By Bhabesh Medhi
Guwahati: Tuberculosis (TB) had wreaked havoc for Minu Puran (name changed) six years back. A worker of a tea estate in Assam's Jorhat district, Minu had lost her husband, one of her sons and a daughter to TB. A TB survivor herself, Minu now lives with her younger son. "It was too late when my husband got infected with TB, we could not save him. My eldest son and daughter also got infected with TB later and died after some years," said Minu while recalling the tough times. Although Minu survived after treatment, the disease impacted her work.
"I was not able to work for a long time due to weakness. Now I am cured and resumed my plucking work in the tea garden," said the 48-year-old tea garden worker. While the disease had ruined the family savings it had also affected her ability to work. The story of Minu assumes significance considering the fact that India has set a deadline of 2025 to end TB.
As a signatory to the United Nation's Sustainable Development Goals (SDGs), India is committed to meeting the 2025 deadline of ending TB, five years ahead of the SDG deadline of 2030. The statistics of the TB, however, indicate that Assam is unlikely to meet the deadline of ending the TB by 2025.
"The tea gardens in Assam are a major challenge for ending TB in Assam. There are about 800 large and medium-sized tea gardens in Assam and 60 to 80 per cent of the TB patients in Assam are from the tea garden areas alone. The tea garden workers are still not aware of the TB infection and its seriousness," said State TB Officer and Joint Director Health (TB) Abhijit Basu.
"Most of the tea garden workers do not even go to the doctor for health issues, rather they go to pharmacies for medicines without doctors' advice. There are also challenges in working in tea garden areas and spreading awareness. Although the government had taken several programmes to make these tea garden populations aware of the health care facilities and include them in health care services, it is yet to deliver the desired results," added Basu.
He said that the doctors do not want to stay in tea garden areas for long which affected the delivery of services to the population. He, however, said that the situation has improved at present compared to the past.
The statistics available with the TB Cell of the National Health Mission (NHM) in Assam say that the identification of TB patients has been on the rise since 2020.
While the TB cases detected in Assam was 35,355 in 2020, it rose to 37,725 and 47,583 in 2021 and in 2021 respectively. The detection of TB cases further rose to 47583 in 2022 and 51,600 in 2023. The statistics further said that 50,132 TB patients were detected in 2024.
The statistics further indicate that most of the TB patients are from the tea garden districts of Assam which includes Dibrugarh, Jorhat, Sonitpur, Tinsukia, Golahghat, Sivsagar, Biswanath and Charaideu districts. While 431 patients were detected in the Dibrugarh district in 2024, 3385 patients were detected from the Sonitpur district. The number of patients was 2036 in Jorhat district followed by 2797 in Nagaon, 1069 in Sivsagar, and 1806 in Charaideu district.
"TB is very challenging. If there is no timely treatment it can cause death, it can be fatal if left untreated and affects other organs like kidneys, spine or brain. In tea garden areas we have seen many fatalities related to TB. While the tea garden workers are not conscious about their health condition, issues like unhygienic living conditions in the labour lines of the tea gardens, their food habits and alcohol abuse often lead to TB cases," said TB Champion Minoti Nayak Puran. Minoti has been working as a TB champion since 2019 in the Nakachari area of Jorhat district. Nakachari area has 18 tea gardens where there are hundreds of TB cases.
Minoti said that the tea garden workers still rely on quacks instead of doctors which complicates their health condition. "Superstition is another reason that is leading to TB cases in tea gardens in the Nakachari area," said Minoti.
"There is also a stigma attached to the TB in our society. The victims often hide that they are suffering from TB due to the stigma, this leads to late detection and complicates the cases," said ASHA worker Sujata Puran, who has been working in the Nakachari area for the last several years.
Sujata also stressed on reducing the healthcare gaps in the tea garden areas and said that there is a great need to strengthen the awareness about TB in the tea garden areas.
