20-year-old Roshan Kumar* hails from Ujiarpur block of Samastipur district in Bihar. Like many others from his village, he travelled to Delhi to work in a factory and to financially support his family. Last year around November, he fell ill - had fever, cough, and appetite loss. He started taking medicines regularly with the hope that his fever would subside, and he can continue working. Missing work for a day meant losing wages for that day, something Roshan could not afford. As his health deteriorated, he decided to return to his village around mid-January 2020. His parents got him diagnosed from the local RMP, who gave him medicines promising that his health would improve. By this time, Roshan lost almost 10kgs within a span of 2 months. Another month passed and there was no improvement in his health. During the first week of March, Bibha Kumari, the community health worker from their village found out about Roshan’s health. She suggested his family to take him to the Primary Health Centre (PHC). Looking at his symptoms, the doctor tested him for TB, his sputum sample was sent for GeneXpert testing. Roshan was diagnosed with MDR TB. By the time his diagnosis results came, the Indian government had announced a nationwide lockdown due to the coronavirus outbreak.
People with MDR TB must visit the district hospital a couple of times to complete their diagnosis process and get their first month’s medicine. This is an extremely difficult task in the lockdown situation. Roshan visited the hospital on 24th March but was sent back as the district hospital was preparing for COVID-19 testing. Roshan’s health was deteriorating further. IIH team requested the Communicable Disease Officer (CDO) of Samastipur, Dr. Shriram Prasad to investigate the matter and ensure Roshan gets his medicine. Within two days, he was asked to visit the district hospital again. As vehicles were not plying, Roshan requested his neighbour to take him to the district hospital on his bike. His diagnosis process was completed, and he received medicine for a month. There has been a slight improvement in his health due to the medicines. After a long time, Roshan is hopeful that he will recover from TB and go back to his normal life.
Documented by: Dyuti Sen and Smriti Ridhi, Project Managers, Innovators in Health (TB REACH grantee)
*All patient names have been changed to protect identity.