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BMC ropes in TB survivors to counsel patients, sees reduced dropout rates

In 2018, Seema Kunchikorne contracted pulmonary multidrug resistant Tuberculosis (MDR-TB). From 65kg, her weight dropped to 45kgs and she slipped into depression. Her husband packed her off to her mother’s house and eventually she was admitted to Sewri TB hospital.

“I was on oxygen support and doctors had also given up all hopes. I didn’t give up due to my son who I had not seen for two years. I pushed myself to eat. Within three months at the hospital, I gained 8kgs and in 2020, I was declared TB-free,” said Kunchikorne.

Now divorced, the Dharavi resident is among 24 TB survivors, which the Brihanmumbai Municipal Corporation (BMC), in a first-of-its-kind initiative, has hired to counsel other patients to ensure better adherence to treatment regime. Started in November 2021, the initiative has yielded encouraging response already by decreasing the dropout rates despite the surge in Covid-19 in the third wave, officials said.

The volunteers are called ‘Saksham Sathi’ and their job is ensure improved adherence to DOTS treatment, curb dropouts, bring back defaulters and increase recovery rate.

Kunchikorne said her journey of recovery made her realise the unspoken issues that TB patients go through, which often affects their mental health and treatment regime.

“This is a first-of-its-kind initiative taken in India. TB survivors are role models for the active patients. By talking to them, the patients earn the belief that they can also recover from the disease, which is curable with proper medication,” said Dr Pranita Tipre, Mumbai’s TB officer.

Along with smart tablets, the TB survivors are given Rs 10,000 under the initiative every month along with a sum of Rs 500 to recharge their devices.

Dr Tipre said that earlier, many patients used to refuse to give their bank details for the monthly Rs 500 incentive provided for their nutrition. “These TB survivors explain to the patients the importance of nutrition in their recovery. With this, we have been able to collect bank details of many patients,” she added.

A study — assessment of prevalence of depression and its associated factors among tuberculosis patients in Ernakulam district, Kerala –found that one-sixth of TB patients suffer from depression with the prevalence higher in those with MDR TB.

A person suffering from TB can develop depression due to several factors such as long duration of treatment, social stigma and lack of family support, officials said.

Talking to The Indian Express, another ‘Saksham Sathi’, Yashwant Amrut Marathe, 23, said TB survivors can connect with patients better as they have faced similar kind of stigmatisation and discrimination.

“To patients who worry about their career gaps due to the disease, I share with them my story, how I have sprung back and am now doing well in my life. We are like their friends who can actually relate to them, without giving fake sympathy,” said the Santa Cruz resident who had contracted TB in 2017.

At present, the survivors, trained by the civic body, are counselling the patients over the phone.

“Soon, we will start community engagement where along with group counselling of patients, we will also involve their relatives,” said Dr Tipre.

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