A mother of three, aged 30, living in rural India, she was infected with tuberculosis (TB) in 2012. Her name is Anita.
In the 1950s the world considered that tuberculosis was eradicated. Unfortunately, a half-century later, the epidemic has reappeared. Every year, nine million people fall sick with TB worldwide and 1.5 million die from it. In 2003, the United Nations had to declare the disease a global emergency, again.
No 1 public health issue in India
With three million patients, India accounts for 31 percent of the global TB burden.
In India, tuberculosis is not only deadly; it also means deep misery for the patients. Too often they face discrimination from their family, friends, employers, neighbors, school authorities, etc. When doctors diagnosed Anita with TB, her husband left her. Sick and illiterate, she had to support herself and her children. Of course, it was even more difficult for her to adhere to her treatment schedule.
That was a shame because tuberculosis is actually curable. But it requires a tedious and long term regimen. In order to cure, every patient has to take up to 75 medication doses over six months or more. They also have to go regularly to a health center so they can take their treatment under observation. After two months of treatment, the symptoms of tuberculosis usually wane off. However, the patients are not fully cured yet.
Too often, though, people get tired with the drugs’ side effects and the commute to the health centers. And since medical records are not digitized, doctors lose track. They don’t follow up as they should. As a result, 60 percent of the patients fail following their regimen. What’s worse, they stop their treatment. This is what happened to Anita.
A man-made phenomenon
After a few months, Anita relapsed, but it was too late. Her disease had morphed into a multiple drug resistant tuberculosis (MDR-TB). MDR-TB affects three million people worldwide, and it kills 80 percent of the patients.
There is a treatment that is even more difficult to follow. It lasts for two years and includes six months of daily, painful injections. Moreover, the drugs are toxic. They cause many side effects like nausea, thyroid disturbance, and even psychological problems.
Anita suffered these side effects, which brought in unbearable pain. At some point, she was so desperate that she tried to commit suicide. Only the thought of her children stopped her. Also, she was lucky because Operation ASHA (OpASHA) was taking care of her.
A local, meticulous approach
OpASHA is one of the world’s largest nonprofits in tuberculosis treatment and prevention. Dr. Shelly Batra and Sandeep Ahuja started it in 2006.
Back in the 1990s, Dr. Batra started offering free treatments and surgeries to disadvantaged patients. As she needed antiseptics, fluids, anesthetics, she asked her friends and relatives for donations. From 1998 onward, her most regular contributor was Sandeep Ahuja, a government official. In 2006, they teamed up to fight tuberculosis in urban slums and rural-poor communities. This is how Operation ASHA started (”Asha” means “hope”).
Batra and Ahuja decided to take TB care at the doorstep of their patients. In the slums they have used corner shops, health clinics or religious places. They have also sent health workers to villages to give medicine to the patients. That way, people don’t have to go to far away hospitals to get their treatment.
Operation ASHA also developed a portable identification device called eCompliance. It allows them to identify each patient by their fingerprint and significantly improve their follow-up.
Every time Anita took her medication, she had to give her fingerprints. And her health worker had to do it as well. This generated irrevocable evidence that the medicine had been taken in the right conditions. If Anita missed a dose, eCompliance would send an SMS alert to her, her health worker and his supervisor. Her counselor had to meet her within 48 hours and deliver her treatment.
Towards the end of tuberculosis?
After two years of treatment, Anita recovered and is now completely cured.
Luckily, she is not alone! eCompliance has been implemented in India, Cambodia, Uganda, Dominican Republic and Kenya. Everywhere it has reduced the default rate by 12 times. Today, 98.5 percent of the organization’s patients finish their TB treatment. As fewer and fewer die from the disease or develop its drug resistant form, Operation ASHA is giving hope to millions of people worldwide!
And this is a good news.