselor. Assuring Rekha that her side-effects would subside at the completion of treatment, Asha conveyed the importance of treatment adherence, communicating the risks of failed treatment, remission and the development of Multi-Drug-Resistant TB (MDR-TB) associated with treatment default. The indispensability and effectiveness of counselors like Asha is evident in Operation ASHA’s successful reduction of default rate to just 1.1%. Counseling, by bridging the gap between patients’ general awareness and personal understanding, provides the backbone of treatment adherence.
Again following Asha’s counseling, Rekha worked through the remaining four months of treatment, with all of its side-effects and inconveniences, and completed the full six month treatment successfully. Fully recovered, sputum negative and feeling “fine and fit”, Rekha was able to resume life as it was. Recognizing the counselor’s work, she commented “Didi’s behavior was very nice. Asha helped us at every step.” Yet, it has been the collective efforts of patients, counselors and staff, families and friends alike, that contribute to Operation ASHA’s extremely high cure rate. The organization’s success story is Rekha’s as well. Concluding her interview she added, “Operation ASHA has cured me.”
Note: Name of the patient has been changed to maintain privacy