Our annual health budget per person is said to be a paltry Rs. 320 (about US$ 8!). Most of this goes into staff salaries. There are always so many people asking for help - and a creaky infrastructure - and all the joys of being 'served' by people who have jobs for life (and for which many have paid hefty bribes to get).
But in our work we strongly feel that when services are available - and they are in the areas of Tuberculosis treatment and Anti-retroviral treatment - both available free - that we should do as little duplicating as possible. Since you and I are paying for these services through the many hidden taxes that are levied on us - we want these to be used as much as possible.
So whenever we can - we encourage our friends who have HIV to get TB meds and HIV meds from the government.
Most people with HIV in our country get TB. And so we are constantly in the business of trying to access TB care.
Though the overall programme (the Revised National Tuberculosis Control Programme) is pretty good by government standards, occasionally is a bit hard to get started into the system. This is particularly true for people with HIV since they often present with unusual symptoms. But over the years we have been successful in getting varied people started on anti-TB medications.
Our latest miracle is Mrs. Sashta. We had admitted her at JSK last month with a long-term fever. She was on the point of death and was not responding to care. By God's grace she stabilised to soe degree. During the 10 days we looked after her at the JSK centre, we were able to control her vomitting - and start her on anti-retroviral therapy from the government. But it was with sadness in our heart that we discharged her still having TB.
Last week we finally decided that though we could not find where in her body she had TB - that it was about the only option open for her. We sent her to to government centre fully expecting them not to start her on the medications - and for us to have to begin arguing and negotiating with them. But they started her immediately! We were so happy to see the system working. Much prayer goes into each step - but what joy when things click!
A few months ago a person came to us from Tamil Nadu. We will call her Diana. She was from a village - and had had long-term fevers and a terrible arthritic pain in her knee. A distant relative was working at one of the better hospitals in Thane - and so they brought Diana here.
Sheba tells me that 'mono-arthritis' should always be suspected as TB. Diana was brought to a orthropaedic surgeon. Then during the work up an HIV test was done. She was found to be HIV positive. The surgeon dropped Diana as a patient and somehow she found her way over to us.
After counselling and listening to this lady, Sheba diagnosed her as having TB of the knee. She was referred to the government TB programme. She went down south for short time and talked with her husband - who works at a hotel. He refused to be tested himself. She talked to other family members who were more helpful and supportive. When she came back to see Sheba yesterday, she had gained 4 kgs. in weight! It is amazing to see what a transformation of this dear lady. She will still need help and support, of course, as the fight against the virus is a life long one - but what a huge leg-up she got due to her good start with the TB treatment!
We trust that Mrs. Sashta too will benefit from the TB meds available - and from our fervent prayers (and the prayers of many!).
This coming week is World TB day (March 24th). Our hats off to workers around the world who ware involved with helping contain TB. May your tribe increase! And even better - may you one day be worked out of a job - since there is no more TB to contain!
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