Why a gendered response to fighting TB is essential
The government has set up schemes to help TB patients, but not enough states focus on women’s vulnerabilities. This is why women must be part of the fight to eliminate it.
Covid-19 will be with us for a while to come as different variants of the virus emerge. But given our record of fairly good management of the pandemic, experts feel that we should refocus on old killers, such as tuberculosis (TB), which seriously affects women.
Much like the pandemic, for TB, women must come to the fore to create awareness and tackle misconceptions about the disease. (Unsplash)
More than one million women and girls get TB every year in India, and it is responsible for several deaths among women. Among women from developing countries, most are affected by pulmonary and genital TB. However, the prevalence of the latter is often overlooked because of its asymptomatic nature of infection. This, therefore, requires screening to be made part of the health management programme.
Another challenge is the treatment of pregnant women with TB, as it can affect the unborn child. On this front, while testing for TB is free under the national tuberculosis elimination programme, the government of Uttar Pradesh (UP) has gone a step ahead to make testing mandatory for all symptomatic pregnant women.
Much like the pandemic, for TB, women must come to the fore to create awareness and tackle misconceptions about the disease. And they have. Mukta Sharma, a public health expert who was the project lead in the Global Fund — a financing and partnership organisation — in UP, Punjab, West Bengal, and Haryana until June this year, says that in the 33 aspirational districts that she worked in, community effort and mobilisation, led mostly by women, have been nothing short of extraordinary.
In these districts, “TB champions” (mostly TB survivors) are mentored for six months after which they start working to spread awareness about the disease. “TB is not cured in a few months, but people stop taking drugs once they feel better. Our TB champions are committed, accountable, and natural communicators. Once trained, they seem to be in great demand by government organisations,” says Sharma.
Sushila from Daliganj in Lucknow is a TB champion. After fighting TB, she now helps other women who are vulnerable to infection or have been infected. Afflicted with a painful intestinal TB in 2020, she stayed away from her husband and children until she was cured. Today, she provides support to 110 TB patients. One of the things she stresses is the need not to discriminate against women with infections. Another TB champion Sunita Tiwari from Lucknow believes that family support is vital. When she had TB, she was shunned by everyone in her family, except her husband. “This made me determined to help other women, since stigma led to many hiding symptoms. My life story and my advocacy have led many of them to seek treatment”, she says.
Women face much more than the clinical metrics of the disease, with no recourse to medical care in time. Though India’s TB programmes have grown, we need to have a more multi-pronged approach to ensure that women get equitable access to TB care, of which counselling is paramount.
Women community leaders, including the indomitable TB champions, are showing the way today. The government has set up schemes to help TB patients, but not enough states focus on women’s vulnerabilities. Only gender-responsive solutions can take the TB elimination drive forward.
Lalita Panicker leads the opinion section at Hindustan Times. Over a 33-year career, she has specialised in gender issues, reproductive health, child rights, politics and social engineering.
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