Rakhi belongs to one of the most vulnerable communities of the panchayat Dumra Mohan, India. When Rakhi showed some symptoms suggestive of TB, Mira Devi, a community health worker working for a Wave 7 TB REACH project, referred the 38-year-old to a Panchayat Coordinator, Soni Kumari. During their initial conversation, Soni found out that Rakhi was previously treated for TB. With the diagnostic help of the TB Programme, it was discovered that Rakhi had now developed drug-resistant TB. She immediately started treatment on 22 January 2020. and continued taking her medicines for two months uninterrupted.
However, once the lockdown due to COVID-19 was imposed in India on 23 March, Rakhi was fearful of leaving her house to continue to take her medication. Because of the lockdown, Innovators in Health (IIH) programme staff continued their regular follow-ups with community members with TB over telephone instead of in-person. During a follow-up with Rakhi, they realized that she had a limited supply of medicines that would last only for a few days. IIH staff tried to convince her to visit the hospital to get the rest of the medicines. Initially, she was reluctant to go but they continued to persuade her. Eventually the programme staff succeeded in explaining to her the importance of continuity of the medicines as she was already on a drug-resistant regimen. The Senior Treatment Supervisor (STS) of the NTEP (National TB Elimination Program, previously RNTCP) was informed of the situation, he spoke to Rakhi and her son and assured complete support. He explained that there would not be any action by police on the way as they would be out for essential activity. This was the final push required.
People with MDR-TB in the Shivajinagar block need to visit the sub-divisional hospital (SDH) in Rosera which is 15 km away to avail treatment facilities. All the public transport options were curbed, and poor families lack private vehicles. Rakhi’s son took his mother on a bicycle to the SDH. They showed amazing determination to cover 30 km on an old cycle. She got the medicines and continues to take it regularly. She also feels that this incident has deepened her understanding of the significance of continuing her medicines as she felt that despite the circumstances her health was a priority for the Government and IIH.
More than 200 people like her have been facilitated similarly (due to the results of routine follow-up with 1475 people with TB) with the help of the Government staff and privately procuring drugs at our level, to avail uninterrupted supply of medicines. Every week our cadre of field coordinators follow up with 1475 public patients. We also check in with 682 ASHAs (community health workers) who are Treatment Supporters of these patients.
Documented by: Dyuti Sen and Smriti Ridhi, Project Managers, Innovators in Health (TB REACH grantee)