Winning the fight against tuberculosis

Manju is 19 years old female student from a suburban area of Chitwan district in Nepal. She was diagnosed with tuberculosis a few weeks before the COVID-19 pandemic. She started taking medicine immediately and showed improvements in the initial months. She started to believe that she had overcome TB. But she was shattered to find that her sputum test revealed she was rather diagnosed with Multi-Drug Resistance Tuberculosis. This result poorly impacted her physical health, social life, and mental well-being and completely devastated the young girl. Nevertheless, she recollected her strength and decided to get treatment.

The COVID-19 pandemic in the country augmented the arduous journey for Manju and her family. The two diseases adversely impacted the financial conditions and social relationships of the family. Her father lost his job to the pandemic and her mother was fired from her work, when her co-workers found that Manju had tuberculosis. This exacerbated their economic hardship. Because Manju had drug-resistant tuberculosis, her sputum sample had to be tested in a sophisticated machine, which was available at another health center. For this, she had to travel five hours on bus. At that time, the country was in lockdown and public vehicles were not available. Manju’s parents sold their only buffalo to hire a van to go to the health center.

As parts of treatment, she was prescribed with oral medicines for nine months and injectable medicines for four months. Unlike many people with TB, Manju had painful experience from the side effects of medicines. She vomited every time she ate food, and injections were excruciatingly painful. Nevertheless, she was determined that her daily medications and regular sputum tests were important to fight against the disease.

Since, both of her parents lost their jobs, her family were struggling to meet ends. Providing daily meals for the family of five became onerous. It became increasingly hard for Manju to have nutritious food to fight this disease. Our district staff came to know about her misery. They met her during the pandemic and provided food package. The package consisted of staple food such as rice, lentils, oil, eggs, and sanitary items like sanitizers, masks and soap. She mentioned the package lasted more than a month for her family. Furthermore, our district team reached out to her and liaised with local health facility, and delivered medicine to her home. We also screened her whole family against Tuberculosis. Unfortunately, her younger brother was also diagnosed with TB.

For Manju, her biggest worry is not having tuberculosis itself but the consequences of the disease. When she was taking injectable medicines, her school hours and medication time conflicted. Also, her close friends, neighbors, and relatives slowly abandoned her and spread rumors about her chronic disease. As a result, Manju gave up her education and kept her isolated in a room.

Before Manju had tuberculosis, she was a vibrant girl who dreamt of pursuing good education and earning a living to support her family. But tuberculosis had destroyed her spirit.

One day she mentioned her interest in learning the English language. So we collaborated with a bilingual native English person and she is now taking the Basic English Language distance course. Manju has recovered well after a suffering for a long time. She has joined BNMT and is working as a volunteer. She is keenly advocating tuberculosis prevention and health promotion in her community.

Consent taken from the patient