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Remote villages struggle for accessible TB and silicosis care in Rajasthan

By Bharat Dogra* 
Despite the wide network of treatment facilities and nutrition support available for tuberculosis patients in India, those living in remote villages often face severe challenges in accessing care. Health facilities are frequently located far from villages, and the stigma attached to the disease discourages many patients from undergoing timely tests.
The situation is particularly distressing in villages that send large numbers of migrant workers, who are often more vulnerable to TB due to their working and living conditions. Many return home already weakened, and delays in treatment sometimes result in their family members becoming infected. Patients also lose precious savings to quacks offering false cures.
To address this crisis, the voluntary organization Basic Healthcare Services (BHS) launched a health initiative in South Rajasthan in 2012. Through its AMRIT clinics and a network of village health workers, BHS ensures early detection, affordable treatment, nutrition support, and follow-up care. Health workers visit homes to identify potential patients, motivate them to seek tests, and monitor treatment completion over six or more months.
As patients successfully complete treatment, they are encouraged to form peer groups that counsel and motivate new patients. At the Rawach clinic, for example, one woman who lost her husband to TB was herself cured after prolonged treatment and later ensured that her young son also completed treatment. In another case, a migrant worker and his family—who all contracted TB—were able to recover with consistent care.
BHS workers stress that consistent follow-up is vital to ensure patients complete treatment, but this becomes difficult for those living in distant villages.
The region is also home to a large number of silicosis patients, mostly stone workers exposed to hazardous dust. While Rajasthan has a policy for compensating silicosis patients or their families after certification, many do not receive recognition despite medical treatment. With silicosis largely incurable, AMRIT clinics provide essential care that makes life more bearable.
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The writer is Honorary Convener, Campaign to Save Earth Now. His recent books include Protecting Earth for Children, Planet in Peril, A Day in 2071, and (in Hindi) Kathin Daur Mein Ummeed

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