Suicide of a TB patient due to lack of affordable treatment in Bundelkhand, brings to light the severe shortcomings of the rural healthcare system

“My brother had been suffering from TB for about four years… one day, we found him dead,” says Chandrapal when we ask him about his brother, a resident of Banda district’s Achreel village, who hung himself last week. He had been suffering from tuberculosis and his condition had deteriorated significantly over the last two years, rendering him physically weak and unable to fend for himself. Being severely weak, with nobody to support him – Chandrapal informs us that he lived on his own – and having run out of food, he finally decided to end his life in sheer desperation. In rural Bundelkhand, a region in a shocking state of turmoil due to acute levels of poverty, unemployment and underdevelopment, the healthcare system often illustrates glaring gaps. India is a nation where two TB patients die every three minutes, and in Bundelkhand, it is a constant epidemic with not only huge death tolls, but intense cover-ups too . (A series of TB reports that we did in 2016 led to intimidation and a string of threats that we found ourselves fielding). The spread of the disease in some places is so rampant and deadly, that locals often refer to it as “nature’s wrath”, or “prakop”. The most effective combative strategy against TB is the WHO-approved cost-effective DOTS programme, which has been in place and fully-functional in India since 1993 (the full-fledged programme also dates back to 1997). Provided to the poor free of charge, at least on paper, the execution of the programme in rural spaces has severe shortcomings. ASHA workers – the official point of contact between the people and the state machinery, and essentially the backbone of the government’s TB control programme – are usually more driven to achieve impressive numbers, rather than facilitating comprehensive treatment. Many of them do not even care to visit the smaller, remote villages and hamlets that come under their jurisdiction, often leaving the poorest of the poor at the mercy of their own fates. This often causes patients to resort to private healthcare, which comes at an exorbitant price. Residents of Banda’s Achreel, for instance, often go to Chhatarpur’s infamously overpriced Nayagaon hospital, which may not guarantee a cure for TB but is sure to wipe out a few lifetime’s savings. And these are the people who can still think of affording it, those less fortunate, like Chandrapal’s younger brother, can neither afford the private hospital treatment nor the commute. “My brother had been suffering from TB for about four years. He had tried to get treatment at several places, including Nayagaon, but it was all in vain. He had spent so much money on all this dawa-daaru, that he didn’t even have enough left to buy himself food twice a day. He anyway lived alone, away from all of us, and it was getting very tough for him to manage. One day, we found him dead,” says Chandrapal. When we visit the local police station to understand how the case was brought to their notice, we find a bored Rajendra Pratap Singh awaiting us. “Yes, someone had committed suicide. We’ve taken care of it now, our inspector has conducted a thorough investigation. All formalities have been completed, ” he informs us. As we leave Chandrapal alone, for him to come to terms with the loss of an estranged brother, lethal TB numbers fill our heads. More than 1.4 crore of the country’s populace currently suffers from this life-threatening illness, and as many as 22 lakh get added to the data every year. How many of these people decide to kill themselves instead of waiting to succumb to the disease? In rural Bundelkhand, we’ll never know. Khabar Lahariya is a women-only network of rural reporters from Bundelkhand.